Mental Health Week offers us a chance to reflect on mental
health and take some positive steps to highlight the importance of
We know that many people find themselves coping not only with
the effects of a Brain Injury, but also a mental illness.
A mental illness can cause additional stress for the person and
their family after a Brain Injury. Common forms of mental illness
include depression, anxiety, and obsessive or compulsive behaviour.
It can be very difficult obtaining good support as services are
normally provided specifically for Brain Injury, or mental illness
- not both.
The link between mental illness &
A mental illness may have been present prior to Brain Injury. A
Brain Injury is also a known risk factor for developing a mental
illness.1 One report indicates 42% of people as having a
dual diagnosis.2 Issues following a Brain Injury that
may lead to a mental illness include grief and loss, adjustment to
disability, pre-injury personality traits and strengths, coping
skills and level of social support.3
It can also occur in the other direction. People with a mental
health disorder are at an increased risk of Brain Injury when
changes in cognitive abilities include reaction time, alertness and
increased risk of self-harm.
Treatment & support
Dual-diagnosis situations require additional support and a
holistic approach, which may include medication, psychological
therapy, and programs focusing on social skills/living skills
The first step is to get an appropriate assessment by a qualified
specialist, such as a neuropsychologist or psychiatrist. There
should be a care plan upon discharge outlining supports and
services in the community to prevent relapse. Case management
should be provided to co-ordinate any mental health and Brain
It is not uncommon for people with a dual diagnosis to access
support - mental health services will say they need a Brain Injury
service, but the Brain Injury services say they should go to a
mental health service. You may like to seek the support of an
advocate to resolve this lack of support for dual diagnosis
References and further information
1 Hibbard, M.R., Uysal, S., Kepler, K., Bogdany, J., &
Silver, J. (1998). Axis I Psychopathology in Individuals with
Traumatic Brain Injury. Head Trauma Rehabilitation, 13,
2 Van Reekum, R., Bolago, I., Finlayson, M. A. J. (1996).
Psychiatric disorders after traumatic brain injury. Brain Injury,
10, 319 - 328.
Australian Institute of Health and Welfare. (2007).
Bulletin 55: Disability In Australia: acquired brain injury.
Retrieved 18 August, 2009.
3 Victorian Government Department of Human Services. (2004).
Acquired Brain Injury and Mental Illness: Protocol between mental
health and other services. Retrieved 18 August, 2009.