About brain injury

• One in 45 Australians live with a brain injury (AIHW, 2007)
• Almost three out of four people with a brain injury are under 65 (AIHW, 2007)
• One in four brain injury hospitalisations are people aged 15 – 24 (AIHW, 2021a)
• 2% of all Australians live with a brain injury (Jackson & Hardy, 2011)

Sources:

• ABS (2003). [Australian Bureau of Statistics]. Disability, Ageing and Carers, Australia: Caring in the Community Catalogue Number 4430.0.55.003, Canberra: ABS
• AIHW (2007). [Australian Institute of Health and Welfare]. Disability In Australia: Acquired Brain Injury, Bulletin 55, Canberra: AIHW.
• AIHW (2021a) [Australian Institute of Health and Welfare]. Health service use for patients with traumatic brain injury, Canberra: AIHW, Australian Government.
• Jackson, M., and Hardy, G. (2011). Acquired Brain Injury in the Victorian Prison System. Corrections Research Paper Series, no. 04. Melbourne : Dept. of Justice, 2011. 

Impact of brain injury

• 51% of Indigenous Australians between 45-59 report a head injury (Jamieson et al., 2008)
• 42% of adult make prisoners have been diagnosed with brain injury (Jackson & Hardy, 2011)
• 30% of Australians seeking homelessness support have a disability (AIHW, 2022)
• Head injuries from falls in older Australians have doubled in the past decade (AIHW, 2019b)
• Fall related injury is six times more likely to occur in residential aged care than the home (AIHW, 2019b)

Sources:

• AIHW (2007). [Australian Institute of Health and Welfare]. Disability In Australia: Acquired Brain Injury, Bulletin 55, Canberra: AIHW. 
• AIHW (2019b) [Australian Institute of Health and Welfare]. The health of Australia’s prisoners 2018. Canberra: AIHW, Australian Government.
• Jackson, M., and Hardy, G. (2011). Acquired Brain Injury in the Victorian Prison System. Corrections Research Paper Series, no. 04. Melbourne : Dept. of Justice, 2011. 
• Jamieson, L. M., Harrison, J. E., & Berry, J. G. (2008). Hospitalisation for head injury due to assault among indigenous and non-indigenous Australians, July 1999 - June 2005. Medical Journal of Australia, 188(10), 576–579. https://doi.org/10.5694/j.1326-5377.2008.tb01793.x 

Common cause of brain injury

• Falls 39% (AIHW 2021a)
• Transport accidents 31% (AIHW 2021a)
• Assault 12% (AIHW 2021a)

Other causes (Newby et al., 2013):

• Stroke
• Degenerative conditions
• Hypoxia/Anoxia (lack of oxygen to the brain)
• Brain tumours
• Infection or disease
• Foetal Alcohol Spectrum Disorder (FASD)

Sources:

• AIHW (2021a) [Australian Institute of Health and Welfare].  Health service use for patients with traumatic brain injury, Canberra: AIHW, Australian Government.  
• Newby, G., Coetzer, R., Daisley, A., & Weatherhead, S. (2013). Practical neuropsychological rehabilitation in acquired brain injury : a guide for working clinicians. In Brain injuries series. London: Karnac. 

Effects of brain injury

Cognitive (Newby et al., 2013).

Problems with:

• Planning and organising
• Memory function & new learning
• Attention and concentration
• Information processing & flexibility
• Decision-making & problem-solving
• Impaired social cognition

Behavioural (Tyerman, 2018)

• Personality changes
• Identity problems
• Irritability & Anger
• Disinhibition & Impulsivity
• Low motivation and initiation
• Egocentricity & Lack of self-awareness
• Risk of domestic violence

Psychological (Newby et al., 2013)

• Low mood & anxiety
• Panic attacks
• Clinical depression
• Increased suicide risk
• Post-traumatic stress disorder (PTSD)

Physical (Newby et al., 2013)

• Mobility and motor impairments
• Fatigue & Sleep problems
• Headaches and pain
• Epilepsy and seizures
• Sensory and perception changes
• Balance and dizziness
• Hearing loss
• Sexual changes
• Communication and speech
• Visual impairments

Social (Newby et al., 2013)

• Changed family relationships
• Barriers to employment & reduced income
• Reduced social support network

Sources:

• Newby, G., Coetzer, R., Daisley, A., & Weatherhead, S. (2013). Practical neuropsychological rehabilitation in acquired brain injury : a guide for working clinicians. In Brain injuries series. London: Karnac. 
• Tyerman, A. (2018). Psychological effects of brain injury. Headway Brain Injury Association, UK. https://www.headway.org.uk/media/3999/psychological-effects-of-brain-injury-e-booklet.pdf 

Domestic and Family Violence

• 69% identified family and domestic violence as the main reason for accessing homelessness services (AIHW, 2022)
• Perpetrators of intimate partner violence are twice as likely to have sustained a brain injury (Brain Injury Australia, 2018)
• 40% of domestic and family violence victims over a 10-year period sustained a brain injury (Brain Injury Australia, 2018)

Sources: 

• Australian Institute of Health and Welfare (2022) Specialist homelessness services annual report 2020–21, AIHW, Australian Government,
  accessed 10 October 2022.
• Brain Injury Australia (2018). The Prevalence of Acquired Brain Injury Among Victims and Perpetrators of Family Violence. Victorian Government Department of Health and Human Services: 2018. https://www.braininjuryaustralia.org.au/wp-content/uploads/BRAININJURYAUSTRALIAfamilyviolencebraininjuryFINAL.pdf

Incarceration

• Disadvantage and support needs are highly prevalent among people in prison, particularly: mental health conditions (40%), cognitive disability (33%), problematic alcohol or other drug use (up to 66%), and past homelessness (33%) (Martin et al., 2021).
• 42% of adult make prisoners and 33% of adult female prisoners have been diagnosed with brain injury (Jackson & Hardy, 2011)
• Former prisoners in stable housing much are less likely to reoffend than those who are homeless or in unstable accommodation (Brown, 2018)

Sources:

• Brown, R. (2018). Supported housing for prisoners returning to the community: A review of the literature. Australian Institute of Criminology , 2018. https://www.aic.gov.au/sites/default/files/2020-05/rr07_supported_housing_300418_0.pdf
• Jackson, M., and Hardy, G. (2011). Acquired Brain Injury in the Victorian Prison System. Corrections Research Paper Series, no. 04. Melbourne : Dept. of Justice, 2011. 
• Martin, C., Reeve, R., McCausland, R., Baldry, E., Burton, P., White, R. and Thomas, S. (2021) Exiting prison with complex support needs: the role of housing assistance, AHURI Final Report No. 361, Australian Housing and Urban Research Institute Limited, Melbourne, https://www.ahuri.edu.au/research/final-reports/361

Indigenous Australians

• 28% of the total homeless population are Indigenous Australians (AIHW, 2014)
• 4 in 10 Indigenous homeless people are aged 18 or under (AIHW, 2014)
• Those in remote communities are three times more likely to acquire a brain injury than in major cities (Harrison, 2006)

Sources:

• Australian Institute of Health and Welfare, 2014. Homelessness among Indigenous Australians. Cat. no. IHW 133. Canberra: AIHW. https://www.aihw.gov.au/getmedia/836e0f83-0fff-492f-8862-8ae43ceb6ab4/17595.pdf
• Harrison, J.E.; Berry, J.G.; Jamieson, L.M. Head and traumatic brain injuries among Australian youth and young adults, July
  2000–June 2006. Brain Inj. 2012

Young People in Residential Aged Care (YPIRAC)

• Every year 2,000 people under 65 enter residential aged care (AIHW, 2019)
• 1,100 long stay NDIS participants are stuck in Australian hospitals at a cost of $860m per annum (Summer Foundation, 2022)
• Particular cohorts at increased risk of unsuitable housing, including: young people, women, and Indigenous Australians (Housing ACT, 2019)

Sources: 

• Australian Institute of Health and Welfare 2019. Pathways of younger people entering permanent
  residential aged care. Cat. no. AGE 89. Canberra: AIHW
• Housing ACT 2019. Support Requirements and Accommodation Options for People in the ACT with High and Complex Service Needs. https://www.communityservices.act.gov.au/housing/about-housing-act/news-and-events/homelessness_services/cohort-study-key-findings
• Summer Foundation 2022. Pre Budget Submission. https://assets.summerfoundation.org.au/pdf_offload/2022/02/Pre-Budget-Submission-Summer-Foundation.pdf