The links between head injury and homelessness: A qualitative study.

The links between head injury and homelessness: A qualitative study.



Homeless individuals have increased vulnerability to hospital admission, mortality, mental health difficulties and substance misuse. Recent research has also identified an increased prevalence of traumatic brain injury (TBI).


This systematic review updates that of Topolovec-Vranic et al (2012). The aim is to re-visit questions regarding the prevalence rate of TBI within the homeless population; injury-related details and the role that TBI may play in homelessness, incorporating new research in this field. Methods: A systematic literature search was conducted using Medline, PsycINFO and Embase to identify published research on TBI and homelessness. Studies that did not have samples comprised exclusively of homeless individuals; studies solely examining non-TBI; review articles and studies published in a language other than English were excluded. All other studies on TBI and homelessness were included. The methodological quality of included studies was assessed using an adapted version of The Downs and Black Checklist (1998). Data on prevalence of TBI, setting, sampling, TBI assessment method, injury-related details and co-morbid difficulties were extracted.


Fourteen studies were identified. The prevalence of TBI ranged from 8- 90%. Some studies used screening tools which have been validated for assessing TBI and others used single questions or questionnaires that have not been validated. 8 Moderate to severe TBI and repeat TBI were common. Methodological quality was high in seven studies and moderate in the other seven.


TBI is more prevalent in the homeless than in the general population. Care providers, health care professionals and policy makers should be made aware of the prevalence of TBI in this population, the implications of cognitive and emotional problems for behaviour and potential need to adapt interventions and support. Services should screen for TBI to increase awareness and improve service delivery to this vulnerable group.

PUBLISHER: University of Glasgow
LOCATION: Glasgow, Scotland