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Abstract #151460

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Carol Waldmann, MD¹, Jill Roncarati, PA-C², Stacy Swain, MPH², and Jesús Géliga, MSHP². (1) Boston Healthcare for the Homeless Program, 729 Massachusetts Ave., Boston, MA 02118, 781 221-6565, cwaldmann@bhchp.org, (2) Boston Health Care for the Homeless Program, 729 Massachusetts Avenue, Boston, MA 02118

Traumatic brain injury (TBI),common in the general population,is particularly common within the homeless population. Homeless persons are at risk of brain injury due to exposure to violence, the high incidence of trauma and accidents, and the prevalence of substance abuse within this population. Neuro-psychiatric and behavioral deterioration following TBI may lead to homelessness. Alcoholism decreases the brain's ability to heal and increases the risk of neuro-psychiatric and physical sequelae of brain injury. People with multiple diagnosis including mental illness, substance abuse and TBI often find it difficult to access appropriate services. These individuals may have trouble negotiating complex systems due to cognitive or behavioral problems. Even with help, barriers exist. The multiply diagnosed are often unable to get assistance because of their co-morbid diagnosis. When a multiply diagnosed patient is homeless these barriers are magnified.In my presentation I plan to elucidate the potential sequelae of TBI and discuss how the neuro-psychiatric and behavioral difficulties can handicap patients ability to care for themselves or access assistance. I hope to show potential approaches that can lead to success in this complicated group. Example experiences will be drawn from my urban homeless primary care practice with Boston Healthcare for the Homeless Program. New data regarding the prevalence of TBI in patients seeking care with Boston Healthcare for the Homless Program will be presented.

Learning Objectives:

• Learn the risk for traumatic brain injury for homeless persons
• Recognize long term sequelae of traumatic brain injury
• Discuss the possible barriers to care and services that face homeless persons with a history of traumatic brain injury
• Learn the prevalence of traumatic brain injury in the population of patients seeking healthcare through Boston Healthcare for the Homeless Population

Keywords: Homelessness, Traumatic Brain Injury

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

• Slides (pdf) or Handout
• Handout (free access)