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More than one in three of Toronto's homeless suffered a traumatic brain injury prior to ending up on the streets, a new study indicates, suggesting that mental health is linked to homelessness.

The paper, published yesterday in the Canadian Medical Association Journal, found that more than half of the homeless population in the city have experienced a severe brain injury, and 70 per cent of them did so before ending up on the streets.

"This raises the possibility that brain dysfunction as a result of a trauma to the head might cause people to essentially drift downwards in society in a way that might end up causing them to become homeless," Stephen Hwang, one of the study's authors and a research scientist at St. Michael's Hospital, said yesterday.

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Studies that detract from the real issue and try to "biologize" or "psychologize" what is purely economic constitute more of an ideological discourse than scientific and reliable studies.

How many financially well off people are roaming the streets "because of mental illness or head injury"?

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Originally posted by mahmud:
I would think that poverty is the cause of homelessness, not mental illness or head injury.

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Originally posted by mahmud:
I would think that poverty is the cause of homelessness, not mental illness or head injury.

Studies that detract from the real issue and try to "biologize" or "psychologize" what is purely economic constitute more of an ideological discourse than scientific and reliable studies.

How many financially well off people are roaming the streets "because of mental illness or head injury"?

Give me a break!

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Excelent post Mahmmud.

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Originally posted by Papal Bull:
mahmud, head injuries, even if they happen to someone well off, can ruin a life quite handily. There are reasons for poverty, which drives homeless. Poverty isn't some sort of giant abstraction that simply is (although it always has been and always will be something to combat), it has root causes. This has nothing to do with biologizing or psychologizing, as you put it, it has to do with a tragic event that has the power to totally derail one's life and puts them at risk, particularly when a system that previously supported them is torn apart for purely ideological purposes. Economics and generalized trends have much to do with this situation, however, so does that individual 'edge'.

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Completely missing the point. You are right poverty is not some "giant abstraction" But it is not as if perfectly normal and totally sane people do not get caught in the poverty trap. They do often.

This type of analysis of the causes of poverty fits hand in glove with the idea that poverty is a condition resultant from the failings of the individual, in line with the simple trope that poor people are lazy (morally corrupt psychology), mentally ill (corrupt psychology), physically disabled (biologizing). It is the person who has failed, not the society which has failed to protect them.

The problem is identified as a problem with the individual not as a societal failure.

[ 11 October 2008: Message edited by: Cueball ]

Most traumatic brain injuries are suffered by the poor, who do the most dangerous jobs and live in the most dangerous conditions. Many of these injuries are improperly diagnosed if they are diagnosed at all, and many are incurable, and cause conditions that require management through heavy medication. Poor people often can't afford to pay for medication.

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Originally posted by M. Spector:
Gosh, you mean they vary from individual to individual?

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I mean ask stupid question, get a stupid answer.

But your response is revealing. I meant more that social support systems are not universally available to all because such systems are not uniform: I thought that should be evident in the word "context". This includes everything from social welfare benefits; to the cause of the injury (WCB becomes involved); to the existence of street outreach programs; to the number of social workers; to the existence family support networks and the legal jurisdiction where the dispossessed live.

[ 12 October 2008: Message edited by: Cueball ]

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Originally posted by M. Spector:
That's not what mahmud was arguing in the post that Cueball described as "excellent". That argument goes something like this: Poverty causes homelessness, end of story.

Nothing nearly as nuanced as what you have stated, with which I agree.

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The nuance is just beyond you. The point is that certain types of analysis are based in focusing attention on individual condition, not the social context in which they exist.

People become poor, (and then homeless) because X,Y,Z condition (insert mental dysfunction, physical dysfunction, moral dysfunction) exists within themselves.

The necessity of the fact of poverty itself is not questioned: It is a giant abstraction, which must "always be fought". What is questioned is that the number of people with brain damage who are poor is disproportional to that of control population, not that there is poverty at all. The disproportion can be resolved by increasing funding support to the specific disadvantaged group to bring it into line with "norms."

The norm that is not questioned is the need for poverty at all, and the focus is upon the fact the person is anomalous in one way or another, which distracts from the critique of the "norm".

And if you are so worried about blindingly obvious conclusions, as implied by your reference to "nuance" how come this statement from the article didn't ring alarm bells for you:

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"This raises the possibility that brain dysfunction as a result of a trauma to the head might cause people to essentially drift downwards in society in a way that might end up causing them to become homeless," Stephen Hwang...

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Like duh? Even worse, this researcher isn't even sure, he merely "raises the possibility". To rephrase your "stupid question" above, "Why are not all people with brain damage homeless?"

[ 12 October 2008: Message edited by: Cueball ]

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Originally posted by Fidel:
Our Canadian society still suffers from attitudes that there are deserving and undeserving poor.

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Rather than embracing this startling fact as yet another of the myriad ways in which capitalism devours and pauperizes the most unfortunate among us who suffer catastrophic injury, the tin pot ideologues simply dismiss it as an attempt to psychologize or biologize the problem. Reaching into their shallow pool of bumper-sticker truths, they assure us that the cause of homelessness is poverty pure and simple, as if this is some kind of proof that the scientists are either wrong or cynical conspirators in a plot to prove that a third of homeless people aren't really poor at all.

Sadly, they are unable to allow the light of scientific evidence to illuminate the ways in which late capitalism not only pushes people into poverty (which is commonplace) but into homelessness (which is uncommon). They fail to see that the simplistic equation "poverty = homelessness" is unbalanced and fails to capture the complexity and variety of either poverty or homelessness.

Ironically, these same ideologues are quite prepared to see the significance of the fact that, for example, two-thirds of homeless people in Winnipeg are aboriginals. They don't dismiss the obvious race element with the "poverty causes homelessness" shibboleth (as if being aboriginal has nothing to do with either poverty or homelessness). But tell them that a third of homeless people have a history of traumatic brain injury and they wave it off as if it's irrelevant.

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Originally posted by M. Spector:
Scientists discover a very high correlation between homelessness and a history of traumatic brain injury.

Rather than embracing this startling fact as yet another of the myriad ways in which capitalism devours and pauperizes the most unfortunate among us who suffer catastrophic injury, the tin pot ideologues simply dismiss it as an attempt to psychologize or biologize the problem. Reaching into their shallow pool of bumper-sticker truths, they assure us that the cause of homelessness is poverty pure and simple, as if this is some kind of proof that the scientists are either wrong or cynical conspirators in a plot to prove that a third of homeless people aren't really poor at all.

Sadly, they are unable to allow the light of scientific evidence to illuminate the ways in which late capitalism not only pushes people into poverty (which is commonplace) but into homelessness (which is uncommon). They fail to see that the simplistic equation "poverty = homelessness" is unbalanced and fails to capture the complexity and variety of either poverty or homelessness.

Ironically, these same ideologues are quite prepared to see the significance of the fact that, for example, two-thirds of homeless people in Winnipeg are aboriginals. They don't dismiss the obvious race element with the "poverty causes homelessness" shibboleth (as if being aboriginal has nothing to do with either poverty or homelessness). But tell them that a third of homeless people have a history of traumatic brain injury and they wave it off as if it's irrelevant.

These blinkered intellectuals suffer from their own kind of poverty.

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On less intelligent boards there is something that is often done when a good post is made. You simply post QFT, or quoted for truth.

Without further adieu,

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Originally posted by M. Spector:
Scientists discover a very high correlation between homelessness and a history of traumatic brain injury.

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In the study, Dr. Hwang and his colleagues surveyed 904 people at homeless shelters and meal programs between 2004 and 2005. Traumatic brain injury was defined as a self-reported head injury that left the person dazed, confused, disoriented or unconscious.

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Originally posted by Papal Bull:
There are lots of different kinds of head injuries

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That's what I was getting at it. Just saying 1/3 of the homeless suffered head injuries, without specifying the seriousness (or lack thereof) of those injuries, isn't very illuminating. I smashed my head on a step and gave myself two black eyes and briefly lost consciousness. I don't consider that a head injury in any serious sense. To me, when I hear about head injuries, it means people who have suffered a serious injury with lasting consequences, usually from motor vehicle accidents.

Added later: Your source defines traumatic brain injury as damage to the brain from any of a number of possible causes. It would be difficult for a layperson to tell the difference between a head injury and a brain injury. That's why I question self-reporting as a statistical tool here.

Later still: If I were homeless and asked this question about head injuries, I could answer "yes" and thus I'd be in the 1/3 category too, even though it would be utterly irrelevant.

[ 13 October 2008: Message edited by: G. Pie ]

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In the study ... Traumatic brain injury was defined as a self-reported head injury that left the person dazed, confused, disoriented or unconscious.

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[ 14 October 2008: Message edited by: G. Pie ]

A number of my clientele are homeless (I work in drug addiction treatment). Through the years, many of us who work with the homeless have made the observation that they seem to suffer a disproportionate number of seizures. Given my field, I presumed it was due to drug and alcohol abuse.

If it turns out that this study is valid, then we can use it to target the help we offer to the homeless. When providing services to them, we can involve neurologists and other experts in brain injuries to make sure these services are more effective.

Any professional social worker who has spent significant time with homeless people will affirm this as a fact, without reference to Hwang's "survey."

Person's here wanted to assert a point about how operative norms shape the way research into homelessness and poverty are done in a manner that actually does not address the economic aspect of poverty and homelessness, specifically, but skirts the issue by focussing on the individual "problem."

I don't understand the objection to people making this point.

[ 14 October 2008: Message edited by: Cueball ]

Whether a person is brain injured, has a drug/alcohol abuse problem, a psychiatric illness, or has suffered some other loss, there are many reasons some people fall off the bottom of the economy. Examining some of these factors doesn't detract from the fact that the state is failing its most vulnerable citizens by the very fact of there being homeless people in the first place.

If you focus on the economic causes of homelessness without addressing the challenges that these people face at the most directly person level, you will be avoiding the faintest whiff of "blaming the victim," but you won't be providing the appropriate level of services specifically tailored to them.

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Originally posted by Sineed:
I don't understand the objection to the possibility that a significant proportion of homeless people may be brain-injured.

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That's not it at all. My objection is to their definition of traumatic brain injury.

Added later: There may well be a significantly higher percentage of the homeless population with brain injuries but this study hasn't identified that state of affairs. It's a poor study, is what I'm saying.

[ 14 October 2008: Message edited by: G. Pie ]

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Originally posted by Sineed:
So...if a study was done (and they have been) that looked at the prevalence of drug and alcohol addiction among homeless people, the usual suspects would pile on it, saying it perpetuates stereotypes, emphasizing personal blame at the expense of wider critiques of economic policy. But people like me and my bosses can use studies like that to go to the decision-makers and get funding for more rehab spaces.

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Yes, I touched on that aspect of this point that is being raised, above I said:

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The necessity of the fact of poverty itself is not questioned: It is a giant abstraction, which must "always be fought". What is questioned is that the number of people with brain damage who are poor is disproportional to that of control population, not that there is poverty at all. The disproportion can be resolved by increasing funding support to the specific disadvantaged group to bring it into line with "norms."

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Originally posted by G. Pie:
My objection is to their definition of traumatic brain injury.

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We defined traumatic brain injury as any self-reported head injury that left the person dazed, confused, disoriented or unconscious. Injuries resulting in unconsciousness lasting 30 minutes or longer were defined as moderate or severe.

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This was not a sociological study, but a medical one.

I approach a lot of medical news with a skeptical eye. In psychiatry, for example, the categories are absolutely arbitrary (it's all in the eye of the beholder) and the data manipulations and consequent conclusions in these studies are ridiculous.

Anyway, how does this particular study help the homeless? Society can't bother to house or feed these people but somehow we're supposed to believe that we're going to provide them with neurological care?

It's frustrating to me because I live in a city (Victoria) with an astonishing number of people living on the streets. We wring our hands, some of us anyway, but we do nothing. Studying reasons why this occurs is of some interest, I guess, but the real problem is that there's nowhere for these people to stay and the nights are getting colder.

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Originally posted by G. Pie:
Why the complete reliance on self-reporting? How many people say they were at Woodstock?

I approach a lot of medical news with a skeptical eye. In psychiatry, for example, the categories are absolutely arbitrary (it's all in the eye of the beholder) and the data manipulations and consequent conclusions in these studies are ridiculous.

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The limitations of the study are acknowledged therein, and the conclusions are modest and conservative.

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Prevalence and severity of traumatic brain injury as well as age at the time of traumatic brain injury were self-reported by participants and are subject to recall errors. Confirmation of these self-reports through the review of health records was beyond the scope of our study....

Future research should expand these findings by using medical records to confirm self-reported traumatic brain injury among homeless people and by correlating a history of traumatic brain injury with objectively assessed cognitive function.

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Added: I still don't understand the benefit to such a study. Let's say for the sake of argument that 1/3 of the homeless really have suffered a brain injury. How does that knowledge help them? They're still marginalized, cold and hungry.

[ 15 October 2008: Message edited by: G. Pie ]

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Originally posted by G. Pie:
I still don't understand the benefit to such a study. Let's say for the sake of argument that 1/3 of the homeless really have suffered a brain injury. How does that knowledge help them? They're still marginalized, cold and hungry.

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Our study's findings underscore the need for clinicians to routinely ask patients who are homeless about a history of traumatic brain injury....

For people with a history of traumatic brain injury, brief neuropsychological screening can provide valuable information on cognitive function.

People with moderate or severe cognitive impairment may be eligible for disability benefits.

Referral to rehabilitaton and other appropriate community services should be considered, as recent studies have shown that rehabilitation interventions improve community integration and other outcomes among people with traumatic brain injury.

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Added: Just spotted this: "neuropsychological screening." Horseshit. There is neurological testing and there is psychological crap; there is no such thing as neuropsychological.

Added again: A prerequisite for most welfare programs is an address. Being "eligible" for disability programs wouldn't help them. As I said, the study was a waste of time and money.

[ 15 October 2008: Message edited by: G. Pie ]

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Originally posted by M. Spector:
I think it's useful to point those things out to medical practitioners, even if they don't "solve" the problems of poverty or homelessness.

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Originally posted by RosaL:
It would have made their lives somewhat easier if they'd had some kind of diagnosis. So, yes, I agree that it's useful to point these things out.

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Originally posted by G. Pie:
Added: Just spotted this: "neuropsychological screening." Horseshit. There is neurological testing and there is psychological crap; there is no such thing as neuropsychological.

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http://en.wikipedia.org/wiki/Neuropsychological

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Originally posted by Papal Bull:

http://en.wikipedia.org/wiki/Neuropsychological

Also, again, how is it a waste of time?

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Because it doesn't help the homeless.

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You keep saying that without offering substantiation. Sure, a lot of things could be cut from the government to pay for lots of thing, but that doesn't mean that this study is a 'waste of time'.

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Well, what exactly does the study prove? And how can that knowledge be applied helpfully to the population it's meant to serve?

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Clearly, studying the effects of drugs is a waste of time. It is, after all, the meta-poverty that hovers above and oppresses everything and that there them no study be done to that there fixit that then problem.

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Too obnoxious to respond to. If you want a dialogue, you'll have to rephrase.

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Ignoring, of course, that studies are usually a god damn useful point in trying to start fighting a problem that is as broad and diverse in its causes and consequences as poverty.

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I disagree. I think academic studies are a notoriously poor way to get started.

[Fixed for typo.]

[ 15 October 2008: Message edited by: G. Pie ]

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Originally posted by G. Pie:

I guess it depends on the diagnosis. If you're a brain-injured person, getting neurological care would be a good thing. Otherwise, forget it. A psychiatric diagnosis is forever. It's up to the victim to prove himself sane. And the "treatment" is a lifetime of drug therapy, coerced or forced in many cases, platitudes and moronic psychiatric "care."

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I agree. But there are other possibilities.

[ 15 October 2008: Message edited by: RosaL ]

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Originally posted by RosaL:
I agree. But there are other possibilities.

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