Addressing brain injury within HCH settings: Screenings, interventions, and outcomes

There are well established approaches for addressing mental illness and substance use disorders. Missing from standard behavioral health treatment are strategies to address cognitive dysfunction. Cognitive rehabilitation is in its infancy relative to mental health and substance use treatment, and most efforts have been directed at early, post-acute injury periods. Serving a population with a high prevalence of brain injuries will be more effective if approaches to improve cognitive function are integrated into behavioral health treatment. This session will describe an approach that seeks to improve outcomes in all three areas: mental health, substance use and cognitive function through the addition of Occupational Therapy services in a multi-disciplinary primary care setting. Serving this population has inspired the development of services designed to address the specific functional impairment associated with brain injuries. Taking a rehabilitative approach to this heretofore unaddressed need in behavioral health holds the promise of more comprehensively fostering recovery with this vulnerable population. Facilitators will provide a background on the evidence to support the need for understanding of brain injury by HCH providers and review the incidence and prevalence of brain injury within homeless and vulnerable populations. Through discussion, facilitators and participants will examine the impact of brain injury on clients' engagement with health services and current barriers to implementing effective intervention for brain injury within HCH settings. Participants will learn about and compare current evidence-based TBI screening tools, the efficacy of screening their population for TBI, and current methods for implementing a TBI screen. Participants will have an opportunity within small groups to identify the relevance of screenings for their population and strategies to implement screenings within their settings. Participants will learn about interventions and approaches for acquired and traumatic brain injury, reflecting evidence-based and real-life clinic experience. Case studies will be presented as examples of successful implementation of screening and strategies and as a learning opportunity for attendees to apply information learned within the course. Participant and facilitators will discuss ways to achieve inclusive models for integrating rehabilitation services within the primary care setting, and facilitators will provide education regarding pathways and resources to achieve these models. Attendees of the course should have an introductory understanding of acquired and traumatic brain injury and be aware of the impact or status of brain injury treatment within their settings.