Central Park, Ottawa, Ontario

Problem Definition

Head injuries are complex, challenging, and expensive to treat; they typically require the attention of a team of health professionals drawn from a range of medical disciplines. The best means to address head injuries is via hazard elimination and, where this approach is not found practical, to utilize risk reduction measures such as seat restraints, air bags, and various forms of protective head gear.

Head injuries create a distinct challenge due to the fact the injury will present in different forms depending on the site of the injury and the affected portion of the brain. Complexity may be compounded by factors such as the age of the victim and any pre-existing medical conditions.

The bulk of the recovery takes place within two years of the initial injury with further progress being relatively slow.

The victim is faced with the forced acknowledgement that they may never fully recover their prior capacities. They must adapt to a chronic condition that will likely prevail for the duration of their natural life.

Victims typically require some form of income support, or income replacement, to account for the fact that they are no longer able to perform in their prior occupational role. Since the occupational setting is a key source of both identity, and community, the victim will likely experience problems resulting from social isolation. This may be exacerbated by the withdrawal of other social contacts due to the fact that mental health injuries are not well understood, or easily accepted, in contemporary society.

Occupational rehabilitation is made difficult by the fact that while we can, through the miracle of reductive science, identify with great precision the constituent components of a piece of fruit, we presently lack the capability to reassemble those constituent elements back into the form of a juicy peach.

Similarly, while it is possible to measure the TBI victim’s neuropsychological response on a range of metrics with a high degree of accuracy, it is only with some difficulty that we may map those responses to existing occupational categories and the performance demands of those occupations.

As a result of the foregoing, the victim of TBI frequently becomes alienated from his / her prior social matrix and often finds that the only available work takes the form of low level, highly routinized occupations, with consequent low remuneration. Or the victim is left to eke out an existence on some form of disability payment, a stipend which may be barely sufficient to provide for the necessities of life.

Acknowledgement of these facts typically result in this population experiencing elevated rates of depression and suicide.