BIA PRESENTS TO THE AMERICAN CONGRESS OF REHABILITATION MEDICINE

Highlights

Brain Injury Australia (BIA) led a consortium – comprising Monash University, Domestic Violence Victoria, No to Violence and the Centre for Excellence in Child and Family Welfare – in Australia’s first research into Family, Domestic and Sexual Violence (FDSV) and Acquired Brain Injury (ABI).

Among the research’s key findings:

  • 2 in every 5 of the 16,000 victim-survivors of FDSV attending Victorian hospitals over a decade had sustained an ABI.

BIA was invited to present its research to the 99th Annual Conference of the American Congress of Rehabilitation Medicine – an organisation with over 100,000 members in more than 65 countries, comprising rehabilitation physicians and other healthcare professionals.

The presentation by BIA’s Executive Officer, Nick Rushworth, included: “that women are disproportionately at risk of ABI due to FDSV shouldn’t really come as any surprise as soon as you consider, as soon as you witness – whether it’s in a boxing ring, a pub or a playground – how instinctive, almost primal, it is to ‘go for the head’ in pursuit of violent advantage”.  Read BIA’s research here

FULL  presentation

  • “40% (6,409) of the 16,296 victims of domestic and family violence attending Victorian hospitals…from July 2006 to June 2016 sustained a [traumatic] brain injury.”
  • “Brain injury…accounted for 14/17 DFV-related deaths over the period.”
  • “57% (116/ 203) of DFV-related major trauma cases involved brain injury.”
  • “54% (2,774/ 5,165) of hospital admissions involved brain injury.”
  • “32% (3,519/ 10,928) of emergency department presentations involved brain injury.”

 

2016 PERSONAL SAFETY SURVEY (conducted from November 2016 to June 2017)

  • 4 in 10 men (3.7 million) and 3 in 10 women (2.9 million) experienced physical violence
  • 1 in 4 women (2.2 million) experienced violence by an intimate partner, compared to 1 in 13 men (703,700)
  • In the most recent incident of physical assault by a male, women were most likely to be physically assaulted by a male that they knew (92% or 977,600)
  • Women were nearly 3 times more likely to have experienced partner violence than men, with approximately 1 in 6 women (1.6 million) and 1 in 16 men (547,600) having experienced partner violence since the age of 15

 

VICTORIA: ROYAL COMMISSION INTO FAMILY VIOLENCE 2016

Recommendation 171: “The Victorian Government fund research into the prevalence of acquired brain injury among family violence victims and perpetrators [within two years].”

 

REBECCA

 

  • “Of the 31% (5,007) of DFV cases who were children <15 years, 25% (1,252) sustained a brain injury.”
  • “43% (7,047) were injured by a spouse or domestic partner, 37% (5,947) were injured by a parent, and 20% (3,304) were injured by another family member…”
  • “…where the family member alleged to have caused   the patient’s injuries was a spouse or domestic partner, 84% of patients were female…where the alleged perpetrator of injury was a parent or other family member, 56% of patients were male.”
  • “Of the total number attending hospital for DFV reasons, 60% (9,845) were female. 59% of these females received their injuries from a spouse or domestic partner.”
  • “…an estimated 61 cases per year of family violence-related hospital admissions in Victoria were expected to have permanent problems related to brain injury.”

 

  • “…from five domestic violence and homeless shelters in the Phoenix, Arizona metropolitan area.” [2016]
  • “In total, 101 of the 115 patients (87.8%) reported more than one brain injury at the hands of their ab “Of those 101 patients, 93 patients (92.1%) reported too many injuries to quantify.”
  • “Of those 101 patients, 93 patients (92.1%) reported too many injuries to quantify.”
  • “Only 21% of our patients saw a physician or presented to an emergency room because of their injuries…”
  • “…from five domestic violence and homeless shelters in the Phoenix, Arizona metropolitan area.” [2016]
  • “In total, 101 of the 115 patients (87.8%) reported more than one brain injury at the hands of their abusers.”
  • “Of those 101 patients, 93 patients (92.1%) reported too many injuries to quantify.”
  • “Only 21% of our patients saw a physician or presented to an emergency room because of their injuries…”

 

VICTORIA Australia

  • 1,800 Victorians attend hospital as a result of DFV each year
  • ≈ 26,000 cases (involving both victims and perpetrators) are referred to specialist DFV services each year
  • ≈ 37,000 applications for DFV intervention orders in the Magistrates’ and Children’s Courts of Victoria each year
  • 220,000 Victorians >18 years reported violence by a partner in the preceding 12 months [2016 Personal Safety Survey, Australian Bureau of Statistics]

 

  • “… was aware of the evidence and the risks associated with repetitive traumatic brain injuries virtually at the inception, but deliberately ignored and actively concealed the information…”
  • “… early-onset of Alzheimer’s Disease, dementia, depression, deficits in cognitive functioning, reduced processing speed, attention, and reasoning, loss of memory, sleeplessness, moods swings, personality changes, and the debilitating and latent disease known as Chronic Traumatic Encephalopathy”

 

  • “Indigenous females experienced 69 times the rate of head injury due to assault experienced by non-Indigenous females.” [2008]
  • “…people identifying as Aboriginal or Torres Strait Islander were overrepresented in hospital admissions (6%) and emergency department presentations (3%) compared with the Victorian population (0.8%).”

 

Recommends

  • “develops and distributes information resources on brain injury, aimed at both victims and perpetrators of family violence, as well as the integrated family violence system”
  • “adds screening questions for brain injury to family violence risk assessments…”
  • “pilots an integrated brain injury and family violence service to support diagnosis, rehabilitation and harm reduction, in conjunction with complementary government initiatives…”
  • “develops (where they do not exist) and maps services and supports for all people with a brain injury at increased risk of perpetrating or becoming a victim of family violence due to their disability, as well as for people with a brain injury resulting from family violence.”

 

  • [6 studies, n=222] “…53% of the interpersonal violence perpetuators had a history of TBI, a prevalence significantly higher than estimates of TBI in the general population.“ [2015]

 

New South Wales – “challenging behaviours” (“behaviours of concern”)
New South Wales Brain Injury Rehabilitation Program (2010) – 659 clients, 53% “met criteria”:

  • “inappropriate social behaviour” (30%);
  • “verbal aggression” (26%);
  • “physical aggression” (11%);
  • “physical acts against self” (5%); and
  • “inappropriate sexual behaviour.” (4%);

“increased contact with the police and criminal justice system…notable consequences of challenging behaviour”

Association with, sometimes violent, offending:

  • injury severity (PTA) α rate, severity behaviours
  • worsen with time
  • for both PWABI and significant others, consistently rated most disabling