Homelessness through the lens of brain injury

Friday, 30 November 2018 - 1:02pm

“I told everyone. It made no difference.” Leigh Andrews, founder of Change Communication, writes about the Homelessness and Brain Injury Project and explains why it's important for the homelessness sector. 


Last year I wrote the Brain Injury and Homelessness Good Practice Guidance for Frontline Services for Homeless Link. It was well received and I felt pleased that homelessness services would have something to help them where they suspected acquired brain injury (ABI) may be a factor in their work.

I was also a bit worried.

I was worried because although I knew I thought ABI was an unrecognised issue in the sector, what if I was wrong? My experience, after all, was just mine. Then, as I had these quiet doubts, the Greater London Authority (GLA) funded St Mungo’s to coordinate the Homelessness and Brain Injury Project (HABIP) to be delivered by myself, Headway East London and Groundswell, led by Westminster City Council.

Now the pressure was on.

As part of the HABIP our task was to deliver training on ABI to 250 staff, work with 20 clients, identify a pathway to support for ABI, build multi-agency links and share our learning over one year. These were all excellent ideas but no one had actually done this before. So, while I confidentially expressed our ability to deliver the necessary outputs, when the GLA asked me what the outcomes would be I confessed we could not be sure. This was unchartered territory, in austere times, during the fastest increase in rough sleeping that I had ever witnessed over five years.

I thought, “What if I’m wrong?” Sadly, I was not. The HABIP found that ABI is a factor causing and maintaining street homelessness and some of the systems, communication and environments within the homelessness sector are exacerbating the problem. Seeing individual’s behaviour through the lens of ABI provided many a lightbulb moment in the ABI training sessions. Staff developed a new understanding of what they could achieve with some adaptations, different thinking and a bit of (considered) risk taking.

All clients I met to discuss suspected ABI kept their appointments and engaged with the conversation. They asked insightful questions and confirmed we were right to raise ABI as a thing, seek funding and address the issue. The sub-title of this blog is a direct quote from an expert by experience. They had sustained a serious head injury and reported this repeatedly to a range of services who, without the awareness of ABI, did not change their method of interaction, seek further advice or try to find out more.

So, let’s be different. You don’t have to do this alone. You don’t have to know everything. It is hard work, but it is absolutely worth it.

The HABIP trained 250 staff in Basic Brain Injury Awareness. We worked with 19 individuals with known or suspected ABI, 15% were considered to have very long histories of street homelessness. All of them bar one either remained or obtained accommodation for the duration of the project. We developed links with NHS partners who specialise in neurological rehabilitation, social service departments dealing with safeguarding issues and mental health services who have appointed Brain Injury Champions.

To help you with ABI I have written the Brain Injury Toolkit for Westminster City Council and St Mungo’s which can be found here. If you are outside of the ‘tri-borough’ area in west London, Homeless Link have an updated version of the Good Practice Guidance for Frontline Workers here. These documents are free to download so do read and share.

The success of HABIP has led to further funding in Westminster to (amongst other things) embed the new knowledge, provide opportunities for services to consider their systems and processes in relation to ABI and develop a Brain Injury Roundtable to promote strategic change. If you want more information about this or any other aspect of the HABIP please do contact me. And keep on making the difference.

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Leigh Andrews

Leigh Andrews

Founder of Change Communication

Leigh Andrews has worked in the homelessness field for over 20 years and has a particular interest in how communication affects health. Leigh is studying Speech and Language Therapy at City, University of London, sits on the Acquired Brain Injury Forum for London, and is the founder of Change Communication.

Twitter: @LeighSLT2B