Cause or correlation; traumatic brain injury often leads to homelessness. Homelessness and substance use can lead to traumatic brain injury. Either way, these interwoven relationships are playing out in harmful ways in the streets of Victoria.

The Victoria Brain Injury Society announced last week it will be opening a new office in Nootka Court off Courtney Street on Sept 10. The announcement couldn’t be more timely.  Executive director Pam Prewett told Capital Daily, “VBIS has always been deeply committed to supporting brain injury survivors, including those who are unhoused. This commitment remains the core part of our mission, and we do not anticipate it changing with our new downtown office.” 

Andy LeFort, a long-time VBIS client, expressed his enthusiasm for the new office., stating, “Having a central, accessible space is a game-changer,” he said. Navigating systems of care and the ability to attend ongoing structured treatments represent barriers to the unhoused. Transit to and from appointments can be costly, so having an office downtown removes that particular barrier—especially since downtown is the area most impacted.  

On July 11, VicPD responded to a call for help to the 900-block of Pandora “for a man in need of medical assistance.” The man allegedly had punched and kicked a paramedic attempting to care for him in the face. 

Once the police arrived, the man, identified later as Hayden Hamlyn, “continued to show aggressive behaviour.” According to police reporting, Hamlyn “ignored officer commands” and then was tased using a Conductive Energy Weapon (CEW). Following the incident, Grant McKenzie, spokesperson for Our Place Society, told reporters Hamlyn suffers “from severe multiple brain injuries.” 

“We know he’s not in his right mind,” said McKenzie. “We called on emergency services numerous times for the last months, trying to get him help, trying to get him assessed, trying to get an MRI on him, taking him into care.” 

Corey Froese, provincial safety director with Ambulance Paramedics of BC & Emergency Dispatchers called the incident “unusual” and “unexpected.” But for those studying the impacts of TBI, the outcome would not surprise. Aggression is one of the most common consequences of traumatic brain injury (TBI). 

Brain Injury Canada reports that approximately 50% of people experiencing homelessness have had a brain injury, with symptoms and outcomes that vary widely. Brain injuries can manifest as cognitive impairments, memory loss, and difficulties with motor functions, affecting the individual's quality of life and creating additional barriers to recovery and stability, particularly for those already struggling with homelessness.

In the midst of an ongoing opioid crisis, the connection between homelessness, substance use and brain injury is troubling. Last month, Capital Daily reported on a groundbreaking study led by clinical psychologist Mauricio Garcia-Barrera at UVic that has shed light on the troubling connection between homelessness and brain injury, which underscores a broader systemic issue that intersects with the opioid crisis.

The ongoing toxic drug crisis, which has been a provincial health emergency for the past eight years, continues to wreak havoc on communities, primarily through overdose deaths and near-fatal incidents. Yet, an emerging concern is drawing attention from researchers and public health officials alike: brain injuries resulting from overdoses, especially among the homeless population. 

The often chaotic and stressful nature of the experience homelessness exposes people to the kinds of perfect circumstantial storms that can trigger aggressive outbursts. Researchers say “increased stress may result from changes in the physical or social environment, the amount or type of stimuli, the individual’s routine, or demands exceeding the individual’s functional ability. When that happens, increased anxiety “may lead to agitation and other challenging behaviors, such as resisting assistance or striking out.”

The UVic study also spotlights the harsh realities of life on the streets—the exposure to violence, inadequate nutrition, and lack of access to medical care—that compound the challenges faced by those with brain injuries. For many, the cycle of homelessness and drug use becomes a vicious loop that is difficult to break without substantial intervention.

Brain Injury Canada’s statistics highlight the critical gap in services for the homeless population suffering from acquired brain injuries. On June 12, one day after Hamlyn’s arrest, the House of Commons  unanimously passed Bill C-277, An Act to establish a national strategy on brain injuries.  Section 2(b) states that the strategy must “include identifying the training, education and guidance needs of health care and other professionals related to brain injury prevention and treatment and the rehabilitation and recovery of persons living with a brain injury.” 

There is currently a notable lack of specific training for frontline workers on how to manage and support individuals with brain injuries. This deficiency leaves many frontline professionals—including paramedics and police ill-equipped to address the complex needs of this group effectively.

Experts agree that de-escalation techniques should be the primary response to TBI-related aggression. De-escalation can look like lowering one’s voice, removing barriers to the person’s individual’s safety and providing them space. That Hamlyn ignored “commands from officers” indicates that these strategies may not have effectively been applied by police on July 11. 

VicPD officers receive training in crisis intervention and de-escalation (CID), Trauma Informed Practice (TIP) and courses related to mental health. New recruits at the Justice Institute of British Columbia also receive training on working with folks with autism spectrum disorder which includes training on strategies for more effective communication and interaction with neurodiverse individuals.

However, according to a VicPD spokesperson, "We don’t have training courses that are specific to working with individuals with acquired brain injuries,” but added that there are “likely some skills acquired from our mental-health and neurodiversity training that would be transferable." The lack of TBI-specific training underscores the potential benefits of adding to training programs in supporting individuals with brain injuries to existing programs not explicitly designed for that purpose.

VicPD is not the only organization that has deficits when it comes to responding to the complexities of supporting people with brain injuries who may be homelessness. 

Brain Injury Canada says there is a “lack of understanding and awareness about homelessness among brain injury specialists.” This gap in knowledge can “hinder the development of comprehensive care plans that address both the social and medical aspects of brain injury for those experiencing homelessness.”

Pam Prewett, executive director of the Victoria Brain Injury Society (VBIS) told Capital Daily, “We have been actively engaged in outreach efforts, working on collaborating closely with Island Health and VicPD to ensure that brain injury survivors receive the understanding and care they need.”