We need to better support First Nations women with violent brain injuries

(Please note that this article contains details about domestic violence.)

Domestic violence causes disability in women due to permanent brain damage.

Traumatic brain injury is damage or alteration of brain function due to a blow or force to the head. This results in bruising, bleeding and tears in the brain tissue.

Such injuries can have short-term (acute) or cumulative (over months or years) effects.

A 2008 study by researchers in Adelaide found that Aboriginal women were 69 times more likely to suffer head injuries – including traumatic brain injuries – from physical assault than non-Indigenous women.

We spoke to Aboriginal women and Torres Strait Islander communities in rural and remote Australia about their experiences of traumatic brain injury caused by violence and their decisions regarding access to health care.

We also talked to family members about what they had observed in other women they cared about who had suffered traumatic brain injury.

Here’s what we discovered and how it can help develop better healthcare and support services.

I no longer feel like the person I once was

Trauma-related brain injuries are not isolated cases. The Aboriginal and Torres Strait Islander women we spoke to reported repeated trauma-related head injuries over long periods of time. Most women reported dozens of head injuries or had lost track of the number of injuries they had sustained.

The violence generally came from current or former male partners, both Indigenous and non-Indigenous.

Aboriginal and Torres Strait Islander women reported living with and coping with many common changes as a result of traumatic brain injury, including:

• Memory problems
• Dizziness and headaches
• Difficulty concentrating and organizing
• Problems with information intake and thinking (sometimes described as “confused thinking”)
• I find it difficult to start a story or keep conversations going with family and friends (described as “I am at a loss for words or the words disappear” or “my brain has a blackout”)
• Mood swings and impulsivity.

Coral said: “I am unconscious and now I am suffering from memory loss, as if I am having difficulty telling a story. These are stories that have happened to me. But I cannot remember them.”

Kirra reported from her own experience: “I put something somewhere, for example a book, keys or a phone. If I can’t see it, I forget where I put it. I have trouble concentrating on one thing.”

The women we interviewed also frequently mentioned being strangled. Even non-fatal strangulation is harmful to the brain because it reduces blood flow to the head and deprives the brain of oxygen.

When and why women seek medical care

Women felt that accessing health care and support services following violence-related traumatic brain injury was not always an option for them, mainly because they were subject to coercive controls or fear of being reported to child protection authorities.

The nature of the injury also influenced their decision to seek medical attention. If there were no visible bruises, cuts or marks, no blood, or no memory of unconsciousness (or fainting), many Aboriginal and Torres Strait Islander women did not go to hospital and treated their symptoms themselves.

Cathy explains: “Then one night he hit me. There was no hospital, no blood, no bleeding, no one would have thought that I had been a victim of domestic violence. I didn’t think it was bad enough to go there.”

How women cope with the symptoms of traumatic brain injury

Aboriginal and Torres Strait Islander women undertook a range of activities to improve their memory and manage their anxiety following their traumatic brain injury. These included:

• Painting and weaving
• Listen to meditation music
• Solve puzzles and other tactile activities.

Family and friends helped the Aboriginal and Torres Strait Islander woman with everyday tasks such as shopping at the supermarket, paying bills and attending appointments. Pat says:

“When I’m at work, someone from the family calls me so I don’t forget. Sometimes my daughter or grandchildren take a photo and send it to me.”

Yet homelessness, isolation and ongoing violence have made it impossible for many Aboriginal and Torres Strait Islander women to access medical help for traumatic brain injury and implement these strategies.

The need for regional and supra-regional investments

We need to improve access to health care and other support services for Aboriginal and Torres Strait Islander women with violence-related traumatic brain injury. Our research shows that this should include:

Any recommendations implemented must include local partnerships with Aboriginal and Torres Strait Islander peoples to ensure that these practical measures are community-owned, culturally appropriate and provide overall benefit without causing further harm.

This article is republished from The Conversation under a Creative Commons license. Read the original article.