We need to better support First Nations women with violence-related brain injuries. Here’s how

Domestic violence causes disability in women through lasting effects on their brain.

Traumatic brain injury refers to damage or altered brain function brought on by a blow or force to the pinnacle. This leads to bruising, bleeding, and tearing of brain tissue.

These kinds of injuries can have short-term (acute) effects or be cumulative (over months or years).

AND 2008 study Research by Adelaide researchers has found that Aboriginal women are 69 times more likely to experience head injuries – including brain injuries – following assault than non-Indigenous women.

We I talked to Aboriginal, Torres Strait Islander and regional and distant communities in Australia discuss their experiences of violence-related brain injury and decision-making around access to health care.

We also talked to relations about what that they had observed in other women necessary to them who had suffered a brain injury.

Here’s what we found and how we will construct on it to develop better healthcare and support services.

I now not feel like the identical person I used to be

Violence-related brain injuries these should not isolated experiences. Aboriginal and Torres Strait Islander women we spoke to reported repeated violence-related head injuries over a protracted time frame. Most women reported dozens of head injuries or lost count of how many that they had.

Violence was typically experienced by current or former partners, each Indigenous and non-Indigenous.

Aboriginal and Torres Strait Islander women reported living in and managing many common changes due to brain injuries, including:

• memory problems
• dizziness and headaches
• difficulties with concentration and organization
• difficulty absorbing information and considering (sometimes referred to as “confused thinking”)
• difficulty starting stories or continuing conversations with family and friends (described as “words being lost or disappearing” or feeling like “my brain is empty”)
• mood swings and impulsivity.

Coral shared:

I actually have a faint, now I suffer from memory loss, as if I actually have difficulty telling stories. These are stories that happened to me. But I am unable to remember them.

Kirra talked about her experiences:

I put something somewhere, like a book, keys, phone. If I am unable to see it, I forget where I put it. I actually have trouble staying focused on one thing.

The women we spoke to also incessantly mentioned strangulation. Non-fatal strangulation can also be harmful to the brain since it reduces blood flow to the pinnacle and deprives the brain of oxygen.

When and why women use healthcare

Women felt that accessing healthcare and support services following a violent brain injury was not at all times an option for them, mainly because they experienced coercive control or feared being reported child protection authorities.

The characteristics of the injury also influenced their decisions about accessing healthcare. Unless there was visible bruising, cuts or marks, blood or a remembered lack of consciousness (or fainting), many Aboriginal and Torres Strait Islander women didn’t go to hospital and managed their symptoms independently.

As Cathy explains:

Then one night he hit me. There was no hospital, no blood, no bleeding, nobody would think that it was domestic violence that happened to me. I didn’t think it was serious enough to go.

How Women Cope With the Symptoms of Traumatic Brain Injury

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

• Painting and weaving
• listening to meditation music
• puzzles and other tactile games.

Family and friends helped Aboriginal and Torres Strait Islander people with on a regular basis tasks comparable to shopping on the supermarket, paying bills and making appointments. Pat says:

A member of the family talks to me on the phone while I’m at the shop so I do not forget. Sometimes my daughter or grandchildren take an image and send it to me.

However, homelessness, isolation and ongoing violence have undermined the flexibility of many Aboriginal and Torres Strait Islander women to seek medical help for brain injuries and to use these strategies.

Need for regional and distant investments

We need to strengthen access to health and other support services for Aboriginal and Torres Strait Islander women with violence-related brain injuries. Our research shows that this could include:

• development of a unified, coordinated care pathway across emergency departments and distant community clinics

• developing a specialized workforce with Brain Injury and Violence Training (comparable to Aboriginal social employees and Aboriginal medical examiners) who can support women in health and community settings

• incorporating questions on the initial assessment of brain injury into core family health and violence assessment tools, including the Aboriginal and Torres Strait Islander Health Survey and the state/territory family violence risk assessment

• educational resources that raise awareness and knowledge about brain injuries and non-fatal strangulation amongst women, families and communities. These must include information that everlasting brain damage can occur even when an individual doesn’t lose consciousness or has no visible injuries

• needs-based financing to provide emergency accommodation services in regional towns and distant communities to make sure that these services can respond effectively to local needs

• investment in the event of concussion clinics in regional and distant areas of Australia.

Any recommendations implemented must include local partnerships with Aboriginal and Torres Strait Islander people to make sure that these practical measures are community-led, culturally appropriate and broadly helpful, without causing further harm.