When we think of concussion, it’s easy to imagine that traumatic brain injury occurs most often in ice rinks and on playing fields, or that it’s an issue that disproportionately affects professional athletes or rambunctious children. In fact, 25 per cent of traumatic brain injuries occur in women, and intimate partner violence may be one of the leading causes of concussion for women in Canada.

Concussion is a traumatic brain injury that affects normal functioning of the brain and can result in headache, confusion and memory impairments, difficulty sleeping and participating in physical activities, nausea, and long-term cognitive or psychiatric symptoms. Concussions are generally caused by blunt force trauma, but can also result from violent shaking. Repeated concussions are linked with dementia-like symptoms later in life.

According to Dr. Paul van Donkelaar, one in three Canadian women will be assaulted by an intimate partner at least once during her lifetime. Each year up to 276,000 will experience domestic violence and of those who seek the safety and support of a women’s shelter, up to 90 per cent will demonstrate signs of traumatic brain injury. For reasons that are deeply personal to the individual and also symptomatic of how our culture responds to women who have experienced abuse, the actual number may be much larger as assaults including intimate partner violence are often not reported.

“We are just in the process of initiating this project, but we do know that there is an urgent need for concussion awareness training and materials for front-line workers in women’s shelters,” explains Dr. van Donkelaar. “Women who have experienced intimate partner violence are less likely to turn to the medical community for care, so we need to empower those who are in positions to help this vulnerable population.”

Women leaving violent relationships may not first seek medical treatment for traumatic brain injury, but instead will turn to different forms of community-based support, such as women’s shelters or survivor support groups. With the support of the Max Bell Foundation and in collaboration with the Kelowna Women’s Shelter and BC Society for Transition Houses, Dr. van Donkelaar is working with Dr. Shelina Babul and her team at the BC Injury Research and Prevention Unit to build a tool for those assisting survivors to help identify concussion, and to support their healing process in order to begin rebuilding their lives after domestic violence.

Building on Dr. Babul’s Concussion Awareness Training Tool (CATT), Dr. van Donkelaar’s work will include guidelines for those who need to identify and support those who have suffered traumatic brain injury. A first-of-its kind initiative, the project is a blend of basic and clinical neuroscience, and offers an opportunity to support a population often overlooked by concussion research. The work of characterizing brain dysfunction using lab-based evaluation in women fleeing violence will build on research originally conducted in athletes.

“We’re still in the planning stages, but we want to get this right,” says Dr. Babul, whose successful concussion resources site, CATT, is an online resource to help individuals and communities affected by concussion to recognize, treat, and prevent concussions to decrease the risk of lasting damage and long-term health issues. “The number of injuries due to intimate partner violence in Canada each year is staggering, and we want to be sure we’re addressing the needs of this particular population in the right way.”

Dr. van Donkelaar’s approach includes working with community partner organizations and survivors to better understand their needs and challenges and using this information to drive the research questions and development of support services. While many view intimate partner violence as a private issue, Dr. van Donkelaar is working to bring the conversation about the effects of traumatic brain injury on women into public focus so that any person seeking help for an abusive situation can find the resources they need to heal and move forward.

CATT currently offers resources for educators, coaches, medical professionals, and parents, and will expand in the year ahead to include resources for workers and employers. Each module is developed alongside module users, so that the tool is truly informed by the needs of a specific population. The tool is updated monthly, so guidelines for each audience are current and informed by the latest research.

Dr. van Donkelaar and Dr. Babul expect to launch the tool on the CATT website in early 2020.