Suicidal responses to traumatic brain injury: Reducing risk and building capacity
Annual incidence rates for traumatic brain injury (TBI) in Australia are estimated at 100 per 100,000. Common sequelae of TBI include motor sensory, cognitive and behavioural impairments that have disabling consequences in domains such as self-care, independent living and social relationships. As a consequence, people with TBI experience poor vocational outcomes, social isolation and emotional distress. People with TBI are four times more likely to commit suicide than people in the general population. Recent research by the authors at the Brain Injury Rehabilitation Unit in Sydney, Australia, has found significant rates of hopelessness (35%), suicide ideation (23%) and suicide attempts (18%) post-injury among a large group of outpatients (N=172). Building capacity to reduce the level of suicidality for this vulnerable group has involved interventions aimed both at the individual and the broader social environment. Initiatives have included (a) the development of a positive mental health program for people with TBI, (b) development of a brochure that people with TBI can use in a crisis situation, (c) information resources for families, (d) staff training in the assessment and management of suicide, and (e) a suicide prevention policy template for brain injury rehabilitation and community services. Adopting this multi-modal approach to building capacity among the various stakeholders in the field of TBI holds out the promise of more effectively addressing this issue. Social workers, with their ability to work across a range of intervention modalities, can play an important role in developing the effectiveness of such suicide prevention efforts.