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Presenters urge screening in high‑risk settings: justice, housing and substance‑use services
Summary
NASHIA presenters highlighted evidence that vulnerable populations—people in substance‑use treatment, the unhoused, justice‑involved people and veterans—have higher rates of reported brain injury and recommended targeted screening and training in those settings.
Presenters recommended that organizations working in high‑risk settings add OBIS screening to their workflows, citing data and published studies on elevated brain‑injury prevalence among particular subpopulations.
Haley Cushin said many milder brain injuries go unreported and that repeated exposures and co‑occurring mental health or substance‑use disorders raise the risk of lasting impairment. She cited a figure that "90 percent of concussions are so are not associated with loss of consciousness," noting symptoms can develop over days or months. Haley also cited three sample prevalence figures from the literature and OBIS subscriber data: up to 53% of people in substance‑use disorder treatment reported a loss of consciousness in some datasets, one study found 43% of participants experiencing homelessness reported a history of brain injury (average first injury age 15), and criminal legal system studies show up to 60% reporting a history of brain injury versus about 8.5% in the general population.
OBIS sample data presented by NASHIA reinforced those priorities: in one subscriber year, 83.3% of 60 screens in housing support services screened positive for a potential brain injury, and 96% of 25 screens in vocational/employment services screened positive. Across positives, 71.9% of screened participants reported inattention and 49.5% reported impulsivity. Presenters said that identifying these issues allows providers to supply compensatory strategies and reduce barriers to service engagement.
