Understanding the barriers and facilitators of brain injury healthcare services

Research Objectives: To understand the perspectives of multiple stakeholder groups on the barriers and facilitators of providing brain injury healthcare services for people with concurrent mental health and addictions concerns.

Design: A qualitative study using relativist ontology with a constructivist approach was conducted.

Setting: Semi-structured focus group interviews were conducted during a one-day event, Consensus on Brain Injury Day, on October 14, 2022, at the University of Victoria in British Columbia (BC), Canada.

Participants: Participants were representatives of stakeholder groups who attended the event, including people with lived experience of brain injury and their caregivers, clinicians, service providers, leaders of brain injury associations, researchers, and policy makers.

Interventions: N/A

Main Outcome Measures: Participants completed semi-structured focus group interviews in groups of three to six people led by discussion facilitators (in-person and virtual delivery). Questions focused on barriers and facilitators of accessing brain injury healthcare services, (e.g., “What are the one or two things about brain injury care that are working really well?”). The interviews were summarized by the facilitators. Manifest content analysis was used to analyze the summarized data from the interviews and explore the information as closely to the intended meanings as possible.

Results: Ninety participants were interviewed during 15 simultaneous focus groups. Findings indicated that participants perceived barriers such as, lack of awareness of brain injury, disconnected healthcare services, and inadequate funding. Participants also noted facilitators including committed professionals, collaboration between professionals and involvement of brain injury societies to foster growing awareness and recognition of brain injury.

Conclusions: This participatory research study identified barriers and facilitators to brain injury healthcare services for people who are experiencing concurrent mental health and addiction concerns in BC. These findings can build on the strength of committed brain injury healthcare professionals and improve services by providing them with mental health and addictions training and empowering them to provide more wrap-around care. Policy makers can use these findings to design accessible, equitable, and client-centered programs for people living with brain injury experiencing concurrent mental health and addiction concerns.

Author(s) Disclosures: N/A