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Challenging Behaviours, Co-morbidities, Service Utilisation and Service Access among Community-dwelling Adults with Severe Traumatic Brain Injury: A Multicentre Study

Published online by Cambridge University Press:  14 May 2014

Grahame K. Simpson ,
Mark Sabaz ,
Maysaa Daher ,
Robert Gordon  and
Barbara Strettles
Grahame K. Simpson*
Affiliation:
Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia John Walsh Centre for Rehabilitation Research, Sydney School of Medicine, University of Sydney, Australia Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney, Australia
Mark Sabaz
Affiliation:
Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia
Maysaa Daher
Affiliation:
Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney, Australia
Robert Gordon
Affiliation:
Australian Health Services Research Institute, University of Wollongong, Australia
Barbara Strettles
Affiliation:
Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney, Australia Agency of Clinical Innovation, Sydney, Australia
*
Address for correspondence: Grahame Simpson, PhD, Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, NSW, Australia. E-mail: grahame.simpson@sswahs.nsw.gov.au
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Abstract

Objective: To examine patterns, predictors and unmet needs of service utilisation and access to mental health and/or drug and alcohol services among community-dwelling adults with severe traumatic brain injury, and compare those who displayed challenging behaviours with those not displaying challenging behaviour.

Design: Retrospective multicentre study.

Subjects: All active clients (n = 507) of the New South Wales (NSW) Brain Injury Rehabilitation Program (BIRP) community rehabilitation teams.

Methods: Clinician-rated data were collected on client challenging behaviours, mental health and functional status, service utilisation and unmet needs. Between-groups analyses (challenging behaviour versus no challenging behaviours) were conducted to examine patterns of service utilisation and unmet needs. Predictors for service utilisation were tested by multiple linear regression.

Results: Challenging behaviours were associated with higher use of BIRP and non-BIRP services and greater levels of unmet needs. Challenging behaviour was an independent predictor of higher levels of service utilisation, in conjunction with pre- and post-injury mental health and drug and alcohol co-morbidities and geographic location. Only 15.3% of the 111 clients with challenging behaviours and co-morbid drug and alcohol problems accessed a drug and alcohol service, while another 32.4% had unmet needs for such services.

Conclusion: Challenging behaviours make an independent contribution to increased levels of service utilisation after severe traumatic brain injury.

Keywords

challenging behaviourstraumatic brain injuryservice utilisationneedsmental healthdrug and alcohol abuse

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Type
Articles
Information
Brain Impairment , Volume 15 , Issue 1 , May 2014 , pp. 28 - 42
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2014 

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