Beyond the NFL: A new plan to treat brain injuries for women escaping abuse

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Kerri Walker has been in two relationships involving domestic violence. Like many survivors, she was hit repeatedly. She was diagnosed with a traumatic brain injury and even suffered an aneurysm. “So when I say my brain is special, it’s special,” she says.

Over the years, Walker, 52, has made many adjustments, including moving from a shelter in Ohio to a new life in Arizona. “We all get forgetful the older we get,” she said. “But if you’ve had an injury and if you’ve had trauma in your life, that affects how your brain develops and so you don’t go about things quite the way everybody else does.”

The last year has seen a spike of interest in traumatic brain injuries, due in large part to the ongoing controversy over the NFL’s handling of cases among former players, more than 40 percent of whom have exhibited symptoms of brain injury; and particularly following the release of the movie "Concussion." In it, Will Smith plays Bennet Omalu, a forensic pathologist who performs the autopsy of football player Mike Webster. Omalu discovers that Webster suffered from a disorder called chronic traumatic encephalopathy, a progressive degenerative disease resulting from repeated traumatic brain injuries, or TBIs. 

Boxers, soldiers, football players: The faces of TBI are almost always those of men in dangerous or physically demanding careers. When soldiers began returning from Iraq and Afghanistan, the Department of Defense spent millions researching new technology like battlefield ultrasound machines that would help assess and treat TBIs quickly. In sports, earlier this month an appellate court affirmed a settlement that would potentially provide retired football players as much as $5 million each in damages for brain injuries. But there is another group of TBI sufferers that has been far less visible: survivors of domestic violence. 

According to the Centers for Disease Control and Prevention, nearly a quarter of American women experience extreme physical violence from intimate partners during their lives. Suffering repeated blows to the head, strangulation, and being violently shaken or slammed against the wall puts them at risk for TBI. But the lack of adequate screening and identification systems means that brain injuries often go unrecognized.

That’s something advocates and researchers in Phoenix hope soon to change. The Sojourner Center, one of the largest and oldest domestic violence shelters in the United States, is partnering with the Central Arizona Center for Therapy and Imaging Services Foundation, a medical research institution, to pilot the Sojourner Center BRAIN (Brain Recovery and Inter-Professional Neuroscience) Program. Through their research — starting with a study planned for May — the organizations hope to create a model for appropriate neurological care for domestic violence survivors and to document the process so that other doctors and practitioners can access data about the long- and short-term effects of TBI in women and children.

“Very little has been documented on what works and what doesn’t work,” explained Maria E. Garay, CEO of the Sojourner Center. She said the Sojourner BRAIN Program will bring to light an underreported public health epidemic and can guide best practices nationwide by producing quantifiable outcomes.

Understanding injuries

Sitting on the outskirts of Arizona’s Maricopa County, The Sojourner Center serves about 9,000 people each year. More than a shelter, the center provides counseling, medical care, a child development center, continuing education and job training programs. To “accept people where they’re at,” in Garay’s words, the staff also tries to meet needs that aren’t always immediately obvious.

For example, only 2 percent of domestic violence shelters in the United States provide kenneling services for pets, although 40 percent of women with pets say they are less likely to leave violent situations for fear of what might happen to their animals. So the Sojourner Center built a pet compound for cats and dogs and offered training in dog grooming. Women have come from other states to take advantage of this program.

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The Sojourner Center's compound for cats and dogs. Photo courtesy of the Sojourner Center

Garay said that, because of their design, many shelters can actually exacerbate issues for women with brain injuries and PTSD. People with TBI are sensitive to light and noise; they struggle to read because of impacted eye movement. “If you have a shelter where there are tons of people and all kinds of lighting and a long intake process that has to happen, most women aren’t able to do that,” she said.

Garay believes that is what’s happening right now in domestic violence shelters across the country: Women who are unable to adapt to the systems in place are told that they’re resistant. They’re kicked out of the very shelters that are supposed to protect them. “They get rotated from one shelter to another,” she said. “Eventually what happens is they end up in the streets with their kids.”

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