An Invisible Epidemic: The Connection Between Domestic Violence and Traumatic Brain Injury

March has the dual distinction of being Women’s History Month and Brain Injury Awareness Month, which aims to raise awareness of and advocate for the more than 5.3 million individuals in the U.S. who are living with permanent brain injury-related disabilities—one in 60 Americans. According to the Brain Injury Association of America, at least 2.8 million Americans sustain concussions and other traumatic brain injuries every year.

When asked to picture someone living with a traumatic brain injury (TBI), who comes to mind?

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Perhaps you picture a soldier wounded in battle or someone who’s been in a car crash. Thanks to high-profile media coverage of former football and other professional sports players with chronic traumatic encephalopathy (CTE), it’s common to think of brain injury as an issue that largely affects male athletes.

While it’s important to prevent, identify, and treat brain injury in all of these groups, there is an invisible epidemic of traumatic brain injury among one of society’s most vulnerable groups: survivors of domestic violence.

An Invisible Epidemic

Domestic violence survivors experience brain injuries at staggeringly high levels.

More than one in three women have experienced physical violence at the hands of an intimate partner—an estimated 10 million adults across the U.S.—and research suggests that as many as 80 percent of these survivors have traumatic brain injuries. 74 percent of domestic violence episodes involve injuries to the head or neck, such as strangulation.

These numbers are shocking, yet the link between domestic violence and traumatic brain injuries is not well understood by first responders, policymakers, and the institutions and systems that care for and work with survivors of domestic violence. Too often, survivors navigate the shelter, law enforcement, judicial, and even medical and victim’s services systems without being assessed for TBIs. 

Devastating Consequences

This lack of understanding can not only deprive survivors of necessary resources and medical care, but it can also lead to a mischaracterization of common TBI symptoms like slurred speech or difficulty regulating emotions as being caused by behavioral health issues, anxiety, or substance use, rather than potential brain injury.

The consequences of traumatic brain injuries reverberate through all aspects of sufferers’ lives and can significantly impact their ability to get back on their feet. Left undiagnosed and untreated, the negative symptoms of TBI—including memory loss, light sensitivity, and constant headaches—too often negatively impact the credibility of survivors’ testimony in the eyes of law enforcement, as well as their ability to navigate the child welfare system, secure and maintain employment and housing, and meet other basic needs.

Imagine trying to find a safe, affordable place for your family to live, perform your best at work, or gain custody of your children while living with constant headaches, dizziness, light sensitivity that makes it painful to look at screens, or intense feelings of depression and anxiety, among many other potentially debilitating symptoms of a traumatic brain injury.

These tasks can be extremely challenging even under the best of circumstances. Doing so with an undiagnosed, untreated brain injury is even more challenging, and can sometimes even prove insurmountable. This invisible epidemic partially explains why domestic violence is one of the leading causes of homelessness in New York City.

The failure to appropriately treat and support survivors experiencing TBIs makes them more likely to be economically distressed in the long term. If we want to provide survivors with the holistic care they need and deserve and end homelessness, we must apply the same attention and resources to head injuries suffered by survivors of domestic violence as we do to those sustained by male athletes.

An Innovative Approach

In 2022, VOA-GNY launched a pilot program in partnership with Safe Living Space, a domestic violence and TBI awareness nonprofit, implementing routine brain injury screenings as part of our domestic violence shelter intake process and connecting those with suspected TBIs with the proper follow-up care. The program is also filling a crucial gap in research and will better equip providers to recognize and respond to brain injury, and lead to data-driven policy changes including public awareness campaigns and funding for additional training and treatment. We’ve also learned valuable lessons, establishing best practices in trauma-informed care for survivors living with traumatic brain injuries.

In the year since we launched this program, the first of its kind in the nation, the results have confirmed our worst fears. Of the more than 400 survivors who have been screened at VOA-GNY’s seven domestic violence shelters to date, a staggering 57 percent report having experienced at least one symptomatic injury to the head or neck within the last year.

These are preliminary results, but they are nonetheless sobering for anyone who cares about the health and long-term success of survivors of domestic violence. We must take drastic action to better understand and confront this epidemic of traumatic brain injuries. It is both an essential component of a plan to help survivors of domestic violence recover and thrive, and of any campaign to end homelessness.

In February 2024, New York City Council Majority Leader Amanda Farías introduced City legislation, Int. No. 29, that would require NYC to train first responders and service providers about the connection between domestic violence and traumatic brain injury. Trainings would include education on the prevalence of TBI among domestic violence survivors, how to identify symptoms of TBI, how to respond to the needs of individuals with TBI, and the long-term health impacts of repeated brain injuries.

This bill is the first legislative action resulting from VOA-GNY’s TBI screening pilot program. If passed, it will serve as an important step in the vital effort to bring awareness to the connection between domestic violence and traumatic brain injury, improve services for survivors, and equip them with the information they need to seek care and get back on their feet

It’s time to show that the health and healing of the millions of domestic violence survivors in our communities matter as much to us as that of professional athletes. It’s what survivors deserve.

Learn more about our services for domestic violence survivors. If you or someone you know is in need of safe shelter, call us 24/7 at 1-855-643-RISE (7473) or click to chat with us. If it's an emergency, please dial 911.