Table 4 Recommendations with representative quotes, rank-ordered by priority

Clinical Practice

 1. Provide accessible and affordable supportive housing

“The funding provided [to affected individuals] needs to be realistic for the housing options… We need to bridge the time gap between waiting for funding and housing options and actually receiving them.”

 2. Enhance resources (financial, human) for service providers

“We must ensure those working with brain injured people are trained and aware, police, nurses, social workers”, “Expanding community supports for people with brain injury living on the streets.”

 3. Design needs-based services that promote quality of life

“Improved psychosocial quality of housing, such as safety, physical location. Some locations are triggering, with drug presence, that can be mentally straining.”

 4a. Improve communication and collaboration between service providers

“Better communication between places, like bigger databases, so that if a person moves they can stay or get connected to the appropriate healthcare services.”

 4b. Adopt a long-term and integrated approach

“The system is a closed loop. We need to address the gaps in care so that when a mental health crisis, brain injury, or homelessness event happens, the system helps them all the way to stability.”

 5. Reduce stigma and discrimination through public health education

“There’s a lot of discrimination, stigma, lack of public visibility… We need to provide better education in regard to brain injury, and the impact of being unhoused, to the general public.”

Research

 1. Evaluate and optimize existing interventions for immediate implementation

“Focus on smaller communities to find the most effective programs. More creative, grass roots approaches.”, “Research the impact of community services.”

 2. Develop specialized interventions and diagnostic techniques

“Researchers need to find out how best to measure, monitor, screen and treat brain injury, especially brain injury caused by toxic drug poisoning, in people who are homeless.”

 3. Collect meaningful data to better understand impacts and intersections

“Brain injury has previously been recognized as an issue, but the intersection of these existing groups—addiction, homelessness, and brain injury—being recognized, that’s important.”

 4. Increase mechanisms for knowledge transfer

“It’s important for researchers to take their results or knowledge and dumb it down so that every day average people can understand it and be better for it.”

 5. Explore methods for risk identification and prevention

“Researchers need to create or improve risk assessment for identifying people most at risk of brain injury and homelessness.”