Beyond Crisis Care in Brain Injury Rehabilitation in Australia

Abstract

Objective: The aim of this commentary was to bring together the various significant issues associated with delivering brain injury rehabilitation in Australia. Through observational critique, the authors aimed to identify gaps in practice and opportunities for change. Approach: In light of Australia's national health reform process, it is necessary to consider rehabilitation practices and models for brain injury service delivery. There are lessons to be learned within the Australian system, but also opportunities to apply international reform. Conclusion: For those within the service delivery system, brain injury rehabilitation can often appear to be a crisis-driven response. Gaps in service provision persist, leaving individuals who have reduced cognitive and emotional capacity to self-navigate an unpredictable health system at a time in their lives when they are least prepared to do so. Deficiencies in the delivery of timely and appropriate psychosocial or behavioral rehabilitation services undoubtedly contribute to the current pressures on the health system created by increased length of stay in neurological and slow-to-recover rehabilitation units, repeat presentations to primary care, and frequent use of community mental health services. Implication: The experiences of people with acquired brain injury highlights the need for early and targeted interventions that can deal with emerging complexities and support needs, interorganizational approaches, and new accommodation options with a matched service philosophy. Rather than count on good fortune, individual outcomes, and the future of brain injury, rehabilitation ought to depend on deliberate and systemic design.

The provision of brain injury rehabilitation services for people living in rural and remote New South Wales, Australia

“…The findings of this study support the proposal that innovative alternative service models for brain injury rehabilitation within Australia should be considered as a matter of urgency [57,58].…”

“…People employed in these positions would focus on capacity building and the development of links with the local Aboriginal community, so as to move towards a more culturally appropriate service that better meets the needs of Aboriginal people with ABI living in rural and remote areas of NSW. These solutions of coordinating services based around the person are both locally and internationally supported within the brain injury community [57,[59][60][61].…”

Is conversation partner training effective in assisting individuals with a traumatic brain injury to display improved communication outcomes

“…Muenchberger, Kendall and Collings (2011) analysed the healthcare system in Australia and its provisions for brain injury rehabilitation. They commented that much improvement was required and early intervention was not well practiced.…”

Healthcare services for people with acquired disability in South-East Queensland, Australia: Assessing potential proximity and its association with service obstacles

“…In Australia, consistent with the WHO's call to action ( Gimigliano & Negrini, 2017 ), there have been calls for more detailed analyses of the health and service infrastructure, to improve access across the continuum of care for people with acquired disabilities ( Middleton et al, 2014 ; Muenchberger et al, 2011 ). In Australia, where distance is a critical consideration for policy makers, the first step in response to this call to action is to map the current service infrastructure and assess what accessibility might resemble for specific populations.…”