Teens Who Have had Traumatic Brain Injury Have Higher Rates of Suicide Attempts, Being Bulied and High-Risk Behavior

Given the prominent headlines about the National Football League and the devastating effects of sports-related concussions, we at Insanitek were intrigued to learn about a recent study that provides the first population-based evidence demonstrating the extent of the association between traumatic brain injuries and mental health outcomes among adolescents.

The study, published April 15, 2014 in the journal PLOS ONE, revealed that teenagers who have suffered a TBI such as a concussion are at significantly greater odds of attempting suicide, being bullied and engaging in a variety of high-risk behaviors.

They are more likely to become bullies themselves, to have sought counselling through a crisis help line or to have been prescribed medication for anxiety, depression or both, according to Dr. Gabriela Ilie, lead author of the study and a post-doctoral fellow at St. Michael’s Hospital in Toronto.

These kids have higher odds of damaging property, breaking and entering, taking a car without permission, selling marijuana or hashish, running away from home, setting a fire, getting into a fight at school, or carrying or being threatened by a weapon.The data used in the study was from the 2011 Ontario Student Drug Use and Health Survey developed by the Centre for Addiction and Mental Health. The survey, one of the longest ongoing school surveys in the world, contains responses from almost 9,000 students from grades 7-12 in publicly funded schools across Ontario. The OSDUHS began as a drug use survey, but is now a broader study of adolescent health and well-being. Questions about traumatic brain injury were added to the survey for the first time in 2011.

We contacted Dr. Ilie to get some insight into her study.

Insanitek: Why it is important to have a population-based study like this one, as well as the clinical studies that were previously available?
Dr. Ilie explained that small-scale clinical studies help establish what relationships may exist between conditions such as TBI and mental health issues, substance use, abnormal behavior or violence, but that it takes a population-based study to verify how big those issues are.

“For instance,” she said, “the Center for Disease Control in the United States said that between 2001 and 2009 the number of traumatic brain injuries among adolescents who play sports increased by 57%.” They knew problem rates were high among teens, but they didn’t really know how big a problem this is because, a lot of TBIs don’t get reported to a hospital.

Because kids often look fine after a concussion, their parents don’t bother to take them to a doctor. “It is important to have a population-based study that relies not only on reports of cases that were hospitalized, but also those that were not taken to a medical doctor,” she said.

Insanitek: What are the most important takeaways from this study?
“Number one is that traumatic brain injury doesn’t happen in isolation,” Dr. Ilie emphasized. She said the study underscores the need for greater vigilance on the part of school guidance counselors, parents, medical doctors and sports coaches. We need to screen for conditions like elevated psychological distress, problems where medication was prescribed for anxiety, depression or both, thinking about suicide and suicide attempts.

We need to find a system whereby when these conditions occur, there is a program in place to help those kids so they don’t fall through the cracks in the system and have no assistance whatsoever. They shouldn’t have to go through life thinking maybe there’s just something wrong with them. There’s nothing wrong with them. They need more support. We need to wake up. We need to understand traumatic brain injuries are a serious thing.

Insanitek: Why, as a scientist, are you interested in this topic?
I’ve been working with the Centre for Addiction and Mental Health and the neurosurgery department at St. Michael’s Hospital for a while. We know the number of mental health issues among teenagers has gone up. We know substance abuse and violent behaviors have gone up. Bullying is an issue. Suicide is an issue. And we want to understand those conditions. We want to know what are the correlates. We want to understand, Is this something about our culture that needs to be changed?

“And this may just be the case. It may just be that an ecological measure ought to occur. Hockey for example. A lot of those traumatic brain injuries occur in team sports like hockey, soccer and American football. Do we need body checking in hockey for kids? Is that a necessity or is that a cultural issue? I love hockey, but look at the Olympics. There’s no body checking there. It’s great, and there was no body checking. There’s no reason for banging someone’s head against the wall. When are we going to wake up?”

Insanitek: Why are you passionate about the science you do?
“Why I so I get fired up about science? Listen. One of the biggest purposes for science and scientific research is to better the quality of our lives. We want to lead happier, healthier, more peaceful lives. I’m a mother. I love kids. Our future depends on them. I want them to be happy. I don’t want to see what I’m seeing. I hear a cry for love through this data, and I hear a wake up call for the parents. So I have an obligation.

“You want to help better your society, and what better way of doing that than to understand why something’s up? I refuse to believe that there’s no fixable, changeable cause underneath those vocational failures we see in children with traumatic brain injuries — mental health issues, substance use, societal problems. There’s always a solution. We just have to look deep enough. We just have to care enough.”