Brain injuries in intimate partner violence finally getting care

Brain injuries suffered during intimate partner violence are finally being diagnosed and treated after years of going unrecognized, thanks to a coordinated approach that's starting to reshape how shelters and health-care systems respond.

Annie, who feared for her safety and asked to use only her first name, didn't realize she'd sustained a traumatic brain injury (TBI) at the hands of her abusive ex-partner. Sleep was nearly impossible, basic tasks like brushing her teeth could take hours, and she frequently forgot things. "I didn't recognize the highway," she said of a driving attempt. "I didn't know where to go anymore … I was completely confused of where I was."

It wasn't until she filled out an intake form at Montreal's West Island Women's Shelter nearly a year ago that she began connecting the dots. She worked with an occupational therapist every week to address her symptoms—a service that wouldn't have been available just a few years earlier.

Guylaine Simard, the shelter's director, has been working with researchers, doctors, social workers and police to create what they call an "ecosystem of care." For four years, the coalition Alliance MH2—which represents 38 shelters across Quebec—has researched the prevalence of TBIs in victims of intimate partner violence with assistance from Carolina Bottari, an occupational therapist and professor at the Université de Montréal's School of Rehabilitation.

According to Statistics Canada's 2025 Survey of Safety in Public and Private Spaces, 8,600 people who experienced physical or sexual violence sustained a concussion or other head injury as a result. Advocates and health-care workers say those injuries are often unreported, and the actual number is likely much higher. "In Quebec, there's really a historic deficit," Simard said. "When it comes to literature, there's nothing—nothing—documented to that effect."

Bottari's team began by placing master's students into shelters to diagnose patients and create treatment plans. She's also been hosting workshops and world cafés bringing together key actors from all areas who work with women who have experienced intimate partner violence to spread awareness of TBIs and adapt services accordingly. "Initially we gave simple cues," Bottari explained. "Talk slower if the woman seems to be struggling, reduce the lights if the woman seems to be getting a headache … we've been working at how do you adjust how you talk, how you transmit important information."