May is mental-health awareness month, and the good news is the conversation around mental well-being has come a long way during the last decade. Rather than mere “awareness” of mental health disorders, many events focus on educating employers about accommodation, eliminating stigma and teaching family members how to support loved ones in crisis. Some campaigns focus on everyday mental wellness, encouraging everyone to practice mindfulness and good sleep hygiene.

For the 1 in 5 adults living with mental illness in the United States, this is good news. When social issues are addressed holistically, access to resources and funding for research and treatment increases. When stigma is eliminated, more people seek treatment, which lessens the negative impacts of mental illness on society as a whole.

These tangential conversations are especially important for brain-injury survivors and their caregivers since, compared to the general population, brain-injury survivors may be far more likely to develop a psychiatric condition than the general population.

One Danish study found people with head injuries were 439 percent more likely to develop organic mental disorders, conditions that lead to decreased mental function. That in and of itself isn’t surprising; it’s well-known that brain-injury survivors are often left to struggle with decreased executive function, a tendency to perseverate, difficulty with memory, emotional regulation issues and a host of other challenges depending on the injury.

However, the same study also found brain-injury survivors were up to 65 percent more likely to develop schizophrenia and 28 percent more likely to develop bipolar disorder.

Granted, this was only one study and the jury is still out on whether head injury can cause psychiatric disorders or merely exacerbates an already-existing underlying issue. Brain injury often includes inflammation of the brain or tissue damage, both of which will disrupt neurotransmission and the function of the endocrinology system, contributing factors to some mental illnesses.

However, it’s difficult for medical professionals to even assess whether brain-injury survivors have a psychiatric conditions because many of the cognitive challenges that stem from brain injury mirror symptoms of certain mental-health conditions such as anxiety or obsessive-compulsive disorder.

Regardless of the cause of a mental-health condition, however, the fact remains that intervention and treatment are crucial in ensuring that brain-injury survivors can live well after brain injury.

The trauma of brain injury itself, including losing one’s autonomy, ability to live independently or ability to practice in their chosen profession, frequently leads to post-traumatic stress disorder or depression, both mental illnesses in their own right. In fact, one study found major depression to be a common diagnosis post-brain injury.

And finally, the psychological toll of being a caregiver or family member of a brain-injury survivor deserves a place in any discussion about mental well-being and self-care.

Brain-injury survivors and their caregivers are inevitably confronted with a psychologically and emotionally traumatizing circumstance to navigate. As such, any discussions, education or awareness initiatives about mental health should include this especially vulnerable population.

Carrie Collins-Fadell is the executive director or the Brain Injury Alliance. Email her at