Exploring the impact of alcohol-related brain damage among homeless people in the UK: A scoping review

Abstract

Background: Alcohol-Related Brain Damage (ARBD) amongst homeless populations in the United Kingdom is a pressing public health issue, typically characterized by severe neurological and psychosocial impairments. Despite its significance, there is limited comprehensive reviews of ARBD within this demographic. 

Methods: A scoping review approach was adopted to map the existing evidence in relation to ARBD among the homeless in the UK. The Population, Concept, and Context (PCC) framework was used to develop search strategies and inclusion criteria for the review. A systematic search of the following databases was also carried out in July 2024: Google Scholar, PubMed, ProQuest, PsycINFO. These databases were selected since they are major health and social care databases. The search terms were designed to capture a broad range of relevant literature, including grey literature. Ten studies were selected for the review. 

Results: The review highlighted significant themes related to ARBD prevalence, impacts and interventions. ARBD is strongly associated with homelessness and can be as high as 70%. Significant neurological and cognitive impairments were reported. Psychosocial impacts included severe stigma, isolation and deteriorating mental health. Barriers for accessing healthcare demonstrated the need for early diagnosis and comprehensive rehabilitation. Integrated care approaches, community-based and peer support interventions were shown to be effective for managing ARBD among the homeless. 

Conclusion: ARBD in the UK homeless population is a multifaceted problem, requiring tailored interventions, with improved access to healthcare, integrated models of care and community-based support that meet the holistic needs of such vulnerable individuals. Future research endeavours should aim to fill the gaps identified in the literature to inform future interventions and policy frameworks.