The Atlanta Journal-Constitution, By ANDY MILLER, 11/20/07 --

Room 491, where Ben Fuller lives, has filled with family.

Fuller's parents and older brother are there. His son, Logan, romps about the Floyd Medical Center room, crawling under furniture and playing with an inflated medical glove.

Fuller is slow to react to the action. Sitting in a wheelchair, he stares out into space for long periods of time. His mother asks him occasional questions, and each answer seems a struggle.

The Fullers have spent three frustrating years searching for needed services for Ben, who suffered a traumatic brain injury at 24 that left him prone to profane and violent outbursts. At each turn, they seem to run into roadblocks. It's estimated that thousands of other Georgia families have encountered similar problems.

A new report says Georgia lacks services for patients like Fuller, whose behavioral problems are linked to jarring blows to the head.

An estimated 187,000 Georgians have a disability related to a traumatic brain injury (TBI), and up to 10 percent of those may need ongoing care for TBI-related behavioral problems, according to the report from the Brain and Spinal Injury Trust Fund Commission. Those problems can include physical aggression and an inability to communicate and control emotions.

Because of that, many of those TBI victims end up institutionalized: in jails, prisons, even the state's mental hospitals. Some become homeless.

The absence of a coordinated system of rehabilitative care for these brain injury victims is largely due to a lack of public and private funding, according to the report, which calls the situation "a crisis."

Money is scarce because of a lack of understanding by lawmakers and insurers, experts say. Private insurers, as well as Medicare and Medicaid, "don't see these services as medically necessary," says Susan Johnson, director of brain injury services at Shepherd Center in Atlanta and a commission member.

The report calls for more training and support for caregivers, better screening of TBI-related behavioral problems and more funding for rehabilitation. Often, residential and community services for TBI patients are either too expensive or don't exist. The report also calls for the Georgia General Assembly to look into the state's deficiencies in dealing with traumatic brain injury.

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Labels: brain damage, brain injury research, TBI, traumatic brain injury