Severe brain injury is the most serious outcome of many road traffic accidents. Having received medical treatment, it is vital for the patient to undergo an effective rehabilitation programme to ensure maximum recovery. However, as there is just one specialist rehabilitation centre in Ireland which is based in Dublin, most people have no option but to return home where they are dependent on their families for the rest of their lives.

Professor Agnes Shiel of NUI Galway's Department of Occupational Therapy says that treatment facilities and a proper rehabilitation service should be available in Galway. She was speaking in advance of the Neuropsychological Rehabilitation Conference 2005 at NUI Galway (11th and 12th July), where international delegates addressed issues including neuropsychological or memory rehabilitation, cognitive rehabilitation and socio-emotional functioning.

Professor Shiel said: "In Ireland, specialist rehabilitation of problems such as serious brain injury is wholly inadequate. There is only one specialist rehabilitation unit and this is based in Dublin. A successful rehabilitation programme needs to be accessible both in terms of starting as soon as possible after the injury is incurred and also in terms of location – that is - it needs to be regionally based so that the person's return to their community can be facilitated. A city the size of Galway should have a dedicated brain injury rehabilitation facility. "

According to Professor Shiel, the average head injury survivor is male and aged between 15 and 25 years. While the numbers with physical difficulties are small (about 10% of the total), the vast majority have ongoing problems with memory, concentration, planning and paying attention. These difficulties mean that they may be unable to lead independent lives, work in open employment and resume their lives as before.

Many return home and are dependent on their families for the rest of their lives. These problems are also experienced by people who incur brain injury from other causes, such as stroke, brain haemorrhage and tumours. This is creating a significant population of people living with ongoing severe difficulties. While people with brain injury may access local Occupational Therapy, Speech and Language Therapy, Physiotherapy and Neuropsychology services, these services are already stretched to capacity.

It is estimated that there are approximately 150 people per 100,000 in the UK who have ongoing difficulties as a result of brain injury. Professor Shiel says that accurate figures for the Irish population are not available but are possibly higher because of the higher number of road traffic accidents.

However, survival rates after head injury are increasing she says. This is mainly due to car safety features such as airbags, improvement in acute and intensive care and advances in pharmacological treatment of secondary complications. "However, the increased survival rates mean that there is an ever-increasing population of people who survive with significant and debilitating problems. Many survivors of head injury never access a rehabilitation programme and cope as best they can with the help of family and friends."

Among those addressing the Neuropsychological Rehabilitation Conference in NUI Galway was Professor Barbara Wilson OBE from Cambridge who helped establish one of the first centres in the UK for memory rehabilitation. Professor Skye McDonald from Sydney discussed emotional difficulties experienced by people suffering from brain injury who are unable to respond to non-verbal communication, while Professor Nadina Lincoln from the University of Nottingham compared different types of rehabilitation pointing out the most effective.

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