Aidan Hamilton 1

Aidan Hamilton
Betsy Natter
Design & Society
1/20/15
A Discussion Linking Societal Attitudes Towards mTBI to the High Rate of Under-Treatment of
mTBI
Societal attitudes in the U.S.A towards mTBI (concussions) leads to under-diagnosis and
under-treating of mTBI. This harms the lives of many people who have received mTBI, whether
it was because they did not receive adequate treatment , or because they received no treatment at
all.
In America mTBI is often treated as a minor injury, akin to shallow cut or a painful
bruise. While the awareness of the severity of mTBI is growing amidst recent stories coming out
of professional sports, the average American does not consider mTBI to be a serious injury. If
you play sports at any level, it's essentially considered a right of passage to receive a concussion.
Unfortunately there is no accurate census data that exists currently to back up these claims, so I
will have to rely on my personal experiences playing sports to evidence my claim that mTBI is
treated lightly in America, though I believe that similar experiences will be shared with the
majority of my readers.
In my experience playing soccer from the time I was 8 until I was 14, there were few on
the multiple teams I played for that did not eventually receive a concussion. I personally received
two, though only one was received while playing soccer. The attitudes that my teammates, as
well their parents and the coaches gave to those that were concussed was certainly one of
concern, but their questions were of the order of ,"when is he going to be able to play again?",
not "how is he doing?". They expected an answer of a week, two at maximum, and that is the

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response they were generally given. I doubt that any of those that received concussions save
myself missed more than a day or two of school, in spite of the fact that the best way to recover
from a concussion is minimum stimulation immediately following the injury. This was the
standard procedure for everyone I knew that received a concussion, with minimum feedback
regarding the severity of the concussion or the speed of the person in questions recovery. This is
improper treatment of mTBI. However this is a fault within the medical community in its
handling of mTBI, which is due in part to societal attitudes, as well as a lack of information of
mTBI available to doctors. This is being corrected internally as newer studies come out with
better methods of treatment of mTBI and the fault I would not place directly on the parents and
social circles surrounding the concussed in question. What I witnessed many times that I do
blame directly on societal attitudes was teammates getting hit hard in the head during practices
and gameplay, with little to no concern of those witnessing it. A number of these instances
caused minor symptoms that in hindsight I now recognize as symptoms for mTBI. But they were
never treated, never even diagnosed. They are still likely walking around with permanent
symptoms from these concussions without even noticing it because they've lived with them for
so long.
People seem to have the belief that the mind and the brain are too separate things, that
there is a soul estranged from the body that determines who somebody is. There is little worry in
getting hit in the head, as compared to breaking a bone, as breaking a bone is a more salient, and
there is little damage to be done by a "light" hit to the head. It is forgotten that the brain is
physical structure, a delicate physical structure that can damaged like anything else. This causes
a belief in American society that hits to the head are minor, and mTIB is likewise minor. Look no
further than Hollywood to see this societal belief, characters are constantly saying and being told,
"you just got a concussion.", as if it's a minor injury, something to be relieved about! Couple this
belief with general misunderstandings about the nature of concussions and how they can be
caused (for instance, the force of the hit has little correlation with the severity/likelihood of

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receiving mTBI) leads to many potential mTBI causing injuries to be overlooked.
These societal attitudes towards mTBI is what I believe leads to the harrowing statistic
that an estimated 25% those who receive a mTBI go completely untreated. While another 35%
are treated in emergency rooms and then immediately released (Gerberding, Julie. Binder, Sue.
2003). If a report by the CDC from 2004 is to be extrapolated to 2015, "According to existing
data, more than 1.5 million people experience a traumatic brain injury (TBI) each year in the
United States." Though the same report goes on to say ,"These data, however, likely
underestimate the problem of MTBI in this country." (Gerberding, Julie. Binder, Sue. 2003.) If
this is to be believed then over 375,000 people receive a concussion each year without getting
any treatment, and as the CDC report says this is likely an underestimate. The societal attitude
that concussions are minor injuries logically directly leads to there being such a high number of
untreated concussions. The 35% being treated in emergency rooms is also harrowing as mTBI is
generally under-diagnosed in emergency room settings as symptoms of mTBI can take multiple
days after the initial impact to manifest. It is also generally improperly treated in emergency
room settings as mTBI treatment requires considerable feedback from the patient and doctors to
successfully treat. So a total of 60% of those who receive of mTBI are not acquiring the care
they need to recover effectively. And this I believe can be traced directly to the societal attitudes
towards concussions I discussed previously!
But why is mTBI such a huge issue? Because its effects, when improperly treated can be
large and long-lasting. mTBI dramatically increases the likelihood of developing serious mental
disabilities. Also, a little known fact about mTBI is 15% of those that have a mTBI injury will
enter into what is known a post-concussion syndrome, which is where a concussion lasts over a 3
weeks. Those with post-concussion syndrome generally have serious symptoms lasting for 6
months to a year if not longer. Many that enter into post-concussion syndrome, especially adults,
acquire permanent symptoms. Without proper treatment, as so many are not getting, mTBIs can

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not fully heal, causing lingering symptoms akin to those from post-concussion syndrome. While
I do not have the direct evidence to state that mTBI increases the likelihood of incarceration,
studies have shown that the rate of previous mTBI for those in prison is extraordinarily high. As
reported in Scientific American, "In prisons, however, approximately 60 percent of adults have
had at least one TBI [mTBIs are included, and lead contributor]and even higher prevalence has
been reported in some systems. " (Harman, Katherine). This is compared to the rate of 8.5%
among the non-incarcerated (Harman, Katherine). This does lead one to believe the that mTBI
increases the risk of incarceration though direct causation hasn't been proven so far. However it
does emphasis the point the mTBI has the potential to have serious consequences.
This shows that the many people that are under-treated for the mTBI are needlessly
risking permanent disability, whether from the mTBI itself, or from the increased risk of
developing serious mental disabilities. And I believe that societal attitudes towards concussions
are what causes the high rate of under-treatment of concussions. This is detrimental to hundreds
of thousands of American lives each year. It's appalling that such a prevalent injury, with such
potential for dire consequences, is going untreated for so many.
In this essay I have attempted through utilizing my personal experience to make a case
that the societal attitudes towards mTBI in the U.S.A are that mTBI is a minor injury. While
utilizing personal experience to make such a claim does jeopardize it, I was faced with little
choice as their is no data on public perception of the severity of mTBI that I could access. So
while that portion of this discussion is debatable, the fact remains that a high percentage of those
the receive a mTBI go untreated. Considering the dire consequences not treating a mTBI can
have, this is a problem that requires public attention. For if I'm correct that societal attitudes do
contribute to this problem, simply making the problem of under-treatment of mTBI known
would reduce the problem, as public perception of mTBI would be altered. So I urge you to learn
more about mTBI yourself, and spread that information to others and change these societal

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attitudes one person at a time.

Works Cited
Gerberding, Julie. Binder, Sue. Report to Congress on Mild Traumatic Brain Injury in the
United States: Steps to Prevent a Serious Public Health Problem. 2003. Print.
La Point, Scott R. "TBI and Substance Abuse Correlates Within a Prison Therapeutic
Community." Diss. Regent U, 2013. Web. Jan.-Feb. 2015.
Harmine, Katherine. "Brain Injury Rate 7 Times Greater among U.S. Prisoners." Scientific
American 4 Feb. 2012. Print.