Dr. Sumantra Monty Ghosh argues that chronic homelessness should be addressed as a cognitive impairment crisis requiring specialized, high-level support.
Key facts
- •Dr. Sumantra Monty Ghosh is an addiction medicine specialist and associate professor at the University of Alberta.
- •Cognitive impairment in the homeless population is linked to factors including traumatic brain injury and substance use disorders.
- •The proposed care model includes 24-hour supervision and structured brain rehabilitation.
- •An estimated 50% of people experiencing chronic homelessness have substantial brain injuries.
- •The commentary was published in the Canadian Medical Association Journal in 2026.
Dr. Sumantra Monty Ghosh, an addiction medicine specialist at the University of Alberta, suggests that current approaches to chronic homelessness in Canada are failing because they overlook widespread cognitive dysfunction. He argues that many individuals experiencing homelessness require support comparable to that provided for dementia patients to live safely and independently.
Causes and scope of impairment
People experiencing homelessness frequently face multiple factors that contribute to cognitive impairment. These include traumatic brain injuries, fetal alcohol spectrum disorder, adverse childhood experiences, and mental health conditions that impact executive function, memory, and comprehension. Dr. Ghosh estimates that approximately half of the population experiencing chronic homelessness suffers from substantial brain injuries.
Proposed policy shift
Dr. Ghosh advocates for moving beyond conventional interventions, such as Housing First, toward a model that incorporates 24-hour supervision, safety monitoring, and brain rehabilitation. He emphasizes that routine screening is necessary to identify those with complex needs and provide appropriate care. Reframing the issue as a cognitive impairment crisis is presented as a foundational step to improving outcomes for unhoused individuals and the broader community.
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This article was independently rewritten by ManyPress editorial AI from reporting originally published by Medical Xpress.
