June 9, 2026
June is Brain Injury Awareness Month, a time to recognize the realities faced by thousands of Manitobans living with brain injury, many of whom may not even realize they have one.
For Dr. Lisa Engel, Associate Professor in the Department of Occupational Therapy at the University of Manitoba’s Rady Faculty of Health Sciences, the issue is both professional and deeply personal.
“I’m actually still unpacking my own personal connection to brain injury,” she said. “There were stories in my family about a relative who was described as ‘difficult,’ and only recently have we begun to realize they were likely living with a brain injury that was never acknowledged.”
An occupational therapist by profession, Dr. Engel has spent much of her career working alongside people living with brain injuries in Saskatchewan, British Columbia, Ontario, and now Manitoba. Her research originally focused on financial capability and financial well-being for people living with cognitive and mental health-related disabilities, including brain injury.
Over time, her work revealed a much larger issue.
“What I kept hearing from clinicians and community members was, ‘This is all great information, but we don’t have enough support and services for brain injury in Manitoba.’”
That realization became the foundation for the Brain Injury in Manitoba Project, a community-based research initiative involving people with lived experience, researchers, and organizations including St.Amant Research Centre, End Homelessness Winnipeg, March of Dimes Canada, and community advocates across the province.
According to Dr. Engel, brain injury is far more common than many people realize.
“In Canada, our best estimate is about 1.6 million Canadians living with acquired brain injury,” she explained. “In Manitoba, the best estimate is between 50,000 and 70,000 people.”
Acquired brain injury can result from traumatic causes such as falls, motor vehicle accidents, violence, or sports injuries. It can also occur through non-traumatic causes including stroke, brain tumours, lack of oxygen to the brain, or certain cancer treatments.
Despite its prevalence, brain injury often goes undiagnosed or misunderstood.
“Brain injury can happen to anyone at any time and last a lifetime,” Dr. Engel said.
She believes one of the biggest reasons brain injury remains “a problem hiding in plain sight” is because many symptoms are invisible.
While some people experience physical effects such as mobility challenges, many live with cognitive, sensory, emotional, or behavioural changes that others cannot easily see.
People may experience chronic headaches, fatigue, memory difficulties, problems concentrating, sensory hypersensitivities, or challenges with problem-solving and emotional regulation. These symptoms can affect every aspect of daily life, from maintaining employment to managing relationships and finances.
Dr. Engel shared an example from one of her research participants who described how overwhelming it was simply trying to visit a bank.
“The lights were blaring, the sounds were overwhelming, and by the time they got to the teller, they were already exhausted,” she explained. “They said they often wore sunglasses, ear plugs, and a hat just to make it through everyday activities.”
Unfortunately, invisible symptoms can also lead to misunderstanding and stigma.
“We’ve heard from people who were trying to manage their finances or navigate public spaces and were accused of being intoxicated or under the influence,” Dr. Engel said. “People often are not recognizing what they’re actually seeing is brain injury.”
The long-term impacts can be significant. Research shows people living with brain injury may experience higher rates of unemployment, social isolation, housing insecurity, and involvement with the justice system.
One recent report from End Homelessness Winnipeg found that one in three people surveyed during the city’s street census reported a history of brain injury. Dr. Engel noted that researchers believe this number is likely underreported, and national studies suggest the rate among people experiencing homelessness may actually be between 50 and 80 percent.
“For many people, the brain injury came before their first experience with homelessness,” she said. “That tells us brain injury may be contributing to housing insecurity.”
Her financial research has also highlighted the hidden economic costs associated with brain injury.
“One participant described it as a ‘brain injury tax,’” she explained. “Life became more expensive because they forgot bills, missed payments, or faced extra challenges navigating systems, all while often earning less income.”
Despite the growing need, Manitoba remains one of the few provinces without a dedicated outpatient rehabilitation clinic for acquired brain injury outside of stroke care.
Dr. Engel says that gap in services reinforces the need for a provincial brain injury strategy, including better data collection, improved supports, and increased public awareness.
“We actually do not collect comprehensive brain injury data in Manitoba,” she said. “If we want to address the issue, we need to understand how many people are affected and what supports are needed.”
The Brain Injury in Manitoba Project is working to change that through community-driven research and advocacy. The project brings together researchers, organizations, and people with lived experience to better understand local needs and develop awareness strategies across Manitoba communities.
Importantly, Dr. Engel says the project is designed to be collaborative and inclusive.
“We have one checkbox to be part of our team,” she said. “Are you passionate about improving the lives of people living with brain injury in Manitoba? If the answer is yes, you belong.”
The team intentionally includes more community members and people with lived experience than researchers. Meetings are structured to remain accessible and flexible, recognizing that traditional approaches are not always inclusive for people living with disabilities.
As Brain Injury Awareness Month continues, Dr. Engel hopes more Manitobans will take the time to learn about brain injury and recognize that many people around them may be living with challenges they cannot see.
“If something changes after a hit to the head, a stroke, or another event that could affect the brain, people should seek support and ask questions,” she said. “The earlier people understand what’s happening, the more opportunities there are to help.”
She also hopes communities become more compassionate and accessible for everyone.
“We don’t always know people’s stories,” Dr. Engel said. “If we make our communities more inclusive and accessible for people living with brain injury and other disabilities, our whole province benefits.”
To learn more see links below:
Brain Injury in Manitoba (BIMb) Project Phase 1 (Winnipeg) infographic & report (August 2024): https://mspace.lib.umanitoba.ca/items/c738a0ee-458c-4d5e-83bd-f9e4c24fc035
End homelessness Winnipeg report (2024): https://endhomelessnesswinnipeg.ca/wp-content/uploads/2024-Winnipeg-Street-Census-Report_Aug2025.pdf
Brain Injury Canada (info about brain injury): https://braininjurycanada.ca/en/?_gl=1%2A10povv4%2A_gcl_au%2AMTE1MDMzNTQyNC4xNzY2NDEzMjUw%2A_ga%2AMTcxNjU4NjA1NC4xNzY2NDEzMjM4%2A_ga_28XCNP1JTR%2AczE3NjY0MTMyMzgkbzEkZzEkdDE3NjY0MTMyODEkajE3JGwwJGgw&_ga=2.161699452.1335001485.1766413250-1716586054.1766413238
Dr. Lisa Engel pictured with her team at the University of Manitoba’s Rady Faculty of Health Sciences.
