The emotional, wellbeing and economic costs of acquired brain injury
Claire MacLaine, Clinical Lead – Brain Injury and Specialist Rehabilitation Case Manager
Every year in the UK, thousands of people’s lives are irrevocably changed by an acquired brain injury (ABI). Every presentation of ABI is different for every individual. Their ability to live independently, communicate, or return to work can be altered in an instant and the consequent effects on families, communities, and society can be profound.
According to the recent Right to Rehabilitation paper, it is estimated that the economic costs of Acquired Brain Injuries (ABI) to the UK are an estimated £43 billion annually. The costs estimated in the paper are those subscribed to the healthcare interventions. These do not take into account the additional financial costs to the primary carers when their family member is undergoing treatment, or when patients and their carers find they can no longer work.
We know the true costs of rehabilitation and treatment for ABI are far greater. While the research sought to capture wellbeing impacts, the reality is that the human cost, the pain, frustration, and loss of identity, cannot be measured in monetary terms.
Many patients may initially lose a sense of independence, requiring ongoing assistance with basic activities such as eating and drinking, washing and dressing, and managing personal cares. This can impact their autonomy and dignity, and thus, their self-esteem. The emotional and psychological impact that ABI can cause such as depression, anxiety, and changes in personality or emotional regulation are also common affecting confidence, motivation, and interpersonal relationships.
Many people with an ABI may experience cognitive challenges, including difficulties with memory, concentration, decision-making, and communication issues which can sometimes isolate individuals and reduce social participation. Persistent fatigue, sensory issues, and chronic pain can also contribute to overall wellbeing decline and reduce a patient’s quality of life. Individuals often describe a distinct loss of self as they struggle to reconnect with their previous identity.
The Right to Rehabilitation paper also fails to account for the emotional and economic toll on families, who often take on the role of unpaid carers. Nor does it capture the wider cost to society — including long-term reliance on health and social care services, welfare support, mental health interventions, and even the criminal justice system. These indirect consequences only strengthen the argument for early and effective rehabilitation.
To support the patient in returning to as independent and functional a life as possible, timely and specialist ABI therapy and care must be provided. The window for rehabilitation following an acquired brain injury is critical; the sooner patients receive person-centred specific interventions, the greater the potential for recovery of cognitive, physical, and emotional function.
Early access to multidisciplinary neurorehabilitation, including physiotherapy, occupational therapy, speech and language therapy, and psychological support, can significantly improve long-term outcomes. Each of these disciplines plays a vital role in helping patients rebuild physical strength, relearn essential life skills, regain communication abilities, and process the emotional impact of their injury. When therapy begins promptly and is delivered consistently, it helps to rewire neural pathways while the brain still has heightened plasticity, maximising the potential for recovery.
Early and coordinated intervention can also prevent secondary complications such as muscle contractures, pressure sores, malnutrition, or depression, all of which can slow or even reverse progress. A structured, team-based approach ensures that treatment goals are aligned across disciplines and that the patient receives holistic, continuous care tailored to their evolving needs.
To be most effective, neurorehabilitation must extend beyond the acute phase of hospital care and continue consistently across community and home-based settings to sustain progress. When patients receive timely therapy in a potent therapeutic quantity, with coordination and continuity across services, the benefits are threefold: improved recovery outcomes, reduced long-term care needs, and enhanced quality of life for both patients and their families.
Beyond improving individual outcomes, timely rehabilitation can reduce the need for long-term care, lower hospital readmissions, and ease the emotional and financial burden on families and health services.