Kristen Sandborn knew something was wrong. Appointments slipped her mind. Conversations vanished. The sequence of everyday events blurred, and her vision shifted in ways that frightened her. She avoided friends, withdrew from gatherings, and carried the weight of a suspicion she could not voice: the punches to the head from her ex-husband had left a mark no one could see. But she never went to a doctor. She never called the police. In Victoria, British Columbia, the calculus of survival is brutal. “When you get punched in the head [by your partner], and you have kids, you don’t go to the doctor about that,” Sandborn said. “You just don’t because you don’t want your kids taken away. It’s almost like the only option you have is to fight your body.”
The silent crisis: brain injury and intimate partner violence
The numbers released by Statistics Canada last October are staggering. In 2024, police services across the country reported 356 victims of intimate partner violence for every 100,000 people aged 12 and older. That totals 128,175 reported victims in a single year. Experts agree the true figure is far higher; fear, shame, and systemic barriers keep countless cases in the shadows. Yet Canada has no standardised screening protocol for emergency departments, GP surgeries, or transition houses — the temporary refuges for women and children fleeing abuse — to document brain injury when violence is reported or suspected. The result is a diagnostic vacuum. Without a screening standard, there is no reliable diagnosis. Without a reliable diagnosis, there is no pathway to provincially funded brain-injury support, and no credible evidence in family courts.
Tori Dach, manager at the Cridge Centre for the Family — British Columbia’s only established programme offering direct services to victims of brain injury from intimate partner violence — puts it plainly. “Without a screening standard, there is no reliable diagnosis. And without a reliable diagnostic standard, there is no pathway to provincially fund brain-injury support or justice in family courts for identifying such injuries.”
A biological ‘fingerprint’ for trauma
At the University of British Columbia, a team working under the ASCEND-IPV initiative — Advocates, Academics, Survivors and Clinicians to End Intimate Partner Violence — is closing in on a solution. Cheryl Wellington, a professor of pathology and laboratory medicine, is among the researchers who published findings in BMJ Journals last autumn detailing their work. They analysed blood samples from 177 survivors, hunting for brain-related proteins. “These proteins are released when the brain is hurt, like crumbs left behind after damage, which leak into the blood,” Wellington explained. The challenge is immense. Brain proteins in blood “are very dilute; like needing to count a few grains of sugar in an Olympic-sized swimming pool,” she said.
But technology is advancing rapidly. UBC now hosts Canada’s largest and most comprehensive programme for detecting blood-based biomarkers for brain disorders. “We are creating a biological baseline of truth,” Wellington said. The research suggests about eight in ten of the women studied likely have some form of brain injury from abuse. The ambition is to build a blood-testing system for emergency departments so that when a survivor presents after an assault, clinicians can collect objective evidence that the brain is involved — something that simply does not happen today.
From the rink to the refuge: crossing scientific frontiers
Paul van Donkelaar, a UBC neuroscientist who studies concussions in hockey and football players, is applying the same tools to survivors. He tracks how repeated hits change brain function. “We started applying the same tests to survivors of IPV,” he said. “We see the same sorts of changes in brain function as in young athletes and sometimes even worse because of everything else that comes with living through violence.”
In sport, the culture has shifted from “shake it off” to “if in doubt, sit them out.” Coaches pull players for assessment after a hard hit. “With IPV, we’re only at that beginning stage,” van Donkelaar said. “People are finally recognising it’s happening, but now we need it written into policy and into health care and legal reforms so the brain injury is actually taken into account.”
The courtroom dilemma: evidence as a double-edged sword
The courts are beginning to take notice. In a landmark family law judgment this May, the Supreme Court of Canada created a new legal basis for people to seek damages for alleged intimate partner violence in relationships marked by coercive control. The decision could make it easier for survivors to win compensation in civil courts. Wellington believes the blood test could give the legal system something it has never had: objective proof that intimate partner violence injures the brain. “It is biological evidence that something has been done to this person to cause damage,” she said. “It’s kind of like the DNA of a brain injury, or an X-ray of a broken bone.”
But there is a trap. In custody disputes, a diagnosis of brain injury has been weaponised to argue cognitive unfitness — to suggest a mother cannot reliably recall events, manage a household, or protect her children. “In our society, no one questions an athlete’s cognitive integrity or their fitness as a parent simply because they’ve sustained a concussion on the field,” Wellington said. “Yet for a survivor of intimate partner violence, a brain injury is often weaponised against [women] in custody battles to suggest they are unstable or unfit.”
Karen Mason, advocate and co-founder of the non-profit Supporting Survivors of Abuse and Brain Injury through Research (SOAR), sees the diagnosis barrier as a game-changer. “While attitudes towards women who suffered brain injury from domestic violence are changing slowly, the efforts at a reliable diagnosis will be a game-changer for mothers embroiled in custody battles with their abusive partners.” She added: “One of the challenges that we’re seeing coming up is that barrier with diagnosis; the court wants a hard line doctor’s diagnosis, which is difficult to get.”
For survivors, Wellington said, a diagnosis changes several things at once. It gives women a biological explanation for symptoms too often dismissed. “There is a reason they might be a bit forgetful. It’s not just in their mind. There could be a biological basis that may be treatable or recoverable in some cases.” It would also open eligibility for support and rehabilitation programmes already used in concussion care, and for any new therapies developed down the road.
Wellington’s team wants every emergency room to perform blood tests for brain injury in suspected IPV cases, and every transition house to refer clients to medical and support services. But that requires “a massive shift in both funding and public consciousness.”
The double-edged sword is real. Evidence of brain injury, while unlocking treatment, could also be turned against mothers in custody battles — exactly what Sandborn feared. When van Donkelaar’s team asked family lawyers directly if a brain injury diagnosis could be used against a mother, the answer was unanimously yes. When asked if they would use it while acting for the alleged perpetrator, the answer was also yes. “They even said they felt awful saying it, but it’s just the reality of the system,” van Donkelaar said.
Sandborn eventually left the marriage. She kept her children, largely because during a later assault she reached her sister before her ex-husband seized the phone; her sister called the police. He received a conditional sentence. When his probation ended, his record disappeared — standard practice for conditional sentences treated as first offences. He continued working in his white-collar profession. “People don’t think that happens,” Sandborn said. “They think it happens in poverty. But it happens at all different levels of the community, different statuses, ethnicities and religious groups. It’s just everywhere.”
Why it Matters
A reliable blood test for brain injury would do more than advance science; it would rewrite the rules of evidence for thousands of Canadian women trapped between violence and a justice system that demands proof they cannot currently provide. It would validate symptoms survivors have been told are imagined, unlock rehabilitation pathways that currently exclude them, and place objective biological data before courts that have historically relied on subjective testimony. But as researchers and advocates warn, the same evidence that liberates could also be weaponised in family courts unless legal safeguards evolve in lockstep with the science. The breakthrough is not just medical — it is a test of whether Canada’s legal and healthcare systems are ready to protect the women they have long failed.