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Homeless Veterans and Mental Health

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Veteran Psychiatry in the US

Abstract

Veterans are more likely than the general civilian population to become homeless (Veteran homelessness: a supplemental report to the annual homeless assessment report to Congress, US Department of Housing and Urban Development and the US Department of Veterans’ Affairs, 2009). While veterans represent 8% of the US population, in 2010, 17% of the homeless were veterans. Nearly 50% of homeless veterans experience mental illness, and two-thirds meet the criteria for substance use disorders (National Survey of Homeless Veterans in 100,000 Homes Campaign Communities, 100,000 Homes, November 2011). Additionally, veterans on average spend nearly 6 years homeless, compared with 4 years for non- veterans. This chapter will summarize the mental health challenges of working with homeless veterans, as well as the initiatives that have recently been implemented to reduce homeless, prevent loss of housing, and address the risk factors associated with veteran homelessness.

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References

  1. Llorente MD, Morton K, Boughton S, Crawford PA. A real welcome home: permanent housing for homeless veterans. Fed Pract. 2016;33(5):26–31.

    Google Scholar 

  2. Estrine S. Service delivery for vulnerable populations: new directions in behavioral health [e-book]. New York: Springer Publishing Company; 2011.

    Google Scholar 

  3. National Alliance to End Homelessness. Veteran homelessness. 2015. Available at: https://endhomelessness.org/resource/veteran-homelessness/. Accessed 7 April 2018.

  4. US Department of Housing and Urban Development and the US Department of Veterans’ Affairs. Veteran homelessness: a supplemental report to the annual homeless assessment report to Congress. 2009. Available at: https://www.va.gov/homeless/docs/2010aharveteransreport.pdf. Accessed 7 April 2018.

  5. U.S. Department of Veterans Affairs. Office of Mental Health and Suicide Prevention (OMHSP). Facts About Veteran Suicide: August 2017. https://www.mentalhealth.va.gov/docs/VA-Suicide-Prevention-Fact-Sheet.pdf. Revised August 2017. Accessed 23 Feb 2018.

  6. Gamache G, Rosenheck R, Tessler R. Overrepresentation of women veterans among homeless women. Am J Public Health. 2003;93(7):1132–6.

    Google Scholar 

  7. 100,000 Homes Campaign. National Survey of Homeless Veterans in 100,000 Homes Campaign Communities. November 2011. Available at: https://www.va.gov/homeless/docs/nationalsurveyofhomelessveterans_final.pdf. Accessed 7 April 2018.

  8. Kasprow WJ, Cuerdon T, DiLella D, et al. Health care for homeless veterans programs: twenty-third annual report. West Haven: Department of Veterans Affairs; 2010.

    Google Scholar 

  9. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: American Psychiatric Association.; 2013.

    Book  Google Scholar 

  10. Schell TL, Marshall GN. Survey of individuals previously deployed for OEF/OIF. In: Tanielian T, Jaycox LH, editors. Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica: RAND Corporation; 2008. p. 87–115.

    Google Scholar 

  11. Rosenheck R, Frisman L, Chung AM. The proportion of veterans among homeless men. Am J Public Health. 1994;84(3):466–9.

    Article  CAS  Google Scholar 

  12. Tsai J, Rosenheck RA. Risk factors for homelessness among US veterans. Epidemiol Rev. 2015;37(1):177–95.

    Article  Google Scholar 

  13. Shepherd-Banigan M, Goldstein K, Fecteau T, et al. Paternal history of mental illness associated with posttraumatic stress disorder among veterans. Psychiatry Res. 2017;256:461–8.

    Article  Google Scholar 

  14. Mares A, Rosenheck R. Perceived relationship between military service and homelessness among homeless veterans with mental illness. J Nerv Ment Dis. 2004;192(10):715–9.

    Article  Google Scholar 

  15. Bossarte RM, Blosnich JR, Piegari RI, et al. Housing instability and mental distress among US veterans. Am J Public Health. 2013;103:S213–6.

    Article  Google Scholar 

  16. Schinka JA, Schinka KC, Casey RJ, et al. Suicidal behavior in a national sample of older homeless veterans. Am J Public Health. 2012;102:S147–53.

    Article  Google Scholar 

  17. Goldstein G, Luther J, Haas G. Medical, psychiatric and demographic factors associated with suicidal behavior in homeless veterans. Psychiatry Res. 2012;199:37–43.

    Article  Google Scholar 

  18. Birgenheir D, Zongshan L, Kilbourne A. Trends in mortality among homeless VA patients with severe mental illness. Psychiatr Serv. 2013;64(7):608.

    Article  Google Scholar 

  19. Kasprow W, Rosenheck R. Mortality among homeless and nonhomeless mentally ill veterans. J Nerv Ment Dis. 2000;188(3):141–7.

    Article  CAS  Google Scholar 

  20. Leda C, Rosenheck R, Gallup P. Mental illness among homeless female veterans. Hosp Community Psychiatry. 1992;43(10):1026–8.

    CAS  PubMed  Google Scholar 

  21. Baum N, Rahav G, Sharon M. Heightened susceptibility to secondary traumatization: a meta-analysis of gender differences. Am J Orthopsychiatry. 2014;84:111–22.

    Article  Google Scholar 

  22. Coumans M, Spreen M. Drug use and the role of homelessness in the process of marginalization. Subst Use Misuse. 2003;38:311–38.

    Article  Google Scholar 

  23. Devine JA, Wright JD. Losing the housing game: the leveling effects of substance abuse. Am J Orthopsychiatry. 1997;67:618–31.

    Article  CAS  Google Scholar 

  24. Zlotnick C, Tam T, Robertson MJ. Disaffiliation, substance use, and exiting homelessness. Subst Use Misuse. 2003;38:577–99.

    Article  Google Scholar 

  25. Tsai J, Rosenheck RA. Risk factors for ED use among homeless veterans. Am J Emerg Med. 2013;31:855–8.

    Article  Google Scholar 

  26. Hoge CW, Castro CA, Messer SC, et al. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004;351:13–22.

    Article  CAS  Google Scholar 

  27. Desai M, Rosenheck R, Kasprow W. Determinants of receipt of ambulatory medical care in a national sample of mentally ill homeless veterans. Med Care. 2003;41(2):275–87.

    PubMed  Google Scholar 

  28. Weissman E, Covell N, Kushner M, Irwin J, Essock S. Implementing peer-assisted case management to help homeless veterans with mental illness transition to independent housing. Community Ment Health J. 2005;41(3):267–76.

    Article  Google Scholar 

  29. Hermes E, Rosenheck R. Psychopharmacologic services for homeless veterans: comparing psychotropic prescription fills among homeless and non-homeless veterans with serious mental illness. Community Ment Health J. 2016;52(2):142–7.

    Article  Google Scholar 

  30. Rosenheck R, Lam JA. Client and site characteristics as barriers to service use by homeless persons with serious mental illness. Psychiatr Serv. 1997;48(3):387–90.

    Article  CAS  Google Scholar 

  31. Tsai J, Middleton M, Rosenheck R, et al. Medical-legal partnerships at veterans affairs medical centers improved housing and psychosocial outcomes for vets. Health Aff. 2017;36(12):2195–203.

    Article  Google Scholar 

  32. Harpaz-Rotem I, Rosenheck R, Desai R. Residential treatment for homeless female veterans with psychiatric and substance use disorders: effect on 1-year clinical outcomes. J Rehabil Res Dev. 2011;48(8):891–9.

    Article  Google Scholar 

  33. Department of Veterans Affairs Office of Inspector General. Homeless incidence and risk factors for becoming homeless in veterans. Report No. 11–03428-173. May 2012. https://www.va.gov/oig/pubs/VAOIG-11-03428-173.pdf.

  34. USICH. Opening Doors. 2015. Available at: https://www.usich.gov/opening-doors Accessed 7 April 2018.

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Correspondence to Kaitlin Slaven .

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Slaven, K., Llorente, M.D. (2019). Homeless Veterans and Mental Health. In: Ritchie, E., Llorente, M. (eds) Veteran Psychiatry in the US. Springer, Cham. https://doi.org/10.1007/978-3-030-05384-0_15

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  • DOI: https://doi.org/10.1007/978-3-030-05384-0_15

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