Needs Assessment of Homeless Veterans: Making Housing Last

DESCRIPTION OF PROBLEM. Veterans are over-represented in the homeless population. However, profiles of homeless veterans are not fully understood. More clarity about factors linked to chronic homelessness can facilitate a better transition to stable, permanent housing. Recent service models emphasize a “housing first” model where transition to stable housing begins with housing, followed with a focus on supportive services. What are the needs of homeless veterans? Can needs be considered similarly across key individual, health/mental health, legal issues, or military experience? Younger veterans are at greater risk for severe/persistent mental illness (eg PTSD). Developmentally, transitions to stable housing & employment include career training/education. For older veterans, this transition may not emphasize job training but rather medical issues linked with older age.

STUDY OBJECTIVES & RESEARCH QUESTIONS. The study objective was to understand the differences and similarities for homeless veterans who served in Vietnam, peacetime, Gulf or Iraq/Afghanistan with respect to the ability to transition into stable housing. Specific research questions include: (1) What factors are linked with longer periods of stay at a homeless shelter, i.e., individual, health/mental health, substance abuse, physical disability, military experience or legal issues? (2) Are these factors consistent across different eras?

METHODS. A record review (N=245) was conducted in April 2010 at a large homeless shelter located in a large urban area in the eastern U.S . Data collected included information on demographic, military experience, substance abuse and mental health issues. Most were men (98.4%); almost two-thirds (61.8%) were high school graduates/attended some college; most were single or divorced (81.7%). Age was linked with period of service (F=68.98; p<.001), with three significantly different average groups: Vietnam veterans (56), peacetime/Gulf veterans (50/46) and Iraqi/Afghanistan veterans (34). 80% of residents were receiving case management (41.1%), substance abuse/mental health services (22%), or services to support transitional housing (17%). Most who participated in the detox/stabilization program were Iraqi/Afghanistan veterans.

RESULTS. Residency ranged from 1 day to over 3 years. Serving in Vietnam was significantly associated with longer stays (F=2.88;p<.05); exposure to combat was not linked. Being convicted of a sex offense was also linked (F=11.63;<.001). This was consistent across different eras. Having chronic alcohol/drug problem was related (F=4.43; p<.05). Physical disabilities were (F=3.25; p<.05). The impact of physical disability was consistent across different eras. Age was weakly correlated (r=.2; p<.01), thus age alone is not the critical factor to consider.

CONCLUSIONS & IMPLICATIONS. Findings indicated that homeless veterans are not a homogenous group. Iraqi/Afghanistan veterans in this center were likely to need detox/stabilization services before they could turn to a focus on stable, permanent housing. Vietnam veterans had significantly longer stays, however further research is needed since the correlation between age & serving in Vietnam was weak. With the increased availability of permanent housing (eg VASH, Housing First models), consideration must be given to what supportive services are needed as veterans transition to independent housing situations. Recommendations are given regarding “housing readiness” principles to follow as veterans prepare to leave the supportive environment of a veterans homeless shelter.