Office of Research & Development

VA research on

Homelessness


Introduction

Being homeless, or being at risk of homelessness, is one of the most difficult problems any Veteran can face.

In its 2017 Annual Homeless Assessment report to Congress, the U.S. Department of Housing and Urban Development reported that just over 40,000 Veterans were experiencing homelessness (including those living on the street or in a shelter, temporary safe haven, or any place unfit to reside in) on a given night in January 2017. Of those Veterans, 91 percent were men and 9 percent were women. That number stands in comparison to a total population of more than 18.5 million living Veterans. These numbers represent a 45 percent decline in Veteran homelessness between the years 2009–2017. 

VA is committed to ending homelessness among Veterans. The department's focus includes:

  • Conducting coordinated outreach to seek out Veterans in need of assistance.
  • Connecting homeless and at-risk Veterans with housing solutions, health care, community employment services, and other support.
  • Collaborating with federal, state, and local agencies; employers; housing providers; faith-based and community nonprofits; and other groups to expand employment and affordable housing options for Veterans leaving homelessness.

VA's National Center on Homelessness Among Veterans (NCHAV), established in 2009, works to promote recovery-oriented care for Veterans who are homeless or at risk for homelessness by developing and disseminating evidence-based policies, programs, and best practices.

In 2012, NCHAV helped establish Homeless Patient Aligned Care Teams (H-PACTs) at VA medical centers throughout the nation. H-PACT teams provide homeless Veterans with comprehensive, individualized care, including services that lead to permanent housing.

VHA offers many health care programs for homeless Veterans. The Domiciliary Care for Homeless Veterans program has been providing medical services to disadvantaged Veterans since the close of the Civil War.

VA's Health Care for Homeless Veterans program offers examinations treatment, referrals, and case management services to homeless Veterans at more than 135 locations.

The National Call Center for Homeless Veterans (1-877-4AID-VET) is staffed by trained responders providing support and resources to Veterans and their families who lack secure housing. Live chat with trained responders is available at the Veterans Crisis Line website.

A full listing of VA programs for Veterans at risk of homelessness and their families can be found here.

top

Selected Major Accomplishments

  • 1987: Initiated the Northeast Program Evaluation Center (NEPEC) to serve homeless Veterans
  • 1991: Established that, in Vietnam Veterans, there does not appear to be a causal relation between homelessness and military service, including exposure to combat
  • 2013: Determined there is an association between homelessness among Veterans and childhood problems such as abuse and family instability
  • 2015: Learned that 30 percent of female and 9 percent of male homeless Veterans have children in their custody
  • 2015: Found that Veterans who had been discharged from the military for misconduct had dramatically higher rates of homelessness than those who left under normal circumstances
  • 2016: Determined that Veterans who had undergone sexual trauma while in the military were more likely to experience homelessness
  • 2017: Found that Veterans' mental health and housing improved when they accessed free legal services in a VA facility

New, Ongoing, and Published Research

As part of its efforts to reduce homelessness among Veterans, VA is developing new research and is supporting ongoing work on health conditions and risk factors that relate to homelessness.

VA research on the topic looks at the causes and risks of homelessness among Veterans and ways to prevent Veterans from becoming homeless. Researchers help develop interventions to improve homeless Veterans' health and provide resources and training to those who work with them.

For more on Homelessness, visit our Women's Health topic page.

If you are interested in learning about joining a VA-sponsored clinical trial, visit our research study information page.

top

➤Risks of becoming homeless

Since 1987, VA's Northeast Program Evaluation Center (NEPEC), based in West Haven, Connecticut, has investigated a range of health issues and VA programs with a significant focus on mental health, including posttraumatic stress disorder (PTSD) and substance abuse. These issues often intertwine with homelessness.

No causal link between homelessness and combat—In 1991, NEPEC researchers found the proportion of homeless Veterans who had served in Vietnam and been exposed to combat was the same as among non-homeless Veterans. Based on this, the researchers concluded that there does not appear to be a causal relation between homelessness and military service, especially Vietnam service and exposure to combat.

Veterans at greater risk for homelessness than non-Veterans—According to a 2015 study by researchers with the VA Connecticut Health Care System and Yale University, both male and female Veterans are at greater risk for homelessness than their non-Veteran counterparts, although this disparity has declined over time. The disparity is most prominent among Veterans of the all-volunteer force—those who signed up for the armed services after July 1, 1973, when the draft was eliminated.

The researchers stated that Veterans appear to have many of the same major risk factors for homelessness as other adults, with the strongest and most consistent ones being substance abuse, severe mental illness, and low income.

They identified risk factors unique to Veterans such as problematic military discharges, low military pay grade, and social isolation after their discharge from the military. However, they noted that combat exposure and PTSD "do not seem to play a distinctively strong role in Veteran homelessness," and hypothesized this may be because Veterans with these issues have special access to VA services designed to meet their needs.

Veterans discharged for misconduct have higher homelessness rates—Researchers with VA's Salt Lake City Health Care System and NCHAV conducted a study published in 2015 indicating that Veterans who had been discharged from the military between 2001 and 2012 for misconduct had dramatically higher rates of homelessness than those who left under normal circumstances. Misconduct was defined as drugs, alcoholism, offenses, or infractions based on military separation codes.

The study looked at the 448,290 Iraq and Afghanistan Veterans who had used VA for care since their discharge. It found that 5.6 percent of those Veterans had been discharged for misconduct, usually drug or alcohol abuse—but that those patients accounted for 28.1 percent of those who became homeless within a year of their discharge.

Overall, 1 percent of VA patients were homeless at some point within a year of their discharge, but 5.4 percent of those discharged for misconduct fell in that category. Misconduct is defined as a discharge related to drugs, alcoholism, offenses against the military code of conduct, infractions of the law, and other misbehaviors.

According to the team, military misconduct may be a proxy indicator for a variety of risk factors associated with homelessness, including adverse deployment experiences, mental health issues, alcohol and substance abuse, post-deployment financial instability, and unemployment.

The team did not consider Veterans who received dishonorable discharges, which makes them ineligible for most VA health care services. In 2017, however, VA announced it would provide up to 90 days of urgent mental health care to Veterans with other than honorable or "bad paper" discharges. Later in 2017, the Department of Defense instructed the Army Review Boards Agency (the office charged with changing military records) to give "liberal consideration" to Veterans looking to upgrade their less-than-honorable discharges because of mental health conditions, traumatic brain injury, sexual assault, or sexual harassment.

The researchers suggest VA identify Veterans with misconduct-related separations at the time they leave the service, and provide them with case management and rehabilitative services during their transition to help keep them from becoming homeless.

Formerly incarcerated Veterans—New England MIRECC researchers conducted a study, published in 2013, that suggested incarceration was not a major barrier to exiting homelessness. The research team studied 14,557 Veterans who were part of the Housing and Urban Development-Veterans Affairs Supportive Housing program during 2008 and 2009, 65 percent of whom had been incarcerated in the past.

Overall, the researchers found that a history of incarceration did not appear to affect progression through the program, or a Veteran's chances of obtaining housing. Veterans with a history of incarceration were just as successful at obtaining hosing in similar time frames when compared with Veterans who had not been incarcerated in the past.

top

➤Homelessness and opioid addiction

Opioids are medications that relieve pain. Taken as prescribed, opioids can be used to manage pain safely and effectively. When abused, however, they can be dangerous. Even a single large dose can cause severe respiratory depression and death. Regular or longer-term use and abuse of opioids can lead to physical dependence, and in some cases addiction. VA medical centers nationwide have treatment programs for opioid addiction.

Homeless Veterans more likely to have opioid addiction—A research team led by VA's Center for Health Equity Research and Promotion and NCHAV found, in a study published in 2015, that 10.2 percent of the Veterans screened were homeless, and another 5.3 percent were at risk for homelessness—approximately 10 times the rate of the general Veteran population accessing VA care.

Compared with male Veterans, women Veterans were less likely to report homelessness (8.9 percent versus 10.3 percent), but more likely to be at risk (11.8 percent versus 4.9 percent.) By age group, Veterans aged 18-34 and 45-54 years most frequently reported homelessness (12.0 and 11.7 percent, respectively) and Veterans aged 45-54 and 55-64 years were most frequently at risk (6.5 and 6.8 percent, respectively.)

The team recommended that programs addressing Veteran homelessness engage with Veterans who are seeking treatment for addiction, and that the integration of homelessness services into addiction treatment settings may improve outcomes in both areas.

top

➤Trauma in homeless Veterans

Relationship of PTSD and anxiety disorders to homelessnessResearchers from the VA New England MIRECC and the Yale School of Medicine found in 2017 that 5.6 percent of more than 300,000 Veterans who had been referred to VA anxiety or PTSD clinics experienced homelessness within the one-year time period of the study. The homelessness rate for the entire Veteran population is about 3.7 percent over a five-year period. Veterans who were unmarried or diagnosed with a drug use disorder were more than twice as likely to become homeless as others.

top

➤Homelessness in women Veterans

From 2016 to 2017, the number of homeless female Veterans increased by 7 percent, compared to 1 percent for their male counterparts. In a 2016 report, NCHAV found that the number of women identified by the program as being homeless, or who were at high risk for becoming homeless and accessed VA programs to end homelessness among female Veterans, had tripled to 36,443 from 2010 to 2015. According to the center, that figure is projected to rise about 9 percent more by 2025, to nearly 40,000.

Factors leading to homelessness among women Veterans appear to be much different than for men, specifically on issues related to adverse childhood experiences, military sexual trauma, and intimate partner violence. Women also tend to be homeless with children, which presents major challenges.

Homeless Veterans with custody of minor children—A 2015 study by researchers with the VA Connecticut Health Care System and Yale University found that 30 percent of female and 9 percent of male homeless Veterans have children in their custody, raising concerns about the parenting environment for these children. Among Veterans with unstable housing, 45 percent of women and 18 percent of men had children in custody. Psychotic disorders were found in 11 percent of homeless Veterans with children in custody.

The researchers suggested that those who provide care for homeless Veterans need to consider the practical and ethical implications of serving homeless parents and their children, with a particular focus on VA's supported-housing program.

Homelessness linked to military sexual trauma—Veterans who had experienced military sexual trauma are at greater risk of homelessness, according to researchers at the VA Salt Lake City Health Care System and VA's National Center for PTSD. In 2016, the team found that 1.6 percent of Veterans who were exposed to sexual trauma during their service were homeless within 30 days of leaving the military. That rate went up to 4.4 percent within one year and was 9.6 percent after five years. That is double the rate for Veterans who had not experienced military sexual trauma.

The study also found that men who went through military sexual trauma experienced higher rates of homelessness than women who had similar experiences.

top

➤Housing First

Traditional housing options for homeless Veterans often require participants to be sober or to be taking part in treatment programs. This leaves many homeless Veterans unable to receive housing that might otherwise be available to them.

In 2011, VA began adopting the Housing First mode of care, which enables people who have not yet achieved sobriety or are still exhibiting symptoms of mental health problems to receive permanent housing through government-funded rental vouchers.

VA supported housing has positive impact on health care—VA's program of providing supported housing for homeless Veterans (HUD-VASH) offers them more than just a roof over their heads. It also provides them with case management by a social worker and referrals to primary care.

A 2016 study led by researchers from the VA Greater Los Angeles Health Care System found homeless Veterans in VA-supported housing were about twice as likely as other homeless Veterans to receive treatment for chronic and acute physical illness, mental illness, and substance use disorders. They were also more likely to have made two or more visits to VA facilities to treat their problems.

Another study of Veterans receiving supported housing, published in 2017 and led by researchers with the New England MIRECC and Yale University, looked at whether supported housing could improve the social networks of 460 formerly homeless Veterans. They found that over an 18-month period those in supportive housing improved their relationships with health care providers and other Veterans they met in treatment, but not with other Veterans they encountered in the places they were living.

Why Veterans are evicted from permanent supportive housing—Eviction from housing, especially supported housing, has a number of negative outcomes for homeless Veterans. In a study published in 2017, NCHAV researchers looked at 20,146 Veterans who left supported housing either because they were evicted or because they accomplished their goals.

They found Veterans with drug use disorders and those who received inpatient, emergency, or outpatient care for mental and behavioral health and substance use issues just before their eviction were at greater risk for eviction than others. Receiving outpatient care generally protected Veterans from eviction. The likelihood of eviction was greatest for Veterans who had received acute care 30 days or less before they were evicted. The researchers believe this information may help counselors to understand that they should intervene with these at-risk Veterans to keep them from eviction.

Implementing Housing First—In 2014, VA researchers from the Birmingham VA Medical Center and their colleagues published the results of a survey of nearly 100 VA employees who were directly involved in the Housing First program. They found that front-line staff faced challenges in housing homeless Veterans quickly because of difficult rental markets, the need to coordinate with local public housing authorities, and a lack of available funds for move-in costs.

They also found, however, that 80 to 90 percent of Veterans housed in this program were able to remain in that housing, keeping them out of hospitals, prison, or both.

Later in 2014, the team published another article showing that VA medical centers that had successfully implemented Housing First shared several significant characteristics.

The leaders of successful medical centers joined front-line staff in the work of finding acceptable housing; elevated people knowledgeable about homelessness into senior leadership positions; and worked to resolve logistical challenges.

They also helped ensure that work groups dealing with homelessness were properly aligned and integrated into their organizations. In addition, the commitment of staff members to ending homelessness was high in successful VA facilities.

In 2016, members of the research team wrote an editorial for the New England Journal of Medicine arguing that while the widespread implementation of Housing First would not generate cost savings, it was still a scientifically sound, economically reasonable, and ethical approach to addressing chronic homelessness.

top

➤Homeless Patient Aligned Care Teams

The H-PACT program was established in 2012 to provide a coordinated “medical home” specifically tailored to the needs of homeless Veterans. Interdisciplinary teams of doctors, nurses, and care managers respond to the ongoing and evolving medical, mental health, and substance abuse needs of homeless Veterans entering the VA system. The H-PACT care teams provide homeless Veterans with medical care, case management, and housing and social services assistance to help them obtain and stay in permanent housing, thereby reducing emergency department use and hospitalizations and improving chronic disease management.

Developing H-PACTs—A 2010 Providence VA Medical Center study found that tailoring primary care to homeless Veterans decreased unnecessary emergency department use and hospital admissions, and also improved chronic disease management. The researchers compared homeless Veterans enrolled in a new population-tailored primary care clinic with a historical sample of patients. Those in the new program had greater improvements in hypertension, diabetes, and lipid control during the first six months. Hospital admissions were also significantly lower for patients in the program.

A 2011 study by the same research group looked at applying the patient-centered medical home primary care approach to homeless Veterans, as well as to cognitively impaired elderly, women Veterans, and patients with serious mental illness. The hope was that tailoring care to specific population-based needs would lead to better treatment. The study found that patients in tailored program had significant increases in primary care use and improvements in chronic disease monitoring and diabetes control.

These and similar studies led to the development and implementation of the H-PACT program in VA.

Clinical care’s link to stable housing—Engagement in clinical medical care can lead to housing stability for homeless Veterans, according to a 2017 study by the VA National Center on Homelessness Among Veterans. The study found that patients who accessed primary care were more likely to find stable housing than those who did not. Patients who accessed primary medical care within one month of the beginning of the study found stable housing after an average of 85 days. Those who did not use primary medical care had an average of 166 days before they found stable housing. Eighty-nine percent of homeless Veterans in the study receiving primary care found stable shelter within six months.

Tailored primary care teams lead to better care satisfaction—Homeless Veterans at VHA facilities with tailored primary care teams had better care experiences than non-homeless Veterans, according to a 2018 National Center on Homelessness Among Veterans study. Researchers surveyed more than 340,000 Veterans receiving care through VHA nationwide. About 4 percent were homeless. In facilities without homeless-tailored teams, homeless patients had more negative and fewer positive experiences than non-homeless patients. In facilities with H-PACTs, this pattern was reversed. H-PACTs appear to offer homeless Veterans a better primary care experience than that received by non-homeless Veterans.

top

➤New ways to reach homeless Veterans

VA is conducting an ongoing project looking at ways to increase homeless Veterans' access to care. The project, led by an NCHAV researcher, is looking at feasible, innovative solutions to the poor health outcomes of homeless Veterans by bridging the gaps that sometimes exist between them and their VA providers.

Peer mentors can play important roles in homeless Veterans' lives—In 2017, researchers from VA's Palo Alto Health Care System and NCHAV published the results a study in which 375 homeless Veterans were assigned either to a formerly homeless Veteran acting as a peer mentor or to usual care, in hopes the peer mentor would help the homeless Veteran increase the number of times he or she engaged with VA health care. The study showed no statistically significant difference in primary care visits between the two groups, but did find that some of the Veterans significantly engaged with the mentors assigned to them.

Another study from 2017 by the same team found that 83 percent of Veterans assigned a peer mentor felt they had benefited from the relationship. Those who benefited most had more peer visits, were more likely to be from a minority group, and were less likely to have PTSD.

A third study from the group, published in 2018, explored the reasons Veterans with PTSD did not benefit as much from peer mentoring and found that "disconnectedness" from society many Veterans with PTSD feel may be what is interfering with their capacity to be helped. Veterans who said they felt like "outsiders" to society, but did not feel disconnected from others, however, were able to benefit significantly from peer mentors.

Integrating legal aid with medical care improves mental health and housing—A study by NCHAV, published in 2017, found that Veterans' mental health and housing improved when they accessed free legal services in a VA facility. The study analyzed legal and medical partnerships between the Connecticut Veterans Legal Center and the VA Connecticut Healthcare System, and between New York Legal Assistance and two VA hospitals.

Researchers looked at the free legal help that was given to 950 Veterans from 2014 through 2016. The team found that the more legal services the Veterans received, the better they fared. Many experienced reduced symptoms of PTSD and psychosis, spent less money on abusive substances, and had better housing situations—even if they lost their legal battles. Their income improved from being able to access more VA benefits, but not from employment, according to the research team.

Many homeless Veterans have negative experiences with primary care—In a large national survey of Veterans with mental health or substance use disorders, homeless Veterans reported more negative experiences with comprehensive care, communication, care coordination, medical decision-making, and self-management support than non-homeless Veterans. Results of the survey were published in 2017. The study was led by researchers with the VA Pittsburgh Healthcare System.

These experiences may make homeless Veterans more likely to avoid mental health and substance use treatment, according to the research team. They conclude that homeless Veterans may need more specific services aimed at encouraging them to continue with primary care services.

Homeless Veterans and mobile phones—Many people living on the streets prioritize having a mobile phone, to give them an identity and a way of communicating with the world. In a study completed in 2014 by VA's Center for Healthcare Organization and Implementation Research in Bedford, Massachusetts, researchers interviewed 106 Veterans in a variety of homeless programs in Massachusetts.

The team found that 89 percent of those surveyed owned a mobile phone, and 76 percent used the internet. Of those who owned a mobile phone, 71 percent said they used text messaging.

Of those with phones, 93 percent were interested in receiving either text messages or phone calls about upcoming medical appointments, and 88 percent wanted to be asked by phone if they would like to schedule an appointment if they had not been seen by a health care provider in over a year.

The findings suggest new avenues to communicate with and intervene on behalf of homeless Veterans.

Americans have become more compassionate toward the homeless—A team led by a researcher from the New England Mental Illness Research Education Clinical Center of Excellence (MIRECC) surveyed the attitudes of 541 adults in November 2016 about homelessness and compared the results to surveys conducted in 1990. The new survey showed people have more compassion and liberal attitudes about homelessness than they did 25 years before.

The largest changes were related to increased support for homeless individuals using public spaces for sleeping and panhandling. The increased public support for homeless individuals shown in the 2016 study presents new opportunities for addressing homelessness through legislation and public health initiatives, according to the research team.

Re-Engage program—Homelessness disproportionately affects Veterans with serious mental illness, such as schizophrenia and bipolar disorder. Many Veterans with serious mental illness are at risk of homelessness because of substance use, unstable employment, and incarceration. Moreover, Veterans with serious mental illness who drop out of VA care are more likely to die than those engaged in VA care. In a landmark quality improvement study, the VA Office of the Medical Inspector and Mental Health Services implemented the Re-Engage program in 2012 to facilitate access to services among Veterans with serious mental illness who had dropped out of VA care. The program led to the majority of Veterans with serious mental illness returning to care and was associated with a subsequent 12-fold decreased risk of mortality compared to Veterans who were not brought back to care.

A 2015 study by VA Ann Arbor Healthcare System researchers found that an enhanced implementation strategy led to better results for the Re-Engage program. Mental health providers at 158 VA facilities were given manuals and training in Re-Engage. The training involved identifying Veterans who had not been seen in VA care for at least one year, documenting clinical status, and reaching out to coordinate health care. After six months, facilities that had not effectively implemented Re-Engage were given additional help. This help included coaching of staff and weekly calls to address barriers to care. Facilities that received the enhanced coordination had better rates of re-engagement of Veterans compared with those using standard implementation.

top

➤Homeless Veterans and HIV

Homeless Veterans are at least three times more likely than the rest of the U.S. population to be infected with HIV, the virus that causes AIDS. A study led by researchers at the VA Greater Los Angeles Healthcare System, published in 2015, looked at a new way to identify Veterans with HIV and get them quickly into treatment programs.

Because traditional HIV testing involves several appointments at health care facilities, including taking the test, receiving the results, and receiving counseling and links to care if the results are positive, this kind of testing is neither practical nor feasible for a highly transient population of homeless individuals.

Instead, the research team, along with counselors from two municipal offices, repeatedly visited three Los Angeles shelters to provide AIDS testing, results, and follow-up if necessary to Veterans and other residents.

The team tested 817 shelter residents, 37 of whom were Veterans. None of the Veterans had HIV; seven of the other residents' tests came back positive, and five of them were linked to care.

The cost of the screening program was $48.95 per client, and the team believes that given the high costs and health risks of untreated HIV infection, the program is cost-effective, and could have a "massive" effect on reducing HIV rates among homeless Veterans and others.

top

➤Dental care

The dental needs of homeless Veterans are well-documented. In surveys listing and ranking the 10 highest unmet needs for homeless Veterans, dental care is consistently ranked by homeless Veterans as one of their top three unmet needs, along with long-term permanent housing and child care.

Dental problems such as pain and missing teeth can be tremendous barriers to looking for and finding work. VA's Homeless Veterans Dental Program provides dental treatment for eligible Veterans in a number of programs, including domiciliary residential rehabilitation treatment and compensated work therapy/transitional residence programs.

Dental care improves several outcomes—A December 2013 study looked at the impact of dental care on homeless Veterans who had been discharged from a VA transitional housing intervention program. The research team for the study included researchers with VA's national Office of Dentistry; NCHAV; and the Fayetteville, Arkansas, and Bedford, Massachusetts, VA medical centers.

The study cohort included 9,870 Veterans, of whom 4,482 received dental care during the program. Veterans who received dental care were 30 percent more likely to complete the intervention program; 14 percent more likely to be employed or financially stable; and 15 percent more likely to have found residential housing.

More on Our Website

top

Selected Scientific Articles by Our Researchers

Differences in experiences with care between homeless and non-homeless patients in Veterans Affairs facilities with tailored and nontailored primary care teams. Jones AL, Hausmann LRM, Kertesz S, Suo Y, Cashy JP, Mor MK, Schaefer JH Jr, Gundlapalli AV, Gordon AJ. VA facilities with H-PACT programs appear to offer a better primary care experience for homeless versus nonhomeless Veterans, reversing the pattern of relatively poor primary care experiences often associated with homelessness. Med Care. 2018 Jul;56(7):610-618.

Posttraumatic stress disorder and interpersonal process in homeless Veterans participating in a peer monitoring intervention: associations with program benefit. Van Voorhees EE, Resnik L, Johnson E, O'Toole T. Disruption to the capacity to develop and maintain social bonds in PTSD may interfere with the capacity to benefit from peer mentorship. Psychol Serv. 2018 Jan 25. (epub ahead of print)

Changes in public attitudes and perceptions about homelessness between 1990 and 2016. Tsai J, Lee CYS, Byrne T, Petrzak RH, Southwick SM. There has been an increase in compassion and liberal attitudes toward homelessness in the past two decades. Am J Community Psychol. 2017 Dec;60(3-4):599-606

Medical-legal partnerships at Veterans Affairs Medical Centers improved housing and psychosocial outcomes for Vets. Tsai J, Middleton M, Villegas J, Johnson C, Retkin R, Seidman A, Sherman S, Rosenheck RA. Medical-legal partnerships represent an opportunity to expand cross-sector, community-based partnership in the VA health care system to address social determinants of mental health. Health Aff (Millwood). 2017 Dec;36(12):2195-2203

Which homeless Veterans benefit from a peer mentor and how? Resnik L, Ekerholm S, Johnson EE, Ellison ML, O'Toole TP. The majority of Veteran participants in this study benefited from receiving peer mentor intervention. J Clin Psychol. 2017 Sep;73(9):1027-1047

Homeless Veterans' use of peer mentors and effects on costs and utilization in VA clinics. Yoon J, Lo J, Gehlert E, Johnson EE, O'Toole TP. Significant impacts of peer mentors on health care patterns were not detected, but some patients had frequent contact with peer mentors. Psychiatr Serv. 2017 Jun 1;68(6):628-631

One-year incidence and predictors of homeless among 300,000 U.S. Veterans seen in specialty mental care. Tsai J, Hoff RA, Harpaz-Rotem I. A notable and important percentage of Veterans seen in VA specialty mental health clinics newly experience homelessness annually. Psychol Serv. 2017 May;14(2):203-207

A national evaluation of homeless and nonhomeless Veterans' experiences with primary care. Jones AL, Hausmann LRM, Haas GL, Mor MK, Cashy JP, Shaefer JH, Gordon AJ. Homeless persons with mental health substance use disorders may need specific services that mitigate negative care experiences and encourage their continuing to receive primary care services. Psychol Serv. 2017 May;14(2):174-183

Providing intensive addiction/housing case management to homeless Veteran enrolled in addictions treatment: a randomized controlled trial. Malte CA, Cox K, Saxon AJ. Intensive addiction and housing case management did not demonstrate benefits beyond standard VA housing and substance use care. Psychol Addict Behav. 2017 May;31(3):231-241

Factors contributing to eviction from permanent supportive housing: lessons from HUD-VASH. Montgomery AE, Cusack M, Szymkowiak D, Fargo J, O'Toole T. Veterans with a drug use disorder and those who received inpatient, emergency, or outpatient care related to mental/behavioral health and substance use conditions near the time of their eviction were most likely to be evicted from supported housing. Eval Program Plann. 2017 Apr;61:55-63

Impact of supported housing on social relationships among homeless Veterans. O'Connell MJ, Kasprow WJ, Rosenheck RJ. Supported housing may play a pivotal role in fostering constructive new relationships with persons associated with service programs but may have a more limited impact on natural support networks. Psychiatr Serv. 2017 Feb 1;68(2):203-206

Permanent supportive housing for homeless people - reframing the debate. Kertesz SG, Baggett TP, O'Connell JJ, Buck DS, Kushel MB. While the widespread implementation of Housing First will not generate net savings, it is a scientifically sound, economically reasonable, and ethical approach to addressing chronic homelessness. N Engl J Med. 2016 Dec 1:375(22):2115-2117

Diagnoses treated in ambulatory care among homeless-experienced Veterans: does supported housing matter? Gabrielian S, Yuan AH, Andersen RM, Gelberg L. Among homeless-experienced Veterans, permanent supported housing may reduce disparities in the treatment of diagnoses commonly seen in ambulatory care. J Prim Care Community Health. 2016 Oct;7(4):281-7

Differential risk for homelessness among U.S. male and female Veterans with a positive screen for military sexual trauma. Brignone E, Gundiapalli AV, Blais RK, Carter ME, Suo Y, Samore MH, Kimerling R, Fargo JD. A positive screen for military sexual trauma was independently associated with postdeployment homelessness, with male Veterans at greater risk than female Veterans. JAMA Psychiatry. 2016 Jun 1;73(6):582-9

Risk factors for homelessness among US Veterans. Tsai J, Rosenheck RA. A systematic review summarizing research on risk factors for homelessness among U.S. Veterans, evaluating the evidence for these risk factors. Epidemiol Rev. 2015:37:177-95

Military sexual trauma among homeless Veterans. Pavao J, Turchik JA, Hyun JK, Karpenko J, Saweikis M, McCutcheon S, Kane V, Kimerling R. In a national sample of female and male homeless VHA users, the prevalence of military sexual trauma among homeless VHA users was higher than the prevalence of such trauma among all VHA users. J Gen Intern Med. July 2013;28(Suppl 2):536-541

top

Homelessness Fact Sheet

fact sheet thumbnail

Download PDF

VA and other U.S. Government Online Resources

Homeless Veterans, U.S. Department of Veterans Affairs

VA programs for homeless Veterans, U.S. Department of Veterans Affairs

Homeless Resources: Veterans Crisis Line, U.S. Department of Veterans Affairs

Homeless Veterans benefits fact sheet, U.S. Department of Veterans Affairs

Homeless Veterans: upcoming events and stand downs, U.S. Department of Veterans Affairs

Homeless Veterans: housing assistance, U.S. Department of Veterans Affairs

Housing help for Veterans, USA.gov

HUD-VASH Exit Study—Final Report, US Department of Housing and Urban Development

Homeless Veterans Reintegration Project, U.S. Department of Labor

HUD-VASH Vouchers, U.S. Department of Housing and Urban Development


Questions about the R&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.