Veterans discharged for misconduct have higher risk of homelessness

Poor mental health, PTSD, brain injuries, addiction problems common

(Reuters Health) — U.S. veterans returning from Afghanistan and Iraq who were discharged due to misconduct are more likely to be homeless than other returning vets, according to a new study.

"The most significant finding was that 26 per cent of veterans who were separated for misconduct-related reasons were homeless at their first VA encounter; and this number climbed to 28 per cent within one year after their first VA encounter," said lead author Dr. Adi V. Gundlapalli of the VA Salt Lake City Health Care System.

"Collectively, these results represent the strongest risk factor for homelessness among U.S. veterans observed to date, and may help to explain the higher risk of homelessness observed among veterans, despite access to VA benefits and services," Gundlapalli told Reuters Health by email.

The researchers used data on 448,290 U.S. active-duty military service members who were separated from the military between 2001 and 2011, deployed in Afghanistan or Iraq, and who subsequently used Veterans Health Administration services.

Service members who separate from the military have Department of Defense codes attributing the separation to misconduct including drugs, alcoholism, offenses and infraction, disability, early release, disqualified, normal, or unknown.

Almost 25,000 of the people in the database had been separated for misconduct, less than six per cent of the total group.

Within five years, 3,441 people had become homeless, accounting for about two per cent of the total sample.

At the five-year point, almost 10 per cent of the veterans discharged for misconduct were homeless, compared to less than two percent of those coded as "normal" separation, the researchers reported August 25 in JAMA.

Military discharge and subsequent transition to civilian living has long been associated with homelessness and poor mental health, according to James Taylor, a lecturer at the School of Health Sciences at the University of Stirling in the Scotland.

"The symptoms of poor mental health, for example, can manifest as, or be a reason for, perceived misconduct," Taylor, who was not part of the new study, told Reuters Health by email.

Poor mental health, posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), alcohol or drug problems might all be involved in misconduct and risk of homelessness, he said.

According to Taylor, the key to addressing veteran homelessness is to "ensure a successful transition from military service back to civilian living, where there are good social contacts and networks (not all military based), strong marital and family support, access to work and meaningful employment."

The VA has many active programs in place to identify veterans at risk and offer them appropriate services, including alcohol or substance abuse treatment, mental health disorder management, case management, and housing services, Gundlapalli said.

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