Wikipedia

Homeless veterans in the United States

Homeless veterans are persons who have served in the armed forces who are homeless or living without access to secure and appropriate accommodation.[1]

Background

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Many of these veterans suffer from post traumatic stress disorder, an anxiety disorder that often occurs after extreme emotional trauma involving threat or injury. Causes of homelessness include:[2]

Demographics

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Veteran homelessness in America is not a phenomenon only of the 21st century; as early as the Reconstruction Era, homeless veterans were among the general homeless population.[3] In 1932, homeless veterans were part of the Bonus Army.[4] In 1934, there were as many as a quarter million veterans living on the streets.[5] During the Truman Administration, there were one hundred thousand homeless veterans in Chicago, and a quarter of that number in Washington, D.C.[6] In 1987, the number of homeless veterans was as high as three hundred thousand.[7]

Estimates of the homeless population vary as these statistics are very difficult to obtain.[8] In 2007, the first veterans of Operation Enduring Freedom - Afghanistan and Operation Iraqi Freedom began to be documented in homeless shelters.[9] By 2009 there were 154,000 homeless, with slightly less than half having served in South Vietnam.[10] According to the VA in 2011, veterans made up 14% of homeless adult males, and 2% of homeless adult females, and both groups were overrepresented within the homeless population compared to the general population.[11] The overall count in 2012 showed 62,619 homeless veterans in the United States.[12] In January 2013, there were an estimated 57,849 homeless veterans in the U.S., or 12% of the homeless population.[13] Just under 8% were female.[14] In July 2014, the largest population of homeless veterans lived in Los Angeles County, with there being over 6,000 homeless veterans, out of the total estimated 54,000 homeless within that area.[15] In 2015, a report issued by HUD counted over 47,000 homeless veterans nationwide, the majority of whom were White and male.[16] In 2016, there were over 39,000 homeless veterans nationwide.[17] A Corps in terms of military size. As of January 2017, the state of California had the highest number of veterans experiencing homelessness. There were an estimated 11,472 homeless veterans.[18] The biggest population of homeless veterans, after California, in 2017 lived in Florida - an estimated 2,817, and in Texas - 2,200.

Aid

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Many programs and resources have been implemented across the United States in an effort to help homeless veterans.[19]

HUD-VASH, a housing voucher program by the United States Department of Housing and Urban Development and Veterans Administration, gives out a certain number of Section 8 subsidized housing vouchers to eligible homeless and otherwise vulnerable U.S. Armed Forces veterans.[20]

Historical

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In 1887, the Sawtelle Veterans Home was constructed to care for disabled veterans, and housed more than a thousand homeless veterans.[21] Other such old soldiers' homes were built throughout the United States,[22] such as the one in New York.[23] These homes became the predecessors of the Veteran Affairs' medical facilities.[24]

Risk factors

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According to a study in 2014, veterans are slightly more likely than non-veterans to be homeless; 9.7% of the general population are veterans, but 12.3% of the homeless population are veterans.[25] These risk factors were found by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This is the first systemic review to summarize research on risk factors for US veterans experiencing homelessness. They evaluated thirty-one studies from 1987 through 2014. The risk factors that are most common among this population are substance abuse disorders and poor mental health, followed by low income and other income related issues, a lack of support from family and friends, or weak social networks.[25]

Supportive housing for veterans compared to non-veterans

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The needs between veterans and non-veterans experiencing homelessness can differ. A study was implemented by the Collaborative Initiative to Help End Chronic Homelessness (CICH) in 2004 by the Interagency Council on Homelessness. They used eleven sites around the United States tracked data for one year by comparing 162 chronically homeless veterans to 388 chronically homeless non-veterans.[25]

Both groups were enrolled in a national supported housing initiative over a one-year period and several differences were noted. The first was that the veterans tended to be from an older age group, identified as male, and were more likely to have completed high school.[25] While in enrolled in supported housing, the mental health of both groups improved through mental health services offered. However, veterans were reported to make greater use of the outpatient mental health services compared to non-veterans. Both groups also gradually reduced the use of health services once housing was obtained, therefore, this suggests that the program is effective in reducing clinical needs among chronically homeless of adults in general.

Department of Veterans Affairs

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On November 3, 2009, United States Secretary Eric K. Shinseki spoke at the National Summit on Homeless Veterans and announced his plan.[undue weight? – discuss]

Along with President Barack Obama, Shinseki outlined a comprehensive five-year plan to strengthen the Department of Veterans Affairs and its efforts to end veteran homeless.[26] The goal was to end veteran homelessness by 2015, but because of budget constraints that has now been pushed to 2017.[27] The plan focused on prevention of homelessness along with help for those living on the streets.[28] The plan would expand mental health care and housing options for veterans, and would collaborate with:[28]

The prominent role of the Department of Veterans Affairs and its joined up approach to veteran welfare help to distinguish the US response to veteran homelessness internationally.[29] In 2009, a hotline was established to assist homeless veterans. As of December 2014, of the 79,500 veterans who contacted the call center, 27% were unable to speak to a counselor, and 47% of referrals led to no support services provided to the homeless veteran.[30]

A study published in the American Journal of Addiction showed a link between veterans' trauma of mental disorders and their substance abuse.[31]

Housing interventions with veterans

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A study conducted by O’Connell, Kasprow and Rosenheck is a secondary analysis of data from the evaluation of the HUD-VASH initiative that began in 1992 to provide housing for veterans with psychiatric disorders. They compared the results of three kinds of interventions with 460 veterans across nineteen sites in the country. They were assigned to three groups; one group was given a voucher and intensive case management, one group was given intensive case management only, and one group was given standard care only.[32] Intensive case management included help locating an apartment, while standard care which consisted of short-term broker case management provided by the Health Care for Homeless Veterans outreach workers. An evaluation assistant conducted follow up interviews every three months for up to five years. Through that they found that individuals in the intensive case management group had lower scores on quality of life which was measured by the Lehman Quality of Life Interview. This is a structured questionnaire to assess the life circumstances of persons with severe and persistent mental illness.[33]

Housing failure is defined as experiencing homelessness for at least one day. Before intake, 43% (n=170) has been homeless between one and six months and 27% (n=105) has experienced homelessness for two years or more.[32] The risk factors are the greatest in the first few months of being housed due to the more structured and supervised setting. Weekly face to face contact, community-based care and services offered by the VA were encouraged, which is vastly different from the life they were used to before this program. The veterans were tracked for five years and the statistics changed vastly over that time. 72% of participants remained housed after one year (N=282), 60% after two (N=235), 52% after three (N=204), 47% after four years (N=184) and 36% after five years (N=141) (5). Those in the HUD-VASH group has a lower risk of returning to homelessness over the course of five years had an 87% lower risk compared to those in intensive care management only group and 76% compared to those in standard care.[32] The greatest risk factor for returning to homelessness was either due to drugs or due to PTSD. Overall, after five years of follow up, 44% of all participants (N=172) returned to homelessness for at least one day after being successfully placed into housing.[32]

Studies of housing first for veterans

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To end homelessness among veterans, new resources and program expansions were introduced. One of the goals set by the U.S. Department of Housing and Urban Developments Veterans Affairs Supportive Housing (HUD-VASH) is to place veterans experiencing homelessness in permanent housing. A housing first approach has been introduced to help support this initiative. One of the goals of Housing First is the rapid placement of veterans to directly from the streets to a permanent home.

Housing first approach works with the HUD supplying housing assistance through a voucher program while the VA provides case management and supportive services through its healthcare system.[34] By having permanent housing, there is a decrease in the usage of shelters, hospitals and correctional facilities. This program is available in all 50 states, the District of Columbia and Guam.  

A study by Montgomery, Hill, Kane and Culhane was a demonstration that was initiated in 2010 and studied the housing methods in the United States for homeless veterans. They evaluated the efficiency of the Housing First (HF) approach compared to a Treatment as Usual (TAU) approach. HF targeted those were experiencing street homelessness while TAU served more women and families. Veterans placed in HF were offered services such as social workers, vocational trainers, a housing specialist and access to a psychiatrist.  Most importantly, HF would issue a housing voucher at the time of lease signing for pre-inspected apartments which were maintained by a contractor. Veterans in the TAU approach received the standard VA case management services for HUD-VASH.[35] In TAU, they remained at their current placement, which could sometimes include an emergency shelter, or they were placed in transitional housing or residential treatment programs.

The study found that the HF has the most effective model in accessing permanent housing and has shown efficiency in reducing rates of homelessness with veterans.[35] Compared to TAU, HF was more successful at quickly moving veterans into permanent housing, their moving process took approximately one month while the TAU approach took about six months.[35] The housing retention rate for HF was 98% and 86% for TAU, meaning that those using the HF model were more likely to maintain housing stability.[35]

Charity

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JROTC cadet from Wilson High School assists at a "Stand Down" event.

In addition to government provided aid, private charities provide assistance to homeless veterans as well.[36] These include providing some homeless veterans vehicles to live in,[37] and building permanent housing for others.[38] Advocating for the rights of homeless veterans through policy implementation and recommendations.[39] Throughout the nation, multiple organizations and agencies host "Stand Down" events where homeless veterans are provided items and services;[40] the first of these was held in San Diego, organized by Vietnam veterans, in 1988.[41]

Homes For Heroes is a US for-profit and non-profit company that provides partner-savings to Veterans buying a home, and offers monetary grants to Veterans, and other medical professionals and first-responders buying a home.[42]

Homes For Angels is a Texas program that provides discounted, affordable real estate services to Veterans and other first-responder service professions buying a home.[43]

Ending veteran homelessness

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In November 2009, Secretary of Veterans Affairs (VA) Eric K. Shinseki set out the goal of ending veterans experiencing homelessness by 2017.  While not all veterans are housed, the current housing initiatives such as the housing first model are ensuring that housing is obtained for a larger portion of veterans experiencing homelessness. In 2019, the HUD-VASH program was able to house more than 11,000 veterans.[44] Overall, since 2008, more than 114,000 veterans experiencing homelessness have been served through the HUD-VASH program.[44] Also, more resources are being implemented to assist with mental health and addiction. As of 2019, more than 78 communities and the entire states of Connecticut, Delaware and Virginia have effectively ended homelessness among veterans.[44]

References

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  1. ^ Service, Department of Veterans Affairs, Veterans Benefits Administration, Benefits Assistance. "Homeless Veterans - Veterans". www.benefits.va.gov. Retrieved 2016-12-09.{{cite web}}: CS1 maint: multiple names: authors list (link)
  2. ^ Reeve Vanneman (1 March 2006). "Causes of homelessness". Sociology 498: Homelessness. University of Maryland. Archived from the original on 29 December 2013. Retrieved 14 January 2015.
  3. ^ Kenneth L. Kusmer (2003). Down and Out, on the Road: The Homeless in American History. Oxford University Press. pp. 37–38. ISBN 978-0-19-516096-3.
    Patrick Markee (27 March 2003). "War and Homelessness" (PDF). Coalition for the Homeless. Retrieved 3 December 2016.
  4. ^ Melissa Block (12 November 2007). "Homeless War Veterans Span U.S. History". NPR News. National Public Radio. Retrieved 3 December 2016.
  5. ^ Labor Law Reporter. Commerce Clearing House. 1934.
  6. ^ Richard O. Davies (1966). Housing reform during the Truman administration. University of Missouri Press. ISBN 9780826200464.
  7. ^ United States. Congress. Senate. Committee on Banking, Housing, and Urban Affairs. Subcommittee on Housing and Urban Affairs (1987). Homelessness in America: Hearing Before the Subcommittee on Housing and Urban Affairs of the Committee on Banking, Housing, and Urban Affairs, United States Senate, One Hundredth Congress, First Session ... January 29, 1987. U.S. Government Printing Office.{{cite book}}: CS1 maint: multiple names: authors list (link)
  8. ^ J.B. Wogan (10 October 2013). "How Michigan Got Better at Counting Homeless Veterans". Governing. e.Republic. Retrieved 3 December 2016.
  9. ^ Judith Blau; Alberto Moncada (30 November 2015). Human Rights: A Primer. Routledge. p. 41. ISBN 978-1-317-25800-1.
  10. ^ Bruce S. Jansson (15 March 2010). Becoming an Effective Policy Advocate. Cengage Learning. p. 72. ISBN 978-0-495-81239-5.
  11. ^ Jamison Fargo; Stephen Metraux; Thomas Byrne; Ellen Munley; Ann Elizabeth Montgomery; Harlan Jones; George Sheldon; Dennis Culhane (August 2011). "Prevalence and Risk of Homelessness among U.S. Veterans: A Multisite Investigation" (PDF). National Center on Homelessness among Veterans. United States Department of Veterans Affairs. Retrieved 3 December 2016.
  12. ^ Alvaro Cortes; Meghan Henry; RJ de la Cruz; Scott Brown; Abt Associates (November 2013). "The 2012 Point-in-Time Estimates of Homelessness" (PDF). Office of Community Planning and Development. The U.S. Department of Housing and Urban Development. Retrieved 14 January 2015.
  13. ^ Meghan Henry; Dr. Alvaro Cortes; Sean Morris; Abt Associates (2013). "The 2013 Annual Homeless Assessment Report (AHAR) to Congress" (PDF). Office of Community Planning and Development. The U.S. Department of Housing and Urban Development. Retrieved 14 January 2015.
  14. ^ "Lessons Learned from the U.S. Department of Labor Grantees: Homeless Female Veterans & Homeless Veterans with Families" (PDF). Institute for Veterans and Military Families. Syracuse University. October 2013. Archived from the original (PDF) on 15 January 2015. Retrieved 14 January 2015.
  15. ^ Holland, Gale (4 July 2014). "L.A. County's homeless population difficult to quantify". Los Angeles Times. Retrieved 3 December 2016.
  16. ^ Meghan Harvey; Azim Shivji; Tanya de Sousa; Rebecca Cohen; Abt Associates (November 2015). "The 2015 Annual Homeless Assessment Report (AHAR) to Congress" (PDF). HUD Exchange. US Department of Housing and Urban Development. Retrieved 3 December 2016. EXHIBIT 5.3: Demographic Characteristics of Homeless Veterans
  17. ^ "2016 PIT Estimate of Homeless Veterans by State" (PDF). HUD Exchange. US Department of Housing and Urban Development. 2016. Retrieved 3 December 2016.
  18. ^ "California Homelessness Statistics in 2017". U.S. Interagency Council on Homelessness. Archived from the original on 2023-04-24. Retrieved 2018-11-27.
  19. ^ Bruce C. Brown (30 December 2013). "Assistance for Homeless Veterans". The Complete Guide to Veterans' Benefits: Everything You Need to Know Explained Simply. Atlantic Publishing Company. pp. 227–236. ISBN 978-1-60138-702-8.
  20. ^ Health, VHA Office of Mental. "U.S. Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program - Veterans Experiencing Homelessness". www.va.gov. Retrieved 2020-11-09.
  21. ^ "An Examination of Waste and Abuse Associated with VA's Management of Land-Use Agreements". The American Legion. 10 February 2015. Retrieved 3 December 2016.
  22. ^ James Marten (1 June 2011). Sing Not War: The Lives of Union and Confederate Veterans in Gilded Age America. UNC Press Books. pp. 171–173. ISBN 978-0-8078-7768-5.
  23. ^ William E. Roscoe (1882). 1713: History of Schoharie County, New York, with Illustrations and Biographical Sketches of Some of Its Prominent Men and Pioneers. D. Mason & Company. p. 447.
  24. ^ "VA History in Brief" (PDF). United States Department of Veterans Affairs. Retrieved 3 December 2016.
  25. ^ a b c d Tsai, Jack; Rosenheck, Robert A. (2015-01-01). "Risk Factors for Homelessness Among US Veterans". Epidemiologic Reviews. 37 (1): 177–195. doi:10.1093/epirev/mxu004. ISSN 0193-936X. PMC 4521393. PMID 25595171.
  26. ^ Affairs, Office of Public and Intergovernmental. "News Releases - Office of Public and Intergovernmental Affairs". www.va.gov. Retrieved 2020-11-08.
  27. ^ "Obama Administration Delays Deadline To End Chronic Homelessness Because Of Budget Constraints". The Huffington Post. 4 February 2015. Retrieved 2016-02-10.
  28. ^ a b "Remarks by Secretary Eric K. Shinseki". Office of Public and Intergovernmental Affairs. United States Department of Veterans Affairs. 3 November 2009. Archived from the original on 1 January 2017. Retrieved 14 January 2015.
  29. ^ Wilding, Mark. (2020). The Challenges of Measuring Homelessness among Armed Forces Veterans: Service Provider Experiences in England, European Journal of Homelessness, 14(1): 107-122.
  30. ^ Kellan Howell (3 December 2014). "Despite first lady's vow to end veteran homelessness, VA fails miserably". Washington Times. Retrieved 14 January 2015.
    Lauren Gilger; Shawn Martin; Angie Holdsworth; Amanda Kost (11 December 2014). "VA ignoring homeless vets? Report finds hotline designed to help homeless vets often fails them". KNXV. Phoenix, Arizona. Archived from the original on 9 January 2015. Retrieved 14 January 2015.
  31. ^ Edens, Ellen L.; Rosenheck, Robert A.; Kasprow, Wes; Tsai, Jack (11 August 2011). "Association of substance use and VA service-connected disability benefits with risk of homelessness among veterans". The American Journal on Addictions. 20 (5). American Academy of Addiction Psychiatry: 412–9. doi:10.1111/j.1521-0391.2011.00166.x. PMID 21838839.
  32. ^ a b c d O'Connell, Maria J.; Kasprow, Wesley; Rosenheck, Robert A. (2008-03-01). "Rates and Risk Factors for Homelessness After Successful Housing in a Sample of Formerly Homeless Veterans". Psychiatric Services. 59 (3): 268–275. doi:10.1176/ps.2008.59.3.268. ISSN 1075-2730. PMID 18308907.
  33. ^ Gupta, Nitin (2000). "Psychometric properties of quality of life (QLS) scale : A brief report". Indian Journal of Psychiatry. 42 (4): 415–420. PMC 2962744. PMID 21407980.
  34. ^ O'Toole, Thomas P.; Pape, Lisa (2015-11-01). "Innovative Efforts to Address Homelessness Among Veterans". North Carolina Medical Journal. 76 (5): 311–314. doi:10.18043/ncm.76.5.311. ISSN 0029-2559. PMID 26946863. Archived from the original on 2018-06-05. Retrieved 2020-05-01.
  35. ^ a b c d Montgomery, Ann Elizabeth; Hill, Lindsay L.; Kane, Vincent; Culhane, Dennis P. (2013). "Housing Chronically Homeless Veterans: Evaluating the Efficacy of a Housing First Approach to Hud-Vash". Journal of Community Psychology. 41 (4): 505–514. doi:10.1002/jcop.21554. ISSN 0090-4392.
  36. ^ Marsha A. Martin (1 June 1997). Heading Home: Breaking the Cycle of Restlessness Among Americas Veterans, a Post-Summit Action Report and Resource Directory. DIANE Publishing. p. 15. ISBN 978-0-7881-7696-8.
  37. ^ Lambert, Cynthia (30 November 2016). "RVs for Veterans has found 60 trailers for homeless veterans, but more are needed". The Tribune. San Luis Obispo, California. Retrieved 3 December 2016.
  38. ^ Shepherd, Michael (27 April 2015). "Maine lawmakers back aid for homeless veterans' cabins at Togus". Morning Sentinel. Augusta, Maine. Retrieved 3 December 2016.
    Nesbitt, Rob (28 November 2016). "Campaign to build 300 cottages for homeless Veterans". WCSH. Swanville, Maine. Retrieved 3 December 2016.[permanent dead link]
    Magnarelli, Tom (15 November 2016). "3 more tiny homes for homeless veterans built in Syracuse". WRVO. Syracuse, New York. Retrieved 3 December 2016.
    Guilfoos, Kristen (16 November 2016). "Texas A&M students build tiny houses to help the homeless". KBTX. College Station, Texas. Retrieved 3 December 2016.
  39. ^ Judith Allender; Cherie Rector; C, Kristine Warner (26 April 2013). Community & Public Health Nursing: Promoting the Public's Health. Lippincott Williams & Wilkins. p. 914. ISBN 978-1-4698-2665-3.
  40. ^ Knicely, John (1 December 2016). "Veterans Stand Down helps hundreds of homeless vets, more help Friday". KIRO. Seattle, Washington. Retrieved 3 December 2016.
    Sausser, Lauren (2 December 2016). "Stand Down Against Homelessness draws smaller crowd this year". The Post and Courier. Charleston, South Carolina. Retrieved 3 December 2016.
    McGhee, Tom (3 November 2016). "Denver, VA offer one-stop service events Thursday to help the homeless". Denver Post. Retrieved 3 December 2016.
  41. ^ Thomas W. Miller (2012). The Praeger Handbook of Veterans' Health: History, Challenges, Issues, and Developments. ABC-CLIO. p. 138. ISBN 978-0-313-38349-6.
  42. ^ Heroes, Homes. "For Heroes FAQ". homesforheroes.com.
  43. ^ Austin Homes, Heart of Austin. "Homes For Angels Texas Home Program". heartofaustinhomes.com/.
  44. ^ a b c "Veterans". National Alliance to End Homelessness. Retrieved 2020-05-01.
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