Abstract
The Veterans Health Administration (VHA) has been increasing efforts to reach out to assist incarcerated veterans. While previous studies have shown strong associations between incarceration and homelessness, few studies have examined distinctive characteristics of incarcerated homeless and non-homeless veterans. National administrative data on 30,348 incarcerated veterans served by the Health Care for Re-entry Veterans (HCRV) program were analyzed. Incarcerated veterans were classified into four groups based on their history of past homelessness: not homeless, transiently homeless, episodically homeless, and chronically homeless. Multinomial logistic regression was used to compare groups on sociodemographic characteristics, criminal justice status, clinical status, and their interest in using VHA services. Of the sample, 70 % were classified as not homeless, 8 % as transiently homeless, 11 % as episodically homeless, and 11 % as chronically homeless. Thus, 30 % of the sample had a homeless history, which is five times the 6 % rate of past homelessness among adult men in the general population. Compared to non-homeless incarcerated veterans, all three homeless groups reported significantly more mental health problems, more substance abuse, more times arrested in their lifetime, more likely to be incarcerated for a non-violent offense, and were more interested in receiving VHA services after release from prison. Together, these findings suggest re-entry programs, like HCRV, can address relevant mental health-related service needs, especially among formerly homeless veterans and veterans in need of services are receptive to the offer of assistance.
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References
Burt, M. R., Aron, L. Y., Douglas, T., Valente, J., Lee, E., & Iwen, B. (1999). Homelessness: programs and the people they serve: Findings of the national survey of homeless assistance providers and clients. Washington, DC: Urban Institute.
Culhane, D. P., Metraux, S., Park, J. M., Schretzman, M., & Valente, J. (2007). Testing a typology of family homelessness based on patterns of public shelter utilization in four U.S. Jurisdictions: Implications for policy and program planning. Housing Policy Debate, 18(1), 1–28.
Edens, E. L., Kasprow, W., Tsai, J., & Rosenheck, R. A. (2011). Association of substance use and VA service-connected disability benefits with risk of homelessness among veterans. American Journal of Addictions, 20(5), 412–419.
Fazel, S., & Baillargeon, J. (2011). The health of prisoners. Lancet, 377(9769), 956–965.
Fischer, P. J. (1988). Criminal activity among the homeless: Study of arrests in Baltimore. Hospital and Community Psychiatry, 39(4), 6–51.
Gelberg, L., & Linn, L. S. (1989). Assessing the physical health of homeless adults. Journal of the American Medical Association, 262(14), 1973–1979.
Greenberg, G. A., & Rosenheck, R. A. (2008). Jail incarceration, homelessness, and mental health: A national study. Psychiatric Services, 59(2), 170–177.
Greenberg, G. A., & Rosenheck, R. A. (2010). Mental health correlates of past homelessness in the National Comorbidity Study Replication. Journal of Health Care for the Poor and Underserved, 21(4), 1234–1249.
Hawthorne, W. B., Folsom, D. P., Sommerfeld, D. H., Lanouette, N. M., Lewis, M., Aarons, G. A., et al. (2012). Incarceration among adults who are in the public mental health system: Rates, risk factors, and short-term outcomes. Psychiatric Services, 63(1), 26–32.
Kuhn, R., & Culhane, D. (1998). Applying cluster analysis to test a typology of homelessness by pattern of shelter utilization: Results from the analysis of administrative data. American Journal of Community Psychology, 26(2), 207–232.
Kushel, M. B., Hahn, J. A., Evans, J. L., Bangsberg, D. R., & Moss, A. R. (2005). Revolving doors: Imprisonment among the homeless and marginally housed population. American Journal of Public Health, 95(10), 1747–1752.
Larimer, M. E., Malone, D. K., Garner, M. D., Atkins, D. C., Burlingham, B., Lonczak, H. S., et al. (2009). Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems. Journal of American Medical Association, 301, 1349–1357.
McGuire, J. (2007). Closing a front door to homelessness among veterans. Journal of Primary Prevention, 28, 389–400.
McGuire, J., Rosenheck, R. A., & Kasprow, W. J. (2003). Health status, service use, and costs among veterans receiving outrearch services in jail or community settings. Psychiatric Services, 54, 201–207.
McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien, C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The addiction severity index. Journal of Nervous and Mental Disease, 168, 26–33.
McNiel, D. E., & Binder, R. L. (2007). Effectiveness of a mental health court in reducing criminal recidivism and violence. American Journal of Psychiatry, 164(9), 1395–1403.
Metraux, S., & Culhane, D. P. (2006). Recent incarceration history among a sheltered homeless population. Crime and Delinquency, 52(3), 504–517.
Noonan, M. E., & Mumola, C. J. (2007). Veterans in State and Federal Prison, 2004 Bureau of Justice Statistics: Special Report: U.S. Department of Justice, Office of Justice Programs.
Sadowski, L. S., Kee, R. A., VanderWeele, T. J., & Buchanan, D. (2009). Effect of a housing and case management program on emergency department visits and hospitalizations among chronically ill homeless adults: A randomized trial. Journal of the American Medical Association, 301(17), 1771–1778.
Solomon, P., Draine, J., & Meyerson, A. (1994). Jail recidivism and receipt of community mental health services. Hospital and Community Psychiatry, 45(8), 793–797.
Tsai, J., Mares, A. S., & Rosenheck, R. A. (2012). Do homeless veterans have the same needs and outcomes as non-veterans? Military Medicine, 177(1), 27–31.
Tsai, J., & Rosenheck, R. A. (2012a). Does housing chronically homeless adults lead to social integration? Psychiatric Services, 63(5), 427–434.
Tsai, J., & Rosenheck, R. A. (2012b). Incarceration among chronically homeless adults: Clinical correlates and outcomes. Journal of Forensic Psychology Practice, 12(4), 307–324.
United States Department of Veterans Affairs. (2009). Secretary Shinseki details plans to end homelessness for veterans. Retrieved January 12, 2012 from http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1807.
United States Department of Veterans Affairs. (2012). Veterans Justice Outreach Initiative Retrieved March 28, 2012 from http://www.va.gov/homeless/vjo.asp.
U.S. Department of Housing and Urban Development. (2007). Defining chronic homelessness: A technical guide for HUD programs. Washington, DC: U.S. Department of Housing and Urban Development.
U.S. Department of Housing and Urban Development, & U.S. Department of Veterans Affairs. (2011). Veteran homelessness: A supplemental report to the 2010 annual homeless assessment report to Congress. Washington, DC: U.S. Department of Housing and Urban Development, Office of Community Planning and Development; U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans.
Watson, A., Hanrahan, P., Luchins, D., & Lurigio, A. (2001). Mental health courts and the complex issue of mentally ill offenders. Psychiatric Services, 52(4), 477–481.
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Tsai, J., Rosenheck, R.A., Kasprow, W.J. et al. Homelessness in a National Sample of Incarcerated Veterans in State and Federal Prisons. Adm Policy Ment Health 41, 360–367 (2014). https://doi.org/10.1007/s10488-013-0483-7
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DOI: https://doi.org/10.1007/s10488-013-0483-7