Substantial Proportion of Homeless and Unstably Housed Veterans with Minor Children has Serious Mental Illness
Psychiatric conditions may be particularly challenging for homeless and unstably housed Veterans with young children. There is no recent literature identifying the prevalence of this population, what their mental health needs are, and what services are available to them. Thus, this observational study examined the prevalence of homeless and unstably housed Veterans with minor children and compared sociodemographic characteristics, as well as medical and mental health conditions of homeless and unstably housed Veterans with and without children, and stratified by gender. Investigators also examined differences in program referral and admission patterns to VA homeless programs among homeless and unstably housed Veterans with children. Using data from VA's Homeless Operations Management and Evaluation System (HOMES), investigators identified Veterans who were homeless (n=67,410) or unstably housed/at risk of losing housing (n=21,732) from April 2011 to November 2012, and who were engaged with VA homeless services.
- Unstably housed Veterans were more likely to have children than homeless Veterans, and women more likely than men. Among both homeless and unstably housed male Veterans with minor children, only about one-third to one-half had custody of their minor children, whereas among women, nearly all had custody of their minor children.
- Both homeless male and female Veterans with children were younger and less likely to have chronic medical conditions and psychiatric disorders than their homeless counterparts. However, 72% of male and 67% of female Veterans with children had a psychiatric diagnosis, and 11% of both men and women were diagnosed with a psychotic disorder. Men also were more likely to have PTSD and other anxiety disorders compared to male Veterans without children.
- Veterans with minor children were more likely to be referred and admitted to VA's permanent supported housing program than other Veterans, and women with minor children in their custody were even more likely to be referred and admitted than men.
- Rates of referrals to mental health services were relatively low (22% and 25% for Veterans with and without children, respectively) given the high prevalence of psychiatric diagnoses in the sample.
- HOMES data used in this study relied on the accurate and diligent documentation of VA clinicians and is limited to Veterans in the VA system.
- Veterans' medical history was based on self-report, which may have resulted in under-reporting.
- The number of "unstably housed" Veterans is likely only a small proportion of the actual population, as the sample was based only on those engaged with VA homeless services.
This study was funded by HSR&D. Dr. Tsai was supported by an HSR&D Career Development Award. Drs. Tsai and Rosenheck are part of HSR&D's Pain Research, Informatics, Multi-morbidities, and Education Center in West Haven, CT.
Tsai J, Rosenheck R, Kasprow W, and Kane V. Characteristics and Use of Services among Literally Homeless and Unstably Housed U.S. Veterans with Custody of Minor Children. Psychiatric Services. May 15, 2015; Epub ahead of print.