Publication year
2014
Citation Title
Homeless female U.S. veterans in a national supported housing program: Comparison of individual characteristics and outcomes with male veterans.
Journal Name
Psychological Services
Journal Volume
11
Issue Number
3
Page Numbers
309-316
DOI
10.1037/a0036323
Summary
Characteristics of male and female Veterans in the Housing and Urban Development- Veterans Affairs Supportive Housing program were examined with administrative data. Homeless females were younger, less likely to have substance use disorders, and more likely to have posttraumatic stress disorder (PTSD) compared to male homeless Veterans in this program. There were no gender differences in housing outcomes or between those who stayed in and left the program.
Key Findings
At baseline, homeless female Veterans were younger, more likely to have children, and to have PTSD and other psychological disorders. In addition, homeless female Veterans were less likely to report combat exposure, be retired or disabled, have lengthy histories of homelessness or incarceration, and have alcohol and drug use disorders compared to homeless male Veterans.
For all Veterans, it took an average of 40 days to be admitted to the Housing and Urban Development; female Veterans were admitted to the program about 10 days sooner than male Veterans.
There was substantial attrition from the program over the period of one year; only 31% of those admitted were still in the program at that time.
Female Veterans had worse mental health scores, but lower drug use ratings over time compared to male Veterans.
Implications for Program Leaders
Provide routine screenings for mental health concerns for Service members
Offer workshops that prepare Service members and their families to encounter common issues related to housing and employment as Service members transition from Active Duty service
Educate Service members and their spouses about how to maintain healthy habits once they leave the military
Implications for Policy Makers
Support programs that help Service members and their spouses improve financial well-being to help with the transition from military service
Encourage the creation of programs that identify and support Service members and their families who are at risk of housing instability and mental health concerns
Recommend education for service providers around the possible effects of the transition from military service on Service members’ families
Methods
National Veterans Affairs (VA) administrative data on Veterans referred to the Housing and Urban Development – Veterans Affairs Supportive Housing program from January of 2008 to April of 2011 were analyzed.
Self-reports in patients’ medical records were used by VA mental health clinicians to gather demographic data, recent housing history, medical problems, and psychiatric diagnoses.
Mental health symptoms and social quality of life measures were obtained at baseline and three months after admission.
Data were analyzed by comparing male and female Veterans’ individual baseline characteristics.
Participants
Forty-three thousand eight hundred fifty-three Veterans (89% male) were referred to the program; however, fewer Veterans were surveyed due to rejection or attrition from the program.
The average age of the sample was 49.4 years (SD = 12). The sample was mostly Black (48%) and White (40%).
Fifty-four thousand had been homeless 0-1 times in the previous three years, 37% were 2-4 times, and 43% had lifetime incarceration of one year or less, 35% had no incarcerations, and 23% had more than one year.
Limitations
Only homeless Veterans referred to the Housing and Urban Development – Veterans Affairs Supportive Housing program were included in this study. Therefore, these results may not generalize to Veterans who are not homeless.
It is not known what the high attrition rate indicates – successful housing obtained, loss of data, decompensation - and this is an essential outcome in order to address the problem of homelessness for Veterans.
Gender was not reported at each follow-up (three, six, nine, and 12 months post-admission), so conclusions based on gender cannot be determined from data after the baseline data collection.
Avenues for Future Research
Explore the causes of the high rate of attrition from the Housing and Urban Development – Veterans Affairs Supportive Housing program
Develop gender-specific interventions for homelessness to identify the most effective models to help male and female Veterans exit homelessness
Gather data from current Service members and their spouses to determine their needs as they prepare to transition from military service
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
As more women serve in the U.S. military, the proportion of females among homeless veterans is increasing. The current study compares the individual characteristics and 1-year outcomes of homeless female and male veterans in the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program nationally. Administrative data on 43,853 veterans (10.69% females; 89.31% males) referred to HUD-VASH were analyzed for gender differences at baseline and over a 1-year period. Homeless female veterans were younger, had shorter homeless and incarceration histories, and were less likely to have substance use disorders than men. However, despite being less likely to report combat exposure, female veterans were more likely to have posttraumatic stress disorder. Homeless female veterans were also much more likely to have dependent children with them and to plan to live with family members in supported housing. Once admitted to HUD-VASH, there were no gender differences in attrition or main housing outcomes. Case managers were faster to admit female veterans to the program, reported better working alliances, and provided more services related to employment and income than male veterans. These findings suggest homeless female veterans may have certain strengths, including being younger, less involved in the criminal justice system, and more adept at relating to professional and natural supports; but special attention to noncombat trauma and family-oriented services may be needed.
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