Among U.S. veterans who returned from Afghanistan and Iraq, being separated from the military for misconduct was associated with an increased risk of homelessness, according to a study in the August 25 issue of JAMA.
Adi V. Gundlapalli, M.D., Ph.D., M.S., of the VA Salt Lake City Health Care System, Salt Lake City, and colleagues analyzed Veterans Health Administration (VHA) data from U.S. active-duty military service members who were separated (end date of last deployment) from the military between October 2001 and December 2011, deployed in Afghanistan or Iraq, and eligible for and subsequently used VHA services. Homelessness was determined by a coding assignment of "lack of housing" during a VHA encounter, by participation in a VHA homelessness program, or both. The U.S. Department of Defense assigns a code upon separation from military service. These codes were categorized into misconduct (drugs, alcoholism, offenses, infractions, other), disability, early release, disqualified, normal, and other or unknown.
The analysis included 448,290 active-duty service members separated during this time period. Homelessness was determined by code (43 percent), participation in a homelessness program (35 percent), or both (27 percent). Although only 6 percent (n = 24,992) separated for misconduct, they represented 26 percent of homeless veterans at first VHA encounter (n = 322), 28 percent within 1 year (n = 1,141), and 21 percent within 5 years (n = 709). Incidence of homelessness was significantly greater for misconduct vs normal separations at first VHA encounter (1.3 percent vs 0.2 percent) and increased with time since first VHA encounter: within 1 year (5.4 percent vs 0.6 percent); at 5 years (9.8 percent vs 1.4 percent).
The authors write that these findings support reports of recently returned veterans with records of misconduct having difficulties reentering civilian life. "This association takes on added significance because the incidence of misconduct-related separations is increasing at a time when ending homelessness among veterans is a federal government priority."
"Identification of those with misconduct-related separations and provision of case management and rehabilitative services at separation by the Department of Defense and the VHA should be investigated as methods to prevent homelessness."
(doi:10.1001/jama.2015.8207; Available pre-embargo to the media at http://media.
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