Naiomi Rivera-Rivera Angel A. Villarreal

Resumen

This research assesses sociodemographic, psychosocial, and military characteristics and their role in homelessness programs readmission to provide a profile of the Caribbean Homeless Veteran of the U.S. military. We evaluated 620 healthcare records of veterans who requested services at the Homeless Program of the VA Caribbean Healthcare System from 2005 to 2014. Statistical analyses consisted of Chi square, Fisher’s exact test, Wilcoxon-Rank Sum tests, and generalized linear models of regression with Poisson distribution. Homeless veterans were characterized by being male, serving in the Army, having low social support, poor house affordability, extreme poverty, unemployment, and psychiatric disorders. Veterans from Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn conflicts exhibited more readmission prevalence risk ratio overall and when adjusted for all factors than veterans of previous conflicts. Psychosocial factors such as substance use, social isolation, legal problems, and psychiatric disorders were identified in the readmission process. Results suggest assistance beyond housing is needed to end veteran homelessness.

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Keywords
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Byrne, T., Treglia, D., Culhane, D. P., Kuhn, J., & Kane, V. (2016). Predictors of homelessness among families and single adults after exit from homelessness prevention and rapid re-housing programs: Evidence from the Department of Veterans Affairs supportive services for Veteran Families Program. Housing Policy Debate, 26(1), 252-275. https://doi.org/10.1080/10511482.2015.1060249

Chinchilla, M., Gabrielian, S., Glasmeier, A., & Green, M. F. (2020). Exploring community integration among formerly homeless veterans in project-based versus tenant-based supportive housing. Community Mental Health Journal, 56(2), 303–312. https://doi.org/10.1007/s10597-019-00473-x

DeViva, J. C., Sheerin, C. M., Southwick, S. M., Roy, A. M., Pietrzak, R. H., & Harpaz-Rotem, I. (2016). Correlates of VA mental health treatment utilization among OEF/OIF/OND veterans: Resilience, stigma, social support, personality, and beliefs about treatment. Psychological Trauma: Theory, Research, Practice and Policy, 8(3), 310–318. https://doi.org/10.1037/tra0000075

Ellison, M. L., Schutt, R. K., Yuan, L. H., Mitchell-Miland, C., Glickman, M. E., McCarthy, S., Smelson, D., Schultz, M. R., & Chinman, M. (2020). Impact of peer specialist services on residential stability and behavioral health status among formerly homeless veterans with cooccurring mental health and substance use conditions. Medical Care, 58(4), 307–313. https://doi.org/10.1097/MLR.0000000000001284

Gabrielian, S., Bromley, E., Hellemann, G. S., Kern, R. S., Goldenson, N. I., Danley, M. E., & Young, A. S. (2015). Factors affecting exits from homelessness among persons with serious mental illness and substance use disorders. The Journal of Clinical Psychiatry, 76(4), e469–e476. https://doi.org/10.4088/JCP.14m09229

Galovski, T., & Lyons, J. A. (2004). Psychological sequelae of combat violence: A review of the impact of PTSD on the veteran's family and possible interventions. Aggression and Violent Behavior, 9(5), 477-501. https://doi.org/10.1016/S1359-1789(03)00045-4

Gundlapalli, A. V., Redd, A., Bolton, D., Vanneman, M. E., Carter, M. E., Johnson, E., Samore, M. H., Fargo, J. D., & O'Toole, T. P. (2017). Patient-aligned care team engagement to connect veterans experiencing homelessness with appropriate health care. Medical Care, 55(9, 2), S104–S110. https://doi.org/10.1097/MLR.0000000000000770

Hamilton, A. B., Poza, I., & Washington, D. L. (2011). "Homelessness and trauma go hand-in-hand": Pathways to homeless-ness among women veterans. Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health, 21(4), S203–S209.
https://doi.org/10.1016/j.whi.2011.04.005

Henry, M., Sousa, T., Roddey, C., Gayen, S., Bednar, T. J. (2021). The 2020 annual homeless assessment report (AHAR) to Congress: PART 1 Point-in-time estimates of homelessness. The U.S. Department of Housing and Urban Development, Office of Community Planning and Development.

Johnson, E. E., Borgia, M., Rose, J., & O'Toole, T. P. (2017). No wrong door: Can clinical care facilitate veteran engagement in housing service-es?. Psychological Services, 14(2), 167 –173.
https://doi.org/10.1037/ser0000124

Kashner, T. M., Rosenheck, R., Campinell, A. B., Surís, A., Crandall, R., Garfield, N. J., Lapuc, P., Pyrcz, K., Soyka, T., & Wicker, A. (2002). Impact of work therapy on health status among homeless, substance-dependent veterans: a randomized controlled trial. Archives of General Psychiatry, 59(10), 938–944. https://doi.org/10.1001/archpsyc.59.10.938

Kline, A., Callahan, L., Butler, M., Hill, L. S., Losonczy, M. F., & Smelson, D. A. (2009). The relationship between military service eras and psychosocial treatment needs among homeless veterans with a co-occurring substance abuse and mental health disorder. Journal of Dual Diagnosis, 5, 357-374. https://doi.org/10.1080/15504260903175882

Lipton, F. R., Siegel, C., Hannigan, A., Samuels, J., & Baker, S. (2000). Tenure in supportive housing for homeless persons with severe mental illness. Psychiatric Services, 51(4), 479–486. https://doi.org/10.1176/appi.ps.51.4.479

Montgomery, A. E., Hill, L. L., Kane, V., & Culhane, D. 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. https://doi.org/10.1002/jcop.21554

O'Connell, M. J., Kasprow, W., & Rosenheck, R. A. (2008). Rates and risk factors for homelessness after successful housing in a sample of formerly homeless Veterans. Psychiatric Services, 59(3), 268 – 275. https://doi.org/10.1176/ps.2008.59.3.268

O'Toole, T. P., Johnson, E. E., Borgia, M., Noack, A., Yoon, J., Gehlert, E., & Lo, J. (2018). Population-tailored care for homeless veterans and acute care use, cost, and satisfaction: A prospective quasi-experimental trial. Preventing Chronic Disease, 15, E23. https://doi.org/10.5888/pcd15.170311

Rivera-Rivera, N., & Villarreal, A. (2020). Caribbean homeless women veterans: Military and psychosocial characteristics and the association of VA service-connected disabilities. Revista Puertorriqueña de Psicología, 31(1), 36-44.

Rosenheck, R., Sorkin, H. & Stefanovics, E. (2021). Increasing the numbers of homeless veterans served by the Veterans Health Administration from 2008 to 2015: Maintaining focus on the intended target population and on sustaining service intensity. Journal of Social Distress and Homelessness, 30(1), 1-11.
https://doi.org/10.1080/10530789.2020.1753914

Thompson, C. J., & Bridier, N. L. (2013). Homeless aging veterans in transition: A life-span perspective. Journal of Aging Research, 2013(570407), 1-10. https://doi.org/10.1155/2013/570407

Tsai, J., Blue-Howells, J., & Nakashima, J. (2019). Needs of homeless veterans: 5 years of the CHALENG Survey 2012-16. Journal of Public Health, 41(1), e16–e24. https://doi.org/10.1093/pubmed/fdy076
Cómo citar
Rivera-Rivera, N., & Villarreal, A. A. (2021). Homeless veterans in the Caribbean: Profile and housing failure. Revista Puertorriqueña De Psicologí­a, 32(1), 74–89. Recuperado a partir de https://repsasppr.net/index.php/reps/article/view/676
Sección
Artículo de investigación