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Health Services Research & Development

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HSR&D In Progress

April 2016

In this Issue: Working to End Homelessness among Veterans
» Table of Contents

Improving Outcomes for Homeless Veterans with Peer Support

Ongoing study

According to a recent national study, up to 20% of HUD-VASH residents will become homeless again over time, and the majority of those Veterans will have co-occurring issues of mental illness and substance abuse. This ongoing study helps to address this problem by implementing and testing the peer support component of The Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking (MISSION-VET) Consumer Workbook - an integrated mental health and substance abuse treatment tested on homeless Veterans with these co-occurring conditions. Investigators will randomly assign 200 Veterans using HUD-VASH vouchers and services, who are determined to be at-risk for housing loss into two groups on a rolling admission basis. The control group that will receive HUD-VASH case management services as usual, while the intervention group will receive MISSION-VET derived peer-support services. Data will be collected for subjects on: substance use, overall mental health functioning, engagement in substance abuse treatment services, the length of time housed, and community participation.


From a sub-sample of 50 Veterans who received peer services (intervention group), Veterans were fairly evenly divided in terms of lifetime homelessness, with 54% being homeless for more than one year in their lifetime. There was little to moderate mental health challenges and symptoms reported, and a little more than one-third of the sample reported that they used drugs in the last 30 days, with 14% having drunk to intoxication. The mean number of sessions that Veterans engaged with Peer Specialists was 9 out of a potential 40 weekly sessions, ranging from 0 to 37. There was substantial variation in the pattern of engagement.


This project aims to provide formerly homeless Veterans with co-occurring substance abuse and mental illness an effective psycho-education peer-intervention that will improve their substance use, housing retention, and community participation.

Principal Investigator: Marsha Langer Ellison, PhD, MSW, HSR&D's Center for Healthcare Organization and Implementation Research (CHOIR), and the Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA.


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