Study Identifies Association between Separation from Military due to Misconduct and Homelessness
BACKGROUND:
Misconduct-related separations from the military are associated with subsequent adverse civilian outcomes that are of substantial public health concern. This study analyzed the association between misconduct-related separations and homelessness among recently returned active-duty military service members. Using VA data, investigators identified 448,290 Veterans who were separated from the military (end date of last deployment) between October 1, 2001 and December 31, 2011; had been deployed to Iraq and/or Afghanistan; and had subsequently used VA healthcare. Homelessness was determined by an assignment of "lack of housing" during a VA healthcare visit, by participation in a VA homelessness program, or both. Veterans' housing status was followed through April 30, 2012. Investigators assessed risk for homelessness as a function of separation category (e.g., normal, misconduct, early release), controlling for patient demographics and military service covariates, including service-related disability, branch, rank, and combat exposure.
FINDINGS:
- Incidence of homelessness at their first encounter with VA healthcare was significantly greater for Veterans who experienced separation due to misconduct compared to Veterans with a normal separation (1% vs. 0.2%), as well as within one year (5% vs. 0.6%) and at five years (10% vs. 1%).
- Although only 6% (n=24,992) of the Veterans in this study separated for misconduct, they represented 26% of homeless Veterans at their first VA healthcare encounter, 28% within 1 year of separation, and 21% within 5 years.
- The overall incidence of homeless among Veterans was 0.3% at the time of their first VA healthcare encounter (n=1,259), 1% within one year (n=4,067), and 2% within 5 years (n=3,441).
IMPLICATIONS:
- These findings support reports of recently returned Veterans with records of misconduct having difficulties re-entering 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.
- This may represent an opportunity to investigate early identification and active case management as strategies to prevent homelessness in this and other vulnerable Veteran populations.
LIMITATIONS:
- Veterans who were dishonorably discharged were not included in this study because they are not eligible for VA healthcare services, thus their information is not in VHA databases. Veterans who do not use VA services were also not included in this study.
- This study cannot determine a causal link between misconduct and homelessness.
AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (IIR 12-084, HIR 10-002). Drs. Gundlapalli, Fargo, Carter, and Samore (Director) are part of HSR&D's Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, UT. Drs. Metraux, Kane (Director), and Culhane are part of VA's National Homeless Center located in Philadelphia, PA.
Gundlapalli A, Fargo J, Metraux S, Carter M, Samore M, Kane V, and Culhane D. Military Misconduct and Homelessness among U.S. Veterans Separated from Active Duty, 2001-2012. JAMA, Research Letter. August 25, 2015;314(8):832-34.
