A model of homelessness among male veterans of the Vietnam War generation

Rosenheck, Robert A.; Fontana, Alan

doi:10.1176/ajp.151.3.421

Cited by 97 publications

(15 citation statements)

References 10 publications

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“…Our data suggest that qualitative alterations in drug usage are more pronounced in southern Somalia. This notion would imply potential threats for the peace-building process in general (e.g., drug-related criminality) and the reintegration of former combatants into civilian society in particular [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

The Consumption of Khat and Other Drugs in Somali Combatants: A Cross-Sectional Study

Odenwald

Hinkel²,

Schauer³

et al. 2007

PLoS Med

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BackgroundFor more than a decade, most parts of Somalia have not been under the control of any type of government. This “failure of state” is complete in the central and southern regions and most apparent in Mogadishu, which had been for a long period in the hands of warlords deploying their private militias in a battle for resources. In contrast, the northern part of Somalia has had relatively stable control under regional administrations, which are, however, not internationally recognized. The present study provides information about drug abuse among active security personnel and militia with an emphasis on regional differences in relation to the lack of central governmental control—to our knowledge the first account on this topic.Methods and FindingsTrained local interviewers conducted a total of 8,723 interviews of armed personnel in seven convenience samples in different regions of Somalia; 587 (6.3%) respondents discontinued the interview and 12 (0.001%) were excluded for other reasons. We assessed basic sociodemographic information, self-reported khat use, and how respondents perceived the use of khat, cannabis (which includes both hashish and marijuana), psychoactive tablets (e.g., benzodiazepines), alcohol, solvents, and hemp seeds in their units. The cautious interpretation of our data suggest that sociodemographic characteristics and drug use among military personnel differ substantially between northern and southern/central Somalia. In total, 36.4% (99% confidence interval [CI] 19.3%–57.7%) of respondents reported khat use in the week before the interview, whereas in some regions of southern/central Somalia khat use, especially excessive use, was reported more frequently. Self-reported khat use differed substantially from the perceived use in units. According to the perception of respondents, the most frequent form of drug use is khat chewing (on average, 70.1% in previous week, 99% CI 63.6%–76.5%), followed by smoking cannabis (10.7%, 99% CI 0%–30.4%), ingesting psychoactive tablets (8.5%, 99% CI 0%–24.4%), drinking alcohol (5.3%, 99% CI 0%–13.8%), inhaling solvents (1.8%, 99% CI 0%–5.1%), and eating hemp seeds (0.6%, 99% CI 0%–2.0%). Perceived use of khat differs little between northern and southern Somalia, but perceived use of other drugs reaches alarmingly high levels in some regions of the south, especially related to smoking cannabis and using psychoactive tablets.ConclusionsOur data suggest that drug use has quantitatively and qualitatively changed over the course of conflicts in southern Somalia, as current patterns are in contrast to traditional use. Although future studies using random sampling methods need to confirm our results, we hypothesize that drug-related problems of armed staff and other vulnerable groups in southern Somalia has reached proportions formerly unknown to the country, especially as we believe that any biases in our data would lead to an underestimation of actual drug use. We recommend that future disarmament, demobilization, and reintegration (DDR) programs need to be ...

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Section: Discussionmentioning

confidence: 99%

The Consumption of Khat and Other Drugs in Somali Combatants: A Cross-Sectional Study

Odenwald

Hinkel²,

Schauer³

et al. 2007

PLoS Med

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“…Combat experience and sequelae of trauma such as posttraumatic stress disorder (PTSD) have shown modest links to becoming homeless (Metraux, Clegg, Daigh, Culhane, & Kane, 2013;Rosenheck & Fontana, 1994). However, a majority of homeless veterans served during peacetime eras (Rosenheck, Frisman, & Chung, 1994) and thus were not exposed to combat.…”

Section: Introductionmentioning

confidence: 99%

Pathways into homelessness among post-9/11-era veterans.

Metraux¹,

Cusack

Byrne

et al. 2017

Psychological Services

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Despite the scale of veteran homelessness and government-community initiatives to end homelessness among veterans, few studies have featured individual veteran accounts of experiencing homelessness. Here we track veterans' trajectories from military service to homelessness through qualitative, semistructured interviews with 17 post-9/11-era veterans. Our objective was to examine how veterans become homeless-including the role of military and postmilitary experiences-and how they negotiate and attempt to resolve episodes of homelessness. We identify and report results in 5 key thematic areas: transitioning from military service to civilian life, relationships and employment, mental and behavioral health, lifetime poverty and adverse events, and use of veteran-specific services. We found that veterans predominantly see their homelessness as rooted in nonmilitary, situational factors such as unemployment and the breakup of relationships, despite very tangible ties between homelessness and combat sequelae that manifest themselves in clinical diagnoses such as posttraumatic stress disorder. Furthermore, although assistance provided by the U.S. Department of Veterans Affairs (VA) and community-based organizations offer a powerful means for getting veterans rehoused, veterans also recount numerous difficulties in accessing and obtaining VA services and assistance. Based on this, we offer specific recommendations for more systematic and efficient measures to help engage veterans with VA services that can prevent or attenuate their homelessness.

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“…1; 7; 13;20 The cumulative risk model has also been applied to homeless veterans and has shown that additional risk factors such as combat exposure, wartime trauma and post-traumatic stress disorder increase vulnerability to homelessness. 21 …”

Section: Introductionmentioning

confidence: 99%

Elderly Homeless Veterans in Los Angeles: Chronicity and Precipitants of Homelessness

Berk‐Clark

McGuire

2013

Am J Public Health

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We interviewed 33 chronically and 26 acutely homeless veterans aged 65 and over about their health and mental health, education and employment experience, social support, service needs and other precipitants of homelessness. Chronically homeless elderly veterans were more likely to have lower levels of education, had greater numbers and longer durations of prior homelessness, fewer social contacts providing instrumental support, and were more likely to report financial barriers to procuring housing. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction. The results suggest the importance of healthcare access and substance disorder treatment among elderly veterans and informs service delivery. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population.

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A model of homelessness among male veterans of the Vietnam War generation

Cited by 97 publications

References 10 publications

The Consumption of Khat and Other Drugs in Somali Combatants: A Cross-Sectional Study

The Consumption of Khat and Other Drugs in Somali Combatants: A Cross-Sectional Study

Pathways into homelessness among post-9/11-era veterans.

Elderly Homeless Veterans in Los Angeles: Chronicity and Precipitants of Homelessness

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