Addressing Veteran Homelessness to Prevent Veteran Suicides

Tsai, Jack; Trevisan, Louis; Huang, Minda; Pietrzak, Robert H.

doi:10.1176/appi.ps.201700482

Cited by 23 publications

(13 citation statements)

References 8 publications

(6 reference statements)

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“…Further, our finding that homelessness and suicide appear to be strongly linked among US veterans accords with a previous study 20. It is not clear exactly why this link is stronger among veterans than non-veterans.…”

Section: Discussionsupporting

confidence: 68%

Association between suicide attempts and homelessness in a population-based sample of US veterans and non-veterans

Tsai

Cao

2019

J Epidemiol Community Health

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BackgroundSuicide and homelessness share many of the same risk factors, but there is little understanding of how they are related to each other.MethodsData on 36 155 US adults (3101 veterans and 33 024 non-veterans) in the National Epidemiological Survey of Alcohol and Related Conditions-III were analysed to examine the association between lifetime homelessness and suicide, net of other factors, in a nationally representative US sample.ResultsUS veterans with homeless histories were 7.8 times more likely to have attempted suicide than veterans with no homeless histories (24.5% vs 2.8%). Non-veterans with homeless histories were 4.1 times more likely to have attempted suicide than those with no homeless histories (23.1% vs 4.5%). Lifetime homelessness was independently associated with lifetime suicide attempts in veterans (AOR=3.75, 95% CI 3.72 to 3.77) and non-veterans (AOR=1.83, 95% CI 1.83 to 1.84).ConclusionThe findings suggest a unique link between homelessness and suicide, especially among US veterans. Strategies to synergise homeless and suicide prevention services, particularly in the Veterans Health Administration, may benefit high-risk individuals.

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Section: Discussionsupporting

confidence: 68%

Association between suicide attempts and homelessness in a population-based sample of US veterans and non-veterans

Tsai

Cao

2019

J Epidemiol Community Health

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“…Addressing homelessness may also be critical to reduce veteran suicide and improve veteran physical and mental health. Homeless veterans are typically unknown and unenrolled in the VA system, and rates of suicide and suicide attempts are increased among homeless veterans compared to veterans in the VA system (Tsai et al, n.d.). A limitation is this study is the underestimation of the number of uncovered veterans and the frequency of chronic health conditions and SPD in the uncovered veterans because the data did not include the homeless.…”

Section: Discussionmentioning

confidence: 99%

Health coverage types and their relationship to mental and physical health in U.S. veterans

Weissman¹,

Russell

Haghighi

et al. 2019

Preventive Medicine Reports

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ObjectiveTo examine sociodemographic characteristics and chronic health conditions in veterans across health coverage types including those without coverage.DesignThe sample included cross-sectional data from veterans aged 18 years and over, collected in the 2016 National Health Interview Survey (n = 3487). Chronic health conditions and sociodemographic variables were examined across eleven health coverage types and combinations of health coverage types, as follows: No coverage, Medicare, Medicaid, Private, TRICARE (formerly known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)), TRICARE and Medicare, Veteran's Administration, Veteran's Administration and Medicare, Veteran's Administration and Private, Veteran's Administration and Private and Medicare.ResultsApproximately 3.9% of veterans did not have coverage. The greatest proportion had private coverage (28.2%), then private coverage plus Medicare (19.6%). Only 5.9% had Veterans Administration coverage solely. Among the veterans not covered, the majority were young, lived alone, had less than a high school education and resided in the South. The most common chronic health conditions among non-covered veterans were obesity and migraine. Regional differences were observed in the types of chronic health conditions. Veterans in the Northeast were less likely to report serious psychological distress. In a logistic regression, younger age (18–44 years), living alone and having less than a high school education were predictive of no coverage, but number of chronic health conditions was not.ConclusionA population of veterans without health coverage may be undeserved and at risk for poor mental and physical health due to non-health related factors.

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“…Although veterans account for only 8.5% of the population, veteran suicides account for approximately 18% of all suicide deaths in the United States (Office of Suicide Prevention in Veterans Health Administration, 2016). Mounting evidence suggests the psychosocial needs of veterans at risk for suicide are markedly complex and include legal involvement, homelessness, substance use, and psychopathology (Bohnert, Ilgen, Louzon, McCarthy, & Katz, 2017; Saxon et al, 2001; Tsai, Trevisan, Huang, & Pietrzak, 2018). As such, understanding these needs is likely key to suicide risk assessment and management of the nation’s veterans.…”

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confidence: 99%

Arrest history and psychopathology among veterans at risk for suicide.

Edwards

Gromatsky

Sissoko

et al. 2022

Psychological Services

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While preliminary evidence suggests an association between legal involvement and suicide risk among veterans, no research to date has explored the prevalence and/or correlates of legal involvement among veterans at high risk for suicide. The current study examined the relation of suicide attempt, suicidal ideation, and psychopathology to history of criminal arrest in a sample of 286 veterans at risk for suicide. Results indicated approximately half (47%) of at-risk veterans had a history of arrest. Inconsistent with hypotheses, arrest history was not associated with history of suicide attempt, current suicidal ideation, or severity of psychopathological symptoms. Arrest history was, however, associated with diagnoses of substance use disorder and antisocial personality disorder in this high-suicide risk sample. Further, likelihood of an antisocial personality disorder diagnosis was associated with higher frequency of past arrests. Taken together, results indicate that many veterans at risk for suicide have a history of arrest, and at-risk veterans with such history likely have a specific pattern of psychopathology, including antisocial personality traits and substance use. As such, legal status and history of justice involvement may be important considerations when assessing suicide risk and management of this high-risk population.

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Addressing Veteran Homelessness to Prevent Veteran Suicides

Cited by 23 publications

References 8 publications

Association between suicide attempts and homelessness in a population-based sample of US veterans and non-veterans

Association between suicide attempts and homelessness in a population-based sample of US veterans and non-veterans

Health coverage types and their relationship to mental and physical health in U.S. veterans

Arrest history and psychopathology among veterans at risk for suicide.

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