Increased Mortality Among Older Veterans Admitted to VA Homelessness Programs

Abstract

Older veterans who were homeless experienced excess mortality and increased suicide risk.

Suicidal Self‐Directed Violence Among Homeless US Veterans: A Systematic Review

“…Suicide decedents were identified using death certificates (one study; Dobscha et al., ) or the National Death Index (two studies; McCarthy et al., ; Schinka et al., ). Only one study (low risk of bias) reported a rate of suicide deaths among homeless veterans (i.e., 81.0 per 100,000; McCarthy et al., ).…”

“…Finally, Schinka et al. (; moderate risk of bias) compared veterans who were admitted into VA homeless programs with veterans who were not and, similarly, found that homeless veterans had significantly higher odds of dying by suicide (OR 1.93, CI (1.13, 3.48), χ 2 = 6.0, df = 1, p < .00; Schinka et al., ). No studies compared homeless veterans with US suicide rates more generally.…”

“…Additional criteria for inclusion were as follows: (1) the presentation of original study data in a peer‐reviewed journal article (i.e., dissertations, conference proceedings, commentaries, editorials, letters, books, book chapters, and reviews were excluded); and (2) the full‐text article was in English. During preparation of this manuscript, authors became aware of two articles published after 11/17/2015 (Schinka, Bossarte, Curtiss, Lapcevic, & Casey, ; Schinka et al., ). Because those studies met all other inclusion criteria, they were included in an effort to make this review as comprehensive as possible.…”

Impact of group motivational interviewing on enhancing treatment engagement for homeless Veterans with nicotine dependence and other substance use disorders: A pilot investigation

“…Given that tobacco use is the leading preventable cause of morbidity and mortality, and that homeless Veterans are highly vulnerable to dependence on nicotine, researchers have called for increased programs designed to enhance smoking cessation treatment engagement within the VA healthcare system, 6 as well as increased innovative approaches for engaging larger number of Veterans admitted to VA homeless programs for reducing the high incidence of mortality among this group. 15 Related to this issue is the ability of homeless Veterans to find housing once they seek assistance through VA supported housing (VASH) or other subsidies for permanent housing within the community. Available rental properties are quite limited for smokers, suggesting that smoking cessation may play an important role in increasing housing attainment.…”

Is homelessness a traumatic event? Results from the 2019–2020 National Health and Resilience in Veterans Study

“…In the Diagnostic and Statistical Manual of Mental Disorders‐Fifth Edition ( DSM‐5 ; American Psychiatric Association, 2013), the precipitating event or stressor is known as Criterion A and involves direct or indirect exposure to “death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence.” The experience of homelessness may qualify for Criterion A as illustrated by comments made by individuals experiencing homelessness, such as “I thought I was going to die” (Law, 2019) and “My fear is being found on the street, but no one knowing how to help me or who I am” (Song et al, 2007). There are also many studies that have found homelessness is linked to substantially elevated rates of health morbidities, physical and sexual victimization, and mortality (Gorman & Rowan, 2019; Nilsson et al, 2018; Riley et al, 2020; Schinka et al, 2016; Tong et al, 2019).…”