Moving Beyond Housing: Service Implications for Veterans Entering Permanent Supportive Housing

Abstract

As a result of efforts to end homelessness among U.S. veterans, more former service members are entering permanent supportive housing (PSH). While PSH has been successfully used to house homeless veterans, more research is needed about services beyond housing placement and retention. This study uses the Gelberg-Andersen behavioral model for vulnerable populations to determine associations between predisposing, enabling, and need characteristics and recent service use (i.e., services to satisfy basic needs, occupational development, financial, healthcare, mental health) among unaccompanied homeless veterans (N=126) entering PSH in Los Angeles. Among the significant findings, as indicated using univariable logistic regression models, were veterans who had incarceration histories were more likely to utilize basic needs services, compared to those without incarceration histories. Veterans who received an honorable discharge were more likely to utilize occupational development services, compared to veterans with other discharge statuses. Veterans who had a case manager were more likely to utilize mental health services than those without a case manager, while those who received social security were less likely to utilize mental health services compared to veterans who did not receive social security. Veterans who met criteria for a psychological disability and veterans who met criteria for probable PTSD were more likely to use basic needs services and mental health services than veterans who fell below these thresholds. Clinical implications for social workers including “equal access to services,” “enhancing economic stability,” “providing safe and affordable housing with trauma-informed services,” and “training service social workers to deliver well-informed linkages and services” are discussed.

Motivational and cognitive correlates of community integration in homeless veterans entering a permanent supported housing program.

“…Although the two samples were selected based on the presence or absence of a psychotic disorder, they were demographically highly similar. Notably, the proportion of African Americans was elevated compared to the Greater Los Angeles population, which is similar to the case in prior research on veterans receiving permanent supported housing in this region (Harris, Winetrobe, Rhoades, Castro, & Wenzel, 2018). High lifetime levels of substance use disorders also characterized both samples, which are very similar to national prevalence rates for veterans in HUD-VASH (Tsai et al, 2014).…”

Health Service Access Among Homeless Veterans: Health Access Challenges Faced by Homeless African American Veterans

“…More recent research on Post-9/11 veterans found that relationship dissolution was closely related to homelessness risk [ 65 ]. According to two studies, not only do veterans experiencing homelessness have less support physically going to and from medical appointments, but social isolation can also limit social pressure to pursue needed medical care, knowledge of available services, or even a desire to pursue care more broadly [ 14 , 55 ]. Chinchilla and colleagues (2019) found no significant differences between African American and White veterans on measures of community adjustment [ 66 ].…”

“…Another study on peer navigators found that ninety percent of homeless veterans accessing peer navigator services identified as members of minority groups; when peer navigators share demographic characteristics and identities with those they serve, veterans may feel more trusting and be more amenable to accessing care [ 56 ]. Peer navigators’ shared experiences allow for interpersonal support and empathy, leading to positive health and housing outcomes [ 14 , 52 , 56 , 88 – 90 ].…”

Closing the Affordable Housing Gap: Identifying the Barriers Hindering the Sustainable Design and Construction of Affordable Homes

“…Poor affordable housing outcomes for low-income groups with high healthcare and support needs are reported internationally. Several studies have displayed a shortage of affordable homes offering features which are relevant to homeless veterans [159], individuals with physical impediments [160][161][162][163], and people suffering from psychiatric disabilities [164], cognitive impairments [165], or complex neurological conditions [166]. This suggests that the design of affordable housing solutions is not properly informed by the needs of individuals affected by complex disabilities and that there is a lack of understanding of what design principles can lead to the provision of affordable residential dwellings which are appropriate for these specific populations, who experience the greatest need [167,168].…”