Running Head: HOMELESS VETERANS

Scholarly Paper: Homelessness Among United States Veterans

Nicole Bayer
Bon Secours Memorial College of Nursing
NUR 3113

HOMELESS VETERANS

A huge problem in the United States is homelessness. At any given time there are
approximately 633,782 homeless Americans. (State of Homelessness, 2012). However a
vulnerable population within the homeless population is Americas bravest, the veterans.
Homelessness is a huge problem among veterans, the brave men and women that sacrificed so
much for others freedom. Homelessness veterans account for 13% of the overall homeless
population. (Carlson, Garvert, Macia, Ruzek, & Burling, 2013). There are many social
determinates of health contributing to veteran homelessness in the United States.
A major social determinate of health contributing to homelessness among veterans is
substance abuse. According to the article Traumatic Stressor Exposure and Post-Traumatic
Symptoms in Homeless Veterans: Approximately 70% of veterans have substance abuse
issues. (Carlson et al., 2013). It is believed that the reason for substance abuse stems from the
trauma exposure and PTSD related to combat. In a study of veterans substance abuse was broken
down into two categories, alcohol use disorder and drug use disorder. It was found that 57% of
veterans were diagnosed with alcohol use disorder and 53% were diagnosed with drug use
disorder. (Tsai, Mares, & Rosenheck, 2012). Although substance abuse is a major factor
contributing to homelessness, it is not the only factor that plays a large role in homelessness.
Another contributing social determinate of health to homelessness among veterans is
mental illness. About 45% of homeless veterans are diagnosed with mental illness. The type of
mental illness can vary from schizophrenia to bipolar disorder to a major depressive disorder or
post-traumatic stress disorder (PTSD). Approximately 26% of veterans are diagnosed with major
depressive disorder, followed by 21% with schizophrenia, 17% with bipolar disorder and 8%
with PTSD. (Tsai et al., 2012). However veterans were more likely to seek outpatient mental

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health services than non-veteran homeless individuals were. According to Traumatic Stressor
Exposure and Post-Traumatic Symptoms in Homeless Veterans:
[] trauma exposure and PTSD are associated with increased rates of substance abuse,
anger and aggression, and impairments in functioning and relationships. In turn,
substance abuse, aggression, job satisfaction, and low social support have all been
associated with homelessness in veterans. [] combat trauma increases risk for
homelessness indirectly, through substance abuse, psychiatric disorder, and low social
support. (Carlson et al., 2013, p.972)
Mental illness, particularly PTSD, can be a result of many traumatic life events such as:
transportation accidents, home/work accidents, natural disasters, physical abuse as a
child, forced sex as a child, physical abuse as an adult, forced sex as an adult, attacked
with a weapon, military horror or scare, sudden death of close family or friend, seeing
someone badly hurt or killed, and some other sudden event that caused fear, helplessness
or horror. (Carlson et al., 2013, p.971)
With that said, mental illness can lead to many other disorders increasing the veterans risks of
becoming homeless. Most of the time homeless is a result of many factors playing a part together
such as alcohol abuse, mood disorders, psychotic disorders, combat PTSD, and chronic medical
conditions.
A serious problem associated with homeless veterans is suicide. According to Suicidal
Behavior in a National Sample of Older Homeless Veterans, the suicide risk of veterans, men and
women of all ages, was 66% higher than observed in the general population (J. Schinka, K.
Schinka, Casey, Kasprow, & Bossarte, 2012). Compared to the general male population, male

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veterans age 50 to 70 years old were 56% to 108% more at risk for suicide. (Schinka et al.,
2012). This is due in part to the PTSD, alcohol and drug abuse, psychiatric disorders, chronic
medical conditions, and most importantly the knowledge of the use and access to firearms. The
population most at risk for suicide among veterans were those that served in the all-volunteer
force and the Vietnam War. There are many programs in place to help these veterans.
There are programs established to help homeless veterans. The U.S. Department of
Veteran Affairs (VA) offers services for homeless veterans and helps them find placement in a
home. They are committed to ending homelessness among veterans. The VA works with the U.S.
Department of Housing and Urban Development and the Department of Health and Humans
Services to provide shelter and services to homeless veterans. The VA also provides extensive
counseling to the homeless to help with mental issues and substance abuse issues. If the veterans
chose to seek treatment in a non-VA community program, the VA coordinates its efforts with
multiple community providers in order to best serve the homeless veterans. (Tsai et al., 2012).
There has also been a study that observes the effect of music therapy among homeless veterans.
The study found that a common issue that needed addressing among the homelessness was the
establishment of trust and getting these homeless individuals to move out of isolation and into
the community, so they can be provided with services that can help them. The music therapy
consisted of familiar tunes and a volunteer staff that played the music at a homeless veterans
intervention program. Benefits of music therapy included increased alertness, engagement,
emotional intimacy and communication, enhanced resilience, mood, personal identity and quality
of life as well as reduced isolation and stress. (Powers, Heim, Grant, & Rollins, 2012). This
study indicated that music therapy may encourage social interaction which can point homeless
veterans in the right direction so they can get help. The Millennium Developmental goal that

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these groups hope to achieve is to eradicate extreme poverty. By providing services and shelters
to homeless veterans and their families they are attempting to eradicate extreme poverty within
this population. By working towards this goal there should be fewer numbers of homeless
veterans in the United States. Two global approaches to eradicating homelessness among
veterans are reducing injuries among and reducing non-communicable diseases. Injuries suffered
during war overseas often impact the way a veterans live their lives. If the injury causes them to
be unable to work then the number of homeless veterans will likely increase. Another injury that
is common among veterans are intentional injuries like suicide. Being suicidal is linked to
homelessness among veterans. Mental illness such as schizophrenia and PTSD is common
among veterans. Having mental illnesses puts these heroes at risk for homelessness. By reducing
injuries and non-communicable diseases globally there would be less homelessness among
veterans and veterans would be in a better state of health. These programs work together to
provide options for homeless veterans in order to keep them off of the streets.
There are many demographics regarding homeless veterans. Many of these individuals
experience substance abuse, mental issues, problems holding a job and low social support as
discussed above. Most of the homeless veterans are older. Within the classification of homeless
veterans, 96% were male and 4% were female. The race of homeless veterans was 47% black,
46% white, 4% Hispanic and 3% other races. (Carlson et al., 2013). As far as the marital status of
homeless veterans, 96% were either divorced, single, separated or widowed. Around 46% were
divorced and 35% were single. Only 4% of homeless veterans were married. Now what is
interesting is that the branch of the military that had the highest number of homeless veterans
was the Army with 48% being homeless. The Army was followed by the Navy at 22% homeless
and the Air Force not far behind at 20% homeless veterans. The Marine Corps had 8% homeless

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veterans while the Coast Guard had a mere 2% of homeless veterans. (Carlson et al., 2013).
Homelessness among veterans is a huge problem in the United States.
There are many social determinates of health that contribute to homelessness. Among the
veterans it seems to be a result of mental illness, substance abuse and social issues. It is
concerning that the majority of the homeless population are veterans from the United States
military. These heroes should not have to worry about where they will sleep every night
wondering if they will ever be able to get the help they desperately deserve. Veteran
homelessness is a huge problem and there needs to be more awareness in order to serve these
heroes that have given and sacrificed everything for Americas freedom.

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References
Carlson, E., Garvert, D., Macia, K., Ruzek, J., & Burling, T. (2013). Traumatic stressor exposure
and post-traumatic symptoms in homeless veterans. Military Medicine, 178(9), 970-973.
doi:10.7205/MILMED-D-13-00080
Powers, J., Heim, D., Grant, B., & Rollins, J. (2012). Music therapy to promote movement from
isolation to community in homeless veterans. Tennessee Medicine: Journal of the
Tennessee Medical Association, 105(1), 38-39.
Schinka, J. A., Schinka, K. C., Casey, R. J., Kasprow, W., & Bossarte, R. M. (2012). Suicidal
behavior in a national sample of older homeless veterans. American Journal of Public
Health, 102S147-53. doi:10.2105/AJPH.2011.300436
The State of Homelessness in America 2012. (2012). National alliance to end homelessness.
Retrieved from http://www.endhomelessness.org/
Tsai, J., Mares, A., & Rosenheck, R. (2012). Do homeless veterans have the same needs and
outcomes as non-veterans?. Military Medicine, 177(1), 27-31.