The Relationship Between Military Service Eras and Psychosocial Treatment Needs Among Homeless Veterans With a Co-Occurring Substance Abuse and Mental Health Disorder

Abstract

This article will examine baseline assessment data from consecutive admissions to the MISSION Program, a transitional case management program for homeless veterans, to better understand the differences across military service eras that impact the psychosocial treatment needs of homeless, mentally ill, substance-abusing veterans. In all, 373 homeless veterans with a co-occurring mental illness and substance abuse disorder received the Structured Clinical Interview for DSM-IV Diagnosis, a modified Addiction Severity Index, the BASIS-32, and a comprehensive assessment battery focusing on other psychosocial treatment needs. Chi-square analysis and ANOVA were used to measure differences in mental health, substance use, physical health status, and homelessness across service eras, broken down by Vietnam era, post-Vietnam era, and Persian Gulf/Middle East era. Persian Gulf/Middle East era veterans were significantly more likely to have mental health problems than other veteran cohorts, especially problems with post-traumatic stress disorder (p ≤ .001), and reported more days of mental health problems in the last month (p = .01). Mideast veterans also became homeless at a significantly earlier age than other veterans (p ≤ .001), were more likely to report housing instability in their families of origin (p ≤ .05) and to attribute their homelessness to mental health problems (p = .01). Service providers need to be aware of the diversity of homeless veterans' service needs by period of military service in order to develop well-targeted, effective interventions.