subject: Veterans and Homelessness [print this page] Veterans and Homelessness Veterans and Homelessness
Veterans Who Are Homeless
By
David J. Koehn, Ph.D.
Challenge
Current population estimates suggest that approximately 107,000 veterans are homeless on any given night, and perhaps twice as many experience homelessness at some point during the course of a year. U.S. Department of Veterans Affairs (VA) is working diligently to eliminate veteran homelessness over the next 5 years and has designated "Eliminate Veteran Homelessness" as one of its 13 Greatest Challenges. Addressing this Challenge will also directly support VA's three integrated objectives for achieving its strategic goals, which include improving capability to delivery benefits, education, and health services to veterans.
One of its key points associated with the homeless deals with applying proven mental health treatments and actively tests promising techniques to relieve suffering. Critical risk factors associated with veteran homelessness are substance abuse and mental health problems (depression, traumatic brain injury- [TBI], and post traumatic stress disorder - [PTSD]). These risk factors are related to an inability of some veterans to handle stress as well as their sense of helplessness and hopelessness readjusting to society. Often they have inadequate coping strategies, experience interpersonal difficulties, lack a social support system, and feel lost as to career and job integration. Based on a RAND publication, "Invisible Wounds of War", PTSD, depression, and TBI all influence labor-market outcomes. Specifically, there is compelling evidence that these conditions will affect service member's return to employment, their productivity at work and their future job prospects, as indicated by impeded educational attainment. With a bleak outlook, many veterans end up homeless.
Key Issues
While there are many support programs provided by both VA and U.S. Department of Defense (DoD) to facilitate treatment, they are not linked. They should be since military personnel move in and out of both systems. This non-connectivity leads to ineffective and inefficient contiguous service delivery. Time to receive service is another problem as wait times to be seen for those seeking help can exceed a month. The courage it took to request services by the homeless veteran is then negated by the wait time, during which they may lose confidence and possibly not show up to be examined. Disparate services are evident in rural areas and offer unique challenges to providing the right types of treatment in a timely manner. Homeless veterans in these rural areas receive little attention for the services they need. No matter where homeless veterans reside, there are insufficient collaborative, holistic, treatment services being provided, and instead treatment modalities are myopic, singularly-focused, and lack an integrated approach.
Solution Approach
In providing better treatment to reduce suffering, two critical and interrelated issues are: (1) health care access and (2) continuity of care. Both are essential and critical to reducing suffering and offering a seamless interdisciplinary, synergistic quality treatment. Essentially there are signals and clues to what does work, but there are insufficient collaborative care model centers which still must be launched across the country. Being able to visualize the limbic system in color 3-D through functional magnetic resonance imaging (FMRI) can offer clues as to how the emotional centers are impacted. Such a picture offers promising assessment data that can be brought to bear on dealing with the emotional centers of the brain. Combining this salient data with an interdisciplinary treatment plan as identified in my paper on "Mental Health and the Veterans" will go a long way to reduce the invisible wounds of war for our veterans and service members.
