Characteristics and service utilization of homeless veterans entering VA substance use treatment.

Abstract

This article compares characteristics and health care utilization patterns of homeless veterans entering substance use disorder (SUD) treatment. Baseline self-report and medical record data were collected from 181 homeless veterans participating in a randomized trial of SUD/housing case management. Veterans, categorized as newly (n = 45), episodically (n = 61), or chronically homeless (n = 75), were compared on clinical characteristics and health care utilization in the year prior to baseline. Between-groups differences were seen in stimulant use, bipolar, and depressive disorders. A significant majority accessed VA emergency department services, and nearly half accessed inpatient services, with more utilization among chronically versus newly homeless. A majority in all groups attended VA primary care (73.5%) and mental health (56.9%) visits, and 26.7% newly, 32.8% episodically, and 56.0% chronically homeless veterans initiated multiple SUD treatment episodes (p = .002). A significant proportion of veterans struggling with homelessness and SUDs appear to remain unstable despite high utilization of VA acute and preventative services. (PsycINFO Database Record

Homelessness as a public mental health and social problem: New knowledge and solutions.

“…In addition to specialty mental health care, Cox, Malte, and Saxon (2017) assessed for health care utilization patterns in homeless veterans engaged specifically in SUD treatment. This study of 181 veterans in a randomized trial of housing and SUD case management were identified as being newly, episodically, or chronically homeless.…”

Homeless Veterans: It Takes a Community

“…The AHCM group did have a longer average stay in the treatment program with a 52.7 days average. The AHCM group was also noted to show more participation within the group than did the HSG control group (Malte, Cox, & Saxon, 2017a). The overall conclusion of this study was mixed and failed to disprove the null hypothesis that HSG was superior to the AHCM approach to homelessness and substance abuse (Malte, Cox, & Saxon, 2017a).…”

“…The AHCM group was also noted to show more participation within the group than did the HSG control group (Malte, Cox, & Saxon, 2017a). The overall conclusion of this study was mixed and failed to disprove the null hypothesis that HSG was superior to the AHCM approach to homelessness and substance abuse (Malte, Cox, & Saxon, 2017a). Research will have to be expanded in order to justify moving away from the HSG program, which has equally modest results as AHCM.…”

“…The test group would receive the intervention of both addiction case management services and housing case management services. Each would work together to follow each participant within the substance abuse program and help to transition the veteran to appropriate housing with continued support by both entities (Malte, Cox, & Saxon, 2017a).…”

Increasing Use of Video Telehealth Among Veterans Experiencing Homelessness with Substance Use Disorder: Design of A Peer-Led Intervention

“…Homelessness compounded by SUD increases life chaos and health risks (e.g., infectious disease through needle sharing) often with fatal consequences (Cox et al, 2017). Hence, it is imperative to connect veterans experiencing homelessness with SUD to healthcare, including primary, specialty, and SUD treatment options.…”