History of co-occurring disorders and current mental health status among homeless veterans

Abstract

BackgroundHomeless veterans are at high risk for co-occurring disorders (COD), defined as mental illnesses that include at least one alcohol or other drug use disorder and at least one non-drug related mental disorder. However, epidemiological studies examining the prevalence of COD and associated mental health status in this population are limited. The objectives of the study were: (1) to describe a history of diagnosed mental disorders among homeless veterans admitted to a transitional housing program, and (2) to examine the associations of the prior diagnosed COD and other mental disorders with current mental health status.MethodsStudy participants were male homeless veterans admitted to a transitional housing program from July 2015 to September 2017 in a large municipal area in Northeast Ohio, the United States. Cross-sectional, self-reported data from the admission assessment were included and analyzed. History of mental disorder diagnoses were aggregated into five categories for the purpose of this study: no mental disorders, only alcohol or other drug use disorder(s), one non-drug related mental disorder, two or more non-drug related mental disorders, and COD. Current mental status were measured as empowerment, mental component summary score (MCS) and physical component summary score (PCS) of health related quality of life (VR-12), and perceived overall well-being. Sample distribution of the five categories and their associations with current mental status were examined using Generalized Linear Model test.ResultsOf all participants, 76.7% had at least one prior diagnosed mental disorder, including 47.4% with any drug-related disorders. Over one-third (37.2%) reported having COD. Compared to those with no mental disorder history, those with COD scored significantly lower on MCS and empowerment scores; those with any prior diagnosed non-drug related mental disorders also scored significantly lower on MCS. No significant differences, however, were found in current mental health status between those with COD and those with mental disorders but not COD.ConclusionsCOD prevalence among homeless veterans was within the parameter of other literature reports. Veterans with COD compared to veterans with no history of mental disorders tended to have lower MCS and empowerment scores. Veterans with COD had the same mental health status as those with other mental disorders.

Translation and adaptation of the German version of the Veterans Rand—36/12 Item Health Survey

“…This patient population has special medical needs, is older, poorer, sicker (with more diseases than veterans nationally) and has a higher percentage of men than the general adult population [ 12 – 14 ]. The creation of the VR instruments has been previously documented [ 13 – 16 ] and shown to be valid for the VA population [ 13 , 17 – 27 ] as well as other general US populations [ 28 – 35 ]. The English-language VR instruments have become an integral part of registries [ 36 ] and studies of National U.S. health programs [ 18 , 37 , 38 ] including the evaluation of the Medicare Advantage Program by the Centers for Medicare and Medicaid Services (CMS).…”

Factors That Influence Quality of Life in People Experiencing Homelessness: A Systematic Mixed Studies Review

“…Four of the 18 quantitative descriptive studies met all of the criteria outlined in the MMAT (Bonin et al, 2017;Garey et al, 2016;Garey et al, 2019;Gentil et al, 2019). Three studies did not describe their sampling criteria well enough to determine if it was adequate to answer the research question (Coleman, 2017;Ding et al, 2018;Ito et al, 2014). The risk of nonresponse bias was high in two studies (Robinson, 2019;Sun et al, 2012).…”

“…Additional physical factors directly affecting QoL among PEH were pain (Ito et al, 2014) and sleep (Crisanti et al, 2017). Mental health diagnoses (Crisanti et al, 2017) and dual mental health and substance use disorder diagnoses were also found to be significantly related to decreased QoL (Ding et al, 2018;McGuire et al, 2011). Additionally, others examined the effects of substance use on QoL and reported that those who used illicit drugs (Magee et al, 2019;O'Brien et al, 2015) and alcohol (Stergiopoulos et al, 2014) had lower QoL than participants who did not report substance use.…”

The Role of Homeless Shelter Workers: A Study of Staff Serving Homeless Veterans

“…Veteran homelessness has received public and scholarly attention in recent decades (Applewhite 1997; Creech et al 2015; Ding, Slate, and Yang 2018; Perl 2015; Tsai, Doran, and Rosenheck 2013; Tsai et al 2016; Tsai, Mares, and Rosenheck 2012). Initially, the issue of homelessness among veterans became noticeable in the 1970s and 1980s (Perl 2015).…”