Military Sexual Trauma Among Homeless Veterans

Abstract

BACKGROUNDMilitary sexual trauma (MST) is the Veteran Health Administration’s (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans.OBJECTIVETo estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men.DESIGN AND PARTICIPANTSNational, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010.MAIN MEASURESAll variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization.KEY RESULTSOf homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST.CONCLUSIONSA substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless programs in providing mental health care to homeless Veterans.

Differential Risk for Homelessness Among US Male and Female Veterans With a Positive Screen for Military Sexual Trauma

“…The results of this study extend previous research [8][9][10][11][12] in several ways. First, the samples used in this study included veterans with and without a history of homelessness, allowing for direct comparisons between these groups.…”

Perceptions of Institutional Betrayal Predict Suicidal Self-Directed Violence Among Veterans Exposed to Military Sexual Trauma

“…MST is associated with significantly increased risk for suicidal self‐directed violence, defined as “behavior that is self‐directed and deliberately results in injury or the potential for injury to oneself” (Centers for Disease Control and Prevention, , p. 21). Veterans who screen positive for MST are more likely to have a history of suicide attempt, relative to Veterans without MST (Kimerling, Gima, Street, Smith, & Frayne, ; Klingensmith, Tsai, Mota, Southwick, & Pietrzak, ; Pavao et al., ). Further, multiple studies suggest that MST is also associated with suicidal ideation (Gradus, Street, Suvak, & Resick, ; Klingensmith et al., ; Monteith, Menefee, Forster, Wanner, & Bahraini, ).…”

Addressing the knowledge gap: sexual violence and harassment in the UK Armed Forces

“…A number of psychological difficulties are reported, including increased symptoms of depression, anxiety and post-traumatic stress disorder (PTSD), substance use disorders and sleep problems 10 18. Furthermore, individuals who have experienced MST have more problems readjusting to civilian life,19 and MST is associated with increased risk of homelessness following discharge 20. While there are a number of differences between the UK and US militaries making comparison questionable, it is clear that sexual violence and harassment makes service personnel more vulnerable to psychosocial problems.…”