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 Compared to veterans who didn't experience sexual assault, battery
or harassment during their military service, those who did were
about twice as likely to be homeless during the five-year study,
researchers found.
"I think what stood out was the magnitude of difference," said lead
author Emily Brignone, of Utah State University in Logan.
The Veterans Health Administration (VHA) introduced universal
screening for military sexual trauma in 2004. This kind of trauma
has been tied to a number of poor health outcomes, including
posttraumatic stress, depression, poor relationships with families
and lower qualities of life.
But whether it affects veterans' risk of homelessness hasn't been
studied until now, the researchers write in JAMA Psychiatry.
The new findings are drawn from VHA data on 601,892 veterans who
served in Iraq or Afghanistan and who left the military between 2001
and 2011.
Overall, 18,597 of these veterans were found to have experienced
sexual trauma, based on a "yes" answer to at least one of two
questions: did you ever experienced unwanted or uninvited sexual
attention, and did someone ever use force or the threat of force to
have sexual contact with you.
About 2 percent of vets who had experienced military sexual trauma
were homeless within 30 days of their first VHA visit, about 4
percent were homeless at one year, and almost 10 percent were
homeless at five years.
Those rates were roughly double what was seen among veterans without
military sexual trauma.
The connection between military sexual trauma and homelessness
appeared to be stronger among males and persisted even after
adjusting for factors such as mental health and substance abuse.
The new study can't say why these veterans were more likely to be
homeless, but Brignone said a number of factors could explain the
link.
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Military sexual trauma, "or even more broadly sexual victimization
can have far-reaching effects on mental health and psychological
outcomes," she said.
An editorial published with the new study points out that more work
is needed to reach veterans who get care outside the VHA, because
only 25 percent identify the VA healthcare system as their primary
provider.
Natalie Mota of the University of Manitoba in Canada and colleagues
write in the editorial, "Such efforts . . . ultimately may help
mitigate the risk of postdeployment homelessness among those who
have served."
Brignone said the new findings underscore the importance of timely
evidence-based interventions.
"Maybe there are ways we can improve screening protocols and get
them into care more quickly, but not everyone who screens positive
is going to want or get care," she said. "I think additional
research is definitely in order."
SOURCE: http://bit.ly/23KmLeP and http://bit.ly/23KmPer JAMA
Psychiatry, online April 20, 2016.
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