Addressing Veteran Homelessness to Prevent Veteran Suicides



The U.S. Department of Veterans Affairs (VA) is shifting its focus from ending veteran homelessness to preventing veteran suicides. With supporting data, this Open Forum argues that VA homelessness services also help address veteran suicides. Analysis of a nationally representative survey of U.S. veterans in 2015 shows that veterans with a history of homelessness attempted suicide in the previous two years at a rate >5.0 times higher compared with veterans without a history of homelessness (6.9% versus 1.2%), and their rates of two-week suicidal ideation were 2.5 times higher (19.8% versus 7.4%). Because the majority of veterans who die by suicide are not engaged in VA care, VA services for the homeless that include outreach efforts to engage new veterans may be reaching some of these veterans. Thus continued federal support for VA homelessness services not only may help address homelessness but also may help prevent suicide of veterans.

In 2009, the U.S. Department of Veterans Affairs (VA) announced its goal to end veteran homelessness and subsequently spent over $10 billion over the next seven years on VA health care, housing, and social services for homeless veterans. Considerable progress has been made, with annual point-in-time counts indicating a 47% drop in veteran homelessness from 2009 to 2016 (1). Under the new federal administration, administrative support and funding for VA homelessness programs may change, but how is not clear. For example, in late 2017, VA Secretary David Shulkin initiated plans to redirect millions of dollars for VA homelessness services to other VA services (2) until a wave of protests from veteran advocates caused the secretary to retract these plans in December (3). Moreover, under the new administration, the VA secretary has made veteran suicide the top clinical priority in the VA, which may shift focus away from veteran homelessness and toward veteran suicide.

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Psychiatry Online