Utah researchers link military sexual trauma to higher risk for veteran homelessness

The devastating consequences of sexual trauma in the military reported by 25 percent of female and 1 percent of male veterans who served in the U.S. armed forces don't end with psychological and physical trauma, but are associated with a much higher risk for homelessness, a study led by Utah researchers has found.

An examination of the records of 601,892 veterans who served in Iraq or Afghanistan found that almost 10 percent of those who reported military sexual trauma (MST) when screened experienced homelessness at some point within five years of first seeking Department of Veterans Affairs (VA) care after their separation from the military between fiscal 2001 and 2011-more than twice the rate of those who reported no MST when screened. Approximately 12 percent of men who reported MST were homeless at some point within five years after seeking VA care compared with approximately 9 percent of women who reported MST.

Just under 584,000 of the vets screened reported no MST, while 18,597 reported MST, including 14,092 women and 4,505 men. The average age of all the veterans in the survey was just under 39. The association with homelessness was independent of other factors including mental health and substance abuse diagnoses. The study, published April 20, 2016, online in JAMA Psychiatry, comes as the U.S. Department of Veterans Affairs declares April as Military Sexual Trauma Awareness Month.

"Some of our men and women in uniform face challenges after they return from service and post-deployment homelessness is an extreme case of poor community reintegration," says Adi V. Gundlapalli, M.D., Ph.D., a researcher with the Salt Lake City VA Health Care System, associate professor of internal medicine at the University of Utah School of Medicine and corresponding author on the study. "Our work adds to the body of knowledge to identify factors associated with homelessness among Veterans with the ultimate goal of mitigating the risk. A positive MST screen status turned out to be a marker for homelessness in the absence of further diagnostic information."

Emily Brignone, B.S., a Utah State University (USU) doctoral candidate is first author, and Jamison D. Fargo, Ph.D., USU associate professor of psychology, is senior author. Rachel Kimerling, Ph.D., an expert in military sexual trauma at the VA Palo Alto, Calif., Health Care System (National Center on PTSD and Center for Innovation to Implementation (Ci2i)), also is an author.

"Male and female veterans who report MST are more vulnerable to homelessness both in the short- and long-term following their discharge from the military, with males at differentially greater risk," Brignone says. "These findings underscore the importance of trauma-informed care and trauma-specific interventions for veterans with a positive screen for MST."

The researchers examined Department of Defense and Department of Veterans Affairs (VA) records to determine MST screen status. The MST screen is considered positive if the veteran reports experiencing either sexual assault, or repeated, threatening sexual harassment during military service.

The higher rate of homelessness among vets who reported MST is seen not only in the long term but also immediately after discharge. The researchers found that among those with a positive screen for MST, 1.6 percent were homeless at some point within 30 days of being discharged and 4.4 percent were homeless at some point within one year. Each of those rates is more than twice as high as homelessness among vets who did not report MST, the authors found.

"Our goal is to raise overall awareness of military sexual trauma, including the impact on male veterans, and associated adverse outcomes such as homelessness," Kimerling says. "We hope all veterans with a history of MST will avail themselves of the free care offered in the VA for management of MST-related conditions."