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Substance Abuse and Mental Health Services Administration
The relationship between military service eras and psychosocial treatment needs among homeless veterans with a co-occurring substance abuse and mental health disorder
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The MISSION Program is a transitional case management program for homeless veterans. This article will examine baseline assessment data from consecutive admissions to the MISSION Program in order to more fully understand the differences across military service eras that impact the psychosocial treatment needs of veterans who are homeless, mentally ill, and have substance-abusing issues (COD). In all, 373 homeless veterans with a COD received the Structured Clinical Interview for DSM-IV Diagnosis, a modified Addiction Severity Index, the BASIS-32, and a comprehensive assessment battery focusing on other psychosocial treatment needs. Chi-square analysis and ANOVA were used to measure differences in mental health, substance use, physical health status, and homelessness across service eras, broken down by Vietnam era, post-Vietnam era, and Persian Gulf/Middle East era. Persian Gulf/Middle East era veterans were significantly more likely to have mental health problems than other veteran cohorts, especially problems with post-traumatic stress disorder (p <= .001), and reported more days of mental health problems in the past month (p = .01). Mideast veterans also became homeless at a significantly earlier age than other veterans (p <= .001), were more likely to report housing instability in their families of origin (p <= .05) and to attribute their homelessness to mental health problems (p = .01). Service providers need to be aware of the diversity of homeless veterans' service needs by period of military service in order to develop well-targeted, effective interventions.