Even if it lasts for a short time, homelessness is a traumatic and oftentimes life-changing experience that brings a lot of stress for the person involved, irrespective of their age, race, or sex. In a country as rich and as developed as America, no person should live without a roof over their head in constant anxiety about what tomorrow may bring. This is especially true of US veterans who were willing to put their life on the line to defend our ideals, values, and way of life.1

Being homeless brings a whole host of problems that make life harder and downright unhealthy. According to available data, as much as 40% of homeless people suffer from some type of chronic illness. Their rough living conditions significantly predispose them to develop tuberculosis, cardiovascular diseases, pneumonia, and HIV. Furthermore, certain types of cancer are more prevalent among homeless people than among other segments of the US population.2

For all these reasons, homelessness shortens people’s lives and puts them at risk of premature death. One study found that, depending on their age, mortality rates among homeless individuals could be 5 to 10 times higher than among the general population. Negative health consequences of homelessness can appear from a young age and even infancy since homeless pregnant women have a higher likelihood of delivering preterm and low birthweight offspring.3

In 2009, Congress passed the Homeless Emergency Assistance and Rapid Transition to Housing, or HEARTH Act, which updated the previous McKinney-Vento Homeless Assistance Act of 1987. The HEARTH Act authorizes assistance to homeless individuals who are defined according to the 4 criteria. Under the HEARTH Act, a person is considered homeless if he/she is:4

  • Literally homeless which extends to people living in a:
    • Place not meant for human habitation, or in a
    • Temporary dwelling, like a shelter, transitional housing, or a Safe Haven, or if they are
    • Exiting an institution where they resided for 90 days or less and were in a shelter or place not meant for human habitation immediately before entering the institution
  • In an imminent risk of homelessness, in case they are:
    • Losing housing within 14 days, or if they
    • Have no subsequent residence identified, or if
    • The person lacks the resources or support networks needed to obtain other housing
  • Homeless under other Federal Statutes, which includes people who:
    • Fall under the category of unaccompanied youth under 25 years of age or families with children who are homeless under other federal statutes
    • Had no lease, ownership interest, or occupancy agreement for permanent housing in the last 60 days
    • Suffer from persistent housing instability (2 or more moves in last 60 days)
    • Can be expected to retain homeless status due to special needs or 2 or more barriers to employment
  • Fleeing or attempting to flee domestic violence and have:
    • No housing options, or
    • No financial resources or support

Substance Abuse and Homeless Veteran Statistics

According to certain estimates, more than 10% of all homeless adults in America are veterans. Connecticut, Delaware, and Virginia have practically eradicated veteran homelessness along with 86 communities around the country. In contrast to them, California with 24.5% and Florida are the home of almost one-third of all homeless veterans in the US.5, 6

Great strides have been made, especially in the last decade, to tackle the problem of homelessness, especially among US veterans. The Department of Housing and Urban Development (HUD), Department of Veteran Affairs (VA), Department of Labor (DOL), and other government agencies and departments that are coordinated through the United States Interagency Council on Homelessness (USICH) have spearheaded this intensive interagency effort. Greater political will and increased focus and financing have resulted in significant improvements.7

According to the 2019 Annual Homeless Assessment Report (AHAR), homelessness among US veterans halved during the 2010-2019 period. Veteran homelessness peaked in 2010, with 74,087 homeless and 43,437 sheltered veterans. In 2019, those numbers were reduced to 37,085 and 22,740 respectively, showing a remarkable 50% drop in just 10 years. While these advances give much reason for optimism, the effects of the pandemic and economic instability will increase the need for further measures.7

When it comes to substance use disorder (SUD), the length of homelessness is an important factor that has a significant impact on whether the veteran will turn to an unhealthy level of alcohol consumption and illicit drugs. The longer veterans stay on the street, the greater the chance of developing a serious physical or mental health issue. Among veterans who were without a home for 2 or more years, roughly 55% developed a mental health condition, while a staggering 76% reported having substance abuse issues.8

Homeless veterans also have a higher incidence of dual diagnosis and tri-morbidity. Dual diagnosis is a co-occurrence of mental illness and addiction, while tri-morbidity is defined as a combination of physical illness, mental health conditions, and substance abuse issues. Almost half of the veterans who were homeless for 2 years or more had a dual diagnosis, while nearly a third had tri-morbidity. These conditions put them in an extremely endangered position that if left unaddressed can have life-threatening consequences.8

Why are Veterans Homeless?

Homelessness is a national problem that can affect anybody. The risk of homelessness is disproportionately higher for veterans than for the rest of the US population. There are numerous reasons why veterans become homeless. The main reasons that are driving homelessness among US veterans are mental health issues, chief among them is post-traumatic stress disorder (PTSD) and various forms of substance use disorder.9

Lack of affordable housing and a proper support system, growing income inequality, and poor access to quality health care were just some of the drivers of veteran homelessness. However, special attention has to be paid to the adverse effects of PTSD and substance use among veterans. These two issues frequently go hand-in-hand and it can be difficult to determine which preceded the other.9

In some cases, veterans with PTSD turn to alcohol and drug use as a form of self-medication, which then further aggravates their mental health condition. On the other hand, severe or long-term addiction can serve as a trigger that causes PTSD and other mental illnesses since veterans represent a particularly vulnerable segment of the population due to their history of military deployments and exposure to multiple mental health risk factors.9

Risk Factors within Homeless Veteran Community

Race and gender don’t play the role of major risk factors for veteran homelessness even though there are demographic differences between them and the rest of the adult homeless population. Both male and female veterans are at greater risk for homelessness than their non-veteran peers. In fact, veterans share many of the same risk factors for homelessness as non-veterans. Still, certain risk factors are unique to the veteran population.9

The most common risk factors that lead to veteran homelessness include:9

  • Factors that are the same for all demographics and populations, such as:
    • Lack of income or loss of a job
    • Lack of support networks
    • Substance use disorder
    • Mental illness
    • History of childhood adversity or abuse
  • Factors that are unique to veterans, including:
    • Problematic military discharges
    • Stress that is caused by transitioning to a civilian life
    • Lack of transferable work experience and skills
    • Low military pay grade
    • Societal stigmas and discrimination
    • Social isolation after military discharge

How Is Substance Abuse Connected to Veteran Homelessness? 

Once people succumb to regular or severe substance abuse, they lose their ability to think clearly. This endangers their ability to stay productive at work, maintain relationships, and be a positive influence and a force for good in their family lives. Loss of judgment can also lead to reckless behavior and dangerous situations that have unwanted consequences, both for veterans and the well-being of their loved ones.10

Addiction also costs a lot of money and can easily eat away at veterans’ budget or savings. Substance abuse represents a big financial burden that may lead to a loss of stability and eventually render veterans homeless. Once veterans experience the combination of homelessness and addiction, it becomes very hard for them to get back on their feet if they don’t get the appropriate support or enroll in proven drug and alcohol rehab programs.5

The longer this situation lasts, the harder it is for veterans to overcome these challenges and the greater the risk of succumbing to substance use or some type of illness, mental or physical. Homeless veterans tend to remain homeless longer than their nonveteran counterparts. Veterans remain homeless for roughly 6 years, whereas nonveterans experience 4 years of homelessness on average. Staying on the street for so long is one of the biggest challenges homeless veterans face when trying to turn their life around.11

Veterans who were diagnosed with mental disorders while serving in the army had a greater chance of becoming homeless upon finishing their military service. Almost half of the men and two-thirds of women veterans who became homeless were diagnosed with a mental health disorder before being discharged from active service. The percentage of newly homeless veterans who were diagnosed with a mental health condition increased to more than 75% prior to them becoming homeless.12

How to Help a Homeless Veteran Avoid Substance Abuse?

Approximately 7 out of 10 homeless veterans reside in principal cities. Lacking a proper home and living in a big city, veterans easily come into contact with illegal drugs and other substances that are offered on the streets. Not having any certainty and hardly any future to look forward to, homeless veterans turn to substance abuse in great numbers, with 70% of them suffering from substance use issues. Their struggles are further compounded by the fact that half of the veterans are 51 or older, have a disability, and suffer from a serious mental illness.12

Addiction, disabilities, stigmas, and a lack of marketable skills put homeless veterans on a downward spiral and it becomes very hard for them to turn things around without assistance from the wider society. Every member of the community that’s in a position to aid homeless veterans, whether through helping with housing or providing them with a job opportunity, should contact a proven rehab provider, veteran’s homeless shelter, or outreach program to learn more about specific things they can do.13

You can also be a positive influence and try to persuade a veteran to use their VA or private insurance coverage to enroll in a substance use rehabilitation program. You can also advise them to try a peer support group, an experience-sharing platform, or to try calling a hotline to discuss their issues and options. Sometimes contact with other people and working with peers can be that little step a veteran needs to find the strength to pull through hard times.13

Perhaps the most effective help for homeless veterans is community and peer-based, nonprofit, “veterans helping veterans” programs. These programs include transitional housing options that offer strong support in a structured, trigger-free environment where fellow veterans help each other in taking back control of their lives. There are more than 2,100 community-based homeless veteran service providers across the US that partner with federal, state, and local agencies. These programs significantly improve homeless veterans’ chances of becoming productive members of the community once more.12

Homeless Veteran Rehab Programs

Homeless veterans who have substance use disorder have the option of enrolling in proven inpatient rehabs and drug and medically-managed alcohol detox programs to tackle their addiction challenges. This will enable them to overcome the underlying issues that caused mental health conditions to arise in the first place. Overcoming addiction will help veterans get a fresh start and start thinking clearly about their future and life possibilities. Depending on their medical situation and personal needs, the VA offers multiple options, including but not limited to:14

  • Health Care for Homeless Veterans (HCHV) – that offers outreach, case management, and residential treatment services. It aids veterans’ transition from homeless living arrangements to stable housing accommodation through appropriate health care services.
  • Homeless Patient Aligned Care Teams (HPACTs) – that is based on the campuses of VA medical centers, community-based outpatient clinics, and Community Resource and Referral Centers. It integrates clinical care, social services, enhanced access, and community coordination inside a “medical home” designed to deal with the needs of homeless veterans.
  • Domiciliary Residential Rehabilitation Treatment Programs (DRRTP) – that offers veterans a residential level of care that treats issues they are commonly impacted by, including mental health issues, substance use disorders, PTSD, and homelessness.
  • Domiciliary Care for Homeless Veterans (DCHV) – that provides a residential level of care to homeless veterans. A DCHV may be a standalone program or part of a unit operating within a larger DRRTP program.
  • General Domiciliary (General Dom) or Psychosocial Residential Rehabilitation Treatment Programs (PRRTP) – These are VA programs that provide a residential treatment level of care to a general veteran population with varying needs. General Dom beds form a part of DRRTP, while PRRTPs represent standalone units.
  • Domiciliary PTSD (Dom PTSD) or Post-Traumatic Stress Disorder Residential Rehabilitation Treatment Program (PTSD-RRTP) – These are VA programs that provide a residential level of care to veterans who have PTSD-related issues, including veterans who suffer from Military Sexual Trauma. Dom PTSD may be part of DRRTP, while PTSD-RRTP represents a standalone unit.
  • Domiciliary SA (Dom SA) or Substance Abuse Residential Rehabilitation Treatment Program (SARRTP) – These VA programs offer a residential level of care to veterans who have a substance use disorder. Dom SA beds may be part of a larger DRRTP, while SARRTP represents a standalone program.
  • Compensated Work Therapy (CWT)-Transitional Residence (TR). The General CWT-TR program provides therapeutic work-based residential rehab services that are aimed at smooth community reintegration of US veterans. Individuals enrolled in Transitional Residence must also be enrolled in the Compensated Work Therapy program.

Frequently Asked Questions