Screening positively for military sexual trauma was independently associated with postdeployment homelessness, particularly among male veterans, according to recent findings.
“The U.S. Department of Veterans Affairs defines military sexual trauma as ‘psychological trauma, which in the judgment of a mental health professional employed by the Department, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the veteran was serving on active duty or active duty for training,’” Emily Brignone, BS, of VA Salt Lake City Health Care System, and colleagues wrote. “Approximately 25% of female and 1% of male veterans report having experienced [military sexual trauma] during their military service. Military sexual trauma is related to adverse outcomes following separation from the military, including [PTSD], depressive disorders, substance use disorders and higher rates of co-occurrence among these diagnoses. Military sexual trauma is also associated with poorer family relations and lower quality of life.”
To assess military sexual trauma as an independent risk factor for homelessness and gender differences in risk, researchers conducted a retrospective cohort study of U.S. veterans who used Veterans Health Administration services between 2004 and 2013. The cohort included 601,892 veterans deployed in Iraq or Afghanistan with a mean age of 38.9 years.
Rates of homelessness among participants who screened positively for military sexual trauma were 1.6% within 30 days, 4.4% within 1 year and 9.6% within 5 years. These rates were more than double those among participants who screened negatively for military sexual trauma (0.7%; 1.8%; and 4.3%, respectively).
A positive screen for military sexual trauma was significantly and independently associated with post-deployment homelessness.
Regression models adjusted for demographic and military service characteristics indicated risk for homelessness within 30 days (aOR = 1.89; 95% CI, 1.58-2.24), 1 year (aOR = 2.27; 95% CI, 2.04-2.53), and 5 years (aOR = 2.63; 95% CI, 2.36-2.93) was higher among veterans who screened positively for military sexual trauma, compared with those who screened negatively.
Military sexual trauma screening status remained independently associated with homelessness after adjusting for co-occurring mental health and substance abuse diagnoses, with adjusted ORs of 1.62 (95% CI, 1.36-1.93) for 30-day risk, 1.49 (95% CI, 1.33-1.66) for 1-year risk, and 1.39 (95% CI, 1.24-1.55) for 5-year risk.
Fully adjusted models found a significant association between military sexual trauma status and sex, indicating a higher risk for homelessness among males who screened positively for military sexual trauma.
“Taken together, results of this study highlight the importance of including [military sexual trauma] in theoretical models of postdeployment homelessness, of considering sex differences in the risk for homelessness in veterans, of promoting prevention and early intervention efforts for [military sexual trauma] and associated mental health difficulties, and of facilitating access to secure housing for those veterans in need,” Natalie Mota, PhD, of University of Manitoba, Winnipeg, Manitoba, Canada, and colleagues wrote in an accompanying editorial. – by Amanda Oldt
The researchers report no relevant financial disclosures.