Overview

Post-traumatic stress disorder (PTSD) is considered a risk factor for homelessness among veterans. The lifetime prevalence of PTSD among all U.S. adults is estimated to be around 6.8%. Research suggests that this rate is much higher among veterans. As many as 30% of Vietnam veterans experience PTSD at some point during their lives. These increased rates of PTSD among veterans may play a role in explaining why they are overrepresented in the U.S. homeless population. While veterans make up 9.7% of the total population, they represent around 12.3% of the homeless population.

What Is PTSD?

Living as a homeless veteran is hard enough. Add in the struggles of PTSD, and it takes the situation to a whole different level. PTSD can affect anyone who’s experienced a traumatic situation, even if they’re not in the military. However, because traumatic situations can be commonplace in war zones, it affects military members disproportionately.       PTSD triggers a person’s “flight-or-flight” response in a situation that doesn’t necessarily require it. To be officially diagnosed with PTSD, a veteran will experience the following symptoms for at least one month:

At least one avoidance symptom. Avoidance symptoms stem from the affected veteran wanting to stay away from places, events or objects that remind them of the traumatic experience, as well as avoiding thoughts or feeling related to it. So, a veteran may avoid talking about war or may steer clear of people who served in the military altogether because being around other veterans brings back bad memories. At least one re-experiencing symptom. Re-experiencing symptoms are quite like they sound—flashbacks, which include physical symptoms such as sweating or elevated heart rate, bad dreams, and frightening thoughts. A veteran with PTSD may feel in immediate danger even when no actual threat is present. At least two cognitions and mood symptoms. Cognitions and mood symptoms mean that the affected person has negative feelings, both about themselves and the world around them, feelings of guilt or blame and has trouble remembering key parts of the event that caused PTSD. At least two arousal and reactivity symptoms. Arousal and reactivity symptoms, which are often constant, include startling easily, feeling tense, sleeping issues, and having angry outbursts.

PTSD is often accompanied by other mental illnesses. Common comorbid conditions include depression, anxiety, and substance abuse.  

Impact

Researchers estimate that between 11 and 20% of veterans who served in Operation Iraqi Freedom or Operation Enduring Freedom struggle with PTSD. Additionally, an estimated 12% of Gulf War veterans experience PTSD, while approximately 30% of Vietnam veterans have experienced PTSD in their lifetime. Many of these veterans with PTSD didn’t receive adequate treatment to help them deal with the traumatic events they witnessed in the military. Consequently, they struggle to maintain jobs and have difficulty finding things in common with their friends and families. When veterans are discharged from the military, many of them struggle to fit back in with civilian life. Research shows veterans’ lack of support and social isolation contributes to homelessness among veterans with PTSD. 

Homeless Veterans

The VA estimates that approximately 11% of homeless people are veterans. Additionally, homeless veterans are nearly entirely male; just 9% of homeless veterans are female. These veterans don’t come from any one particular war zone. Among them, homeless veterans served in wars ranging from World War II to Vietnam to Afghanistan and Iraq, as well as in the military’s anti-drug efforts in South America, says the National Coalition for Homeless Veterans (NCHV). So while PTSD is more common in veterans than in the general population, it is not any more of a risk factor for homelessness than other mental conditions. Other risk factors among veterans include other mental disorders, substance use, traumatic brain injuries, weak social support networks, low income, and unemployment.

Solutions

Many people assume the VA and other federal government departments are taking care of veterans when they leave the military. The VA does have a specialized homelessness program for veterans that provides health care to nearly 150,000 while more than 40,000 homeless veterans receive some sort of monthly compensation or pension, notes the NCHV. Additionally, the department has secured more than 45,000 beds for homeless veterans across the United States. For example, a joint program between the VA and the Department of Housing and Urban Development has awarded more than 85,000 Section 8 Housing Choice Vouchers to Public Housing Authorities across the country since 2008. In 2012, the VA introduced the Supportive Services for Veteran Families (SSVF) with the goal of both preventing homeless veterans and finding housing for those who do experience homelessness. In 2015, this service helped more than 157,000 people, including 99,000 veterans and 34,000 children, with just 9.4% returning to homelessness after benefits expired. That’s why there are community-based organizations that aim to meet the needs of homeless veterans—more than 2,100 of them across the country. The groups do what they can to work in collaboration with governmental agencies, veteran service organizations, and other homeless aid groups. NCHV notes that the most effective programs are those that allow for transitional housing for the veteran that’s both structured and substance-free—the ideal solution for all veterans struggling to return to a normal life.

How to Help

If you know of a homeless veteran, you can contact your local VA Medical Center. Trained staff can offer information about resources available in your community and the steps you might take to help someone. While you can’t force someone to get help (as long as the person is competent), sharing resources or alerting a professional to the situation may be a step in the right direction.  Notifying staff at your VA center of the situation is important. Some centers provide outreach workers who can meet with homeless veterans on the streets to provide them with urgent medical care or to inform them of housing assistance or treatment options for mental health or substance abuse issues.