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Background: Homelessness is a major public health problem among U.S. military veterans. However, contemporary, population-based data on the prevalence, correlates, and mental health burden of homelessness among veterans are lacking. Methods: Data were analyzed from the 2019–2020 National Health and Resilience in Veterans Study, a nationally representative survey of veterans (n = 4069). Analyses examined the prevalence and correlates of homelessness, as well as the independent associations between homelessness and current probable psychiatric conditions, suicidality, and functioning. Results: The lifetime prevalence of homelessness was 10.2% (95% confidence interval 9.3–11.2). More than 8-of-10 veterans reported experiencing their first episode of homelessness following military service, with a mean of 10.6 years post-discharge until onset (s.d. = 12.6). Adverse childhood experiences (ACEs), cumulative trauma burden, current household income, younger age, and drug use disorder emerged as the strongest correlates of homelessness (49% of total explained variance). Veterans with a history of homelessness had elevated odds of lifetime suicide attempt, attempting suicide two or more times, and past-year suicide ideation [odd ratios (ORs) 1.3–3.1]. They also had higher rates of current probable posttraumatic stress disorder, major depressive, generalized anxiety, and drug use disorders (ORs 1.7–2.4); and scored lower on measures of mental, physical, cognitive, psychosocial functioning (d = 0.11–0.15). Conclusions: One in ten U.S. veterans has experienced homelessness, and these veterans represent a subpopulation at substantially heightened risk for poor mental health and suicide. ACEs were the strongest factor associated with homelessness, thus underscoring the importance of targeting early childhood adversities and their mental health consequences in prevention efforts for homelessness in this population. [ABSTRACT FROM AUTHOR]

Rapid rehousing (RRH), a programmatic approach that seeks to help households currently experiencing homelessness quickly regain stable housing, has garnered increasing attention over the past decade in the United States and internationally. However, there has been no attempt to assess evidence of the effectiveness of RRH. We address this gap by conducting a systematic review to assess the overall quality of evidence on the impact of RRH; summarize evidence of the effectiveness of RRH on housing, health, social, economic and other outcomes; and summarize evidence regarding whether the effectiveness of RRH varies as a function of the characteristics of persons receiving RRH. We rate the overall methodological rigour of evidence on the impact of RRH as moderate. We find mixed evidence about the impact of RRH as compared to usual care and other housing interventions, and no evidence of a differential impact of RRH depending on recipient characteristics. We discuss how future research might help guide the provision of RRH. [ABSTRACT FROM AUTHOR]

This study examined experiences with eviction, house foreclosures, and homelessness in a large U.S. city sample of adults with Coronavirus Disease-2019 (COVID-19). A total of 3595 adults with COVID-19 participated in an assessment of health and well-being after completing contact tracing activities. The sample had a 5.7% lifetime prevalence of eviction, 3.7% lifetime prevalence of house foreclosure, and 8.2% lifetime prevalence of homelessness. Relative importance analyses revealed drug use was the most important variable associated with any lifetime eviction, lifetime house foreclosure, lifetime homelessness, and being currently at-risk of eviction or recently evicted. Loneliness was also relatively strongly associated with any lifetime eviction or homelessness, while socioeconomic characteristics were the most importance variables associated with late mortgage payments in the past month. Treatment for addiction problems may be important for in the aftermath of the COVID-19 pandemic and adults with histories of housing instability may be particularly at risk. [ABSTRACT FROM AUTHOR]

This study evaluated a pair of video games called the RePresent games that taught users how to represent themselves in civil court. A quasi-experimental study was conducted that compared 69 RePresent game users and 78 non-game users with civil legal issues across four U.S. states on legal, mental health and psychosocial outcomes over 3 months. The results revealed that RePresent game users reported greater legal knowledge, better mental health and higher quality of life than non-game users across time, and a greater rate of improvement in legal knowledge than non-game users over time. These findings suggest that gamifying education about legal procedures for the general public holds great potential in helping individuals obtain self-help legal assistance although some formal mental health treatment may be needed for many seeking legal aid. [ABSTRACT FROM AUTHOR]

This study examined the descriptive terms used in referring to homeless populations. Data were from a 2020 national survey of 6,607 middle- and low-income U.S. adults with or without lived experiences of homelessness and a 2021 survey of a convenience sample of 354 U.S. researchers, homelessness service providers, and policy makers. Among the middle- and low-income adults, 70%–73% reported using the term "homeless person," although adults with histories of homelessness were more likely to use "person experiencing homelessness" than those with no such histories. Among the providers, researchers, and policy makers, ≥39% reported using "person experiencing homelessness" in both writing and speaking, and they also had consensus around using "person at risk of homelessness" and "person in shelter." Most stakeholders agreed that "homeless person" or "person experiencing homelessness" are acceptable terms. Because usage may vary by social background, profession, and individual, best practice may be to ask individuals with experiences of homelessness what terms they prefer to use. [ABSTRACT FROM AUTHOR]

The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well-studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors related to social integration, (b) examine the association between clinical symptoms and social integration, and (c) examine whether social integration is associated with life satisfaction. A factor analysis identified six components of social integration: housing, community participation, civic activities, religious faith, social support, and treatment support. Social integration was found to be largely independent of clinical symptoms and had only a weak association with life satisfaction. These findings suggest supported housing programs needed to focus on improving client outcomes in several domains of social integration regardless of symptoms and that additional efforts are needed to improve life satisfaction among clients. (Contains 4 tables.)