Addressing Homelessness in the Veteran Community through a Trauma-Focused Lens.

Overview: Homelessness among the veteran population is a multidimensional systemic social problem. However, even with the vast number of individuals without adequate housing, innovative and proven methods have been implemented to address the issue. Having innovative treatment approaches in a client-centered manner will be examined while discussing an evidence-based treatment.Proposal text: The 2020 Annual Homeless Assessment Report to Congress reported, "On a single night in 2020, roughly 580,000 people were reported homeless in the United States" (2020 AHAR, p. 5). Also reported from this report was that 37,572 veterans were homeless, which accounted for eight percent of the total number of homeless people (2020 AHAR, p. 52). "Understanding the behavioral health needs of the homeless population and developing interventions to address their needs is instrumental to preventing and ending homelessness" (Tsai et al., 2017, p. 113). According to the SAMHSA report completed in 2019, 3.9 million veterans over 18 had substance use and mental health disorder. Therefore, it is important to note that veterans who are homeless, not engaged in services, and utilizing acute services frequently are most likely homeless or on the verge of losing their housing.
Montgomery et al. (2016) reported that permanent supportive housing provides housing to marginalized, vulnerable, and history of being homeless. However, the added supportive services assist them with their mental health and substance use. One collaborative effort that is currently in practice is between the U.S. Department of Housing and Urban Development (HUD) and the Department of Veterans Affairs (V.A.)-Supportive Housing (S.H.), which is specifically known as the HUD-VASH program. The goal is housing first while providing supportive services to address mental and medical health needs to maintain permanent housing.
While providing permanent housing is essential, it is equally important to engage with challenging individuals to address long-term barriers to sustaining housing. According to research, while the HUD-VASH program effectively increases providing permanent housing, "it is less effective for Veterans with mental health and substance use" (Smelson et al., 2018). This paper aims to define and analyze an evidenced-based treatment approach from a micro level to address homelessness with the veteran community with co-occurring disorders.
MISSION-Vet
MISSION-Vet uses CIT (Critical Time Intervention) and Dual Recovery Treatment (DRT) to fulfill its mission to end homelessness in the veteran community. There are five critical components of the MISSION-Vet program: CTI, DRT, peer support, and case management (Smelson et al., 2011). The MISSION Vet treatment method utilizes CTI with modification to apply "critical time" case management services to veterans exiting inpatient treatment while also working in tandem with the HUD-VASH program. This way, each veteran's needs are individualized, and it considers that some may require more "attention" than others. While providing a safe housing situation is important, it is equally as important to address the trauma through the use of evidence-based practices.
Lastly, challenges with the cultural perception of mental illness, lack of housing (transitional, emergency, and permanent), and barriers to accessing and retaining services to be discussed.