Homelessness among veterans is a prominent issue in the United States. Veterans are especially vulnerable to homelessness due to the unique challenges they face when returning home from war, including physical and mental health issues, substance use disorder (SUD), unemployment, and lack of access to financial resources.1

Homelessness can be traumatic for anyone, but it can be especially traumatic for veterans who are used to life in the military, transitioning from a structured environment to one of instability and feeling invisible. These veterans may often feel isolated and abandoned and have a hard time adjusting to life on the streets. Additionally, living without a stable home can cause mental health issues and impede access to medical care resources that would otherwise be available, furthering the downward spiral for already vulnerable individuals.1

The exact number of homeless individuals is difficult to gauge. According to the Homeless Emergency Assistance and Rapid Transition to Housing, or the HEARTH Act, this population can be divided into four main categories: literally homeless, in imminent risk of homelessness, homeless under other federal statutes, and fleeing or attempting to flee domestic violence.2

Literally Homeless: This category includes struggling individuals who are sleeping on the streets or in places not meant for human habitation such as parks and abandoned buildings. A lot of these individuals suffer from chronic disabilities related to their military service and substance abuse problems that prevent them from finding stable housing.
In Imminent Risk of Homelessness: This group consists of those who have recently lost their place of residence due to eviction or loss of income and are in danger of becoming homeless within 14 days if they don’t find alternate housing. They may rely on family or friends for temporary housing but are still at risk for homelessness if there is no long-term solution available.
Homeless Under Other Federal Statutes: This category refers to those who qualify as homeless according to definitions used by federal statutes. These definitions may include people staying in shelters or transitional housing programs, as well as those living with family members on a temporary basis due to economic hardship or disability resulting from their military service.
Fleeing or Attempting To Flee Domestic Violence: This population includes those who have left a violent home environment due to abuse by an intimate partner or family member and now lack safe housing options. Many times these individuals may have difficulty accessing services because they do not meet other criteria for being classified “homeless” under federal program standards and therefore cannot receive assistance meant for this demographic.

Substance Abuse and Veteran Homelessness Statistics

Substance abuse is an unfortunately common issue among veterans and has been implicated as a key contributing factor in veteran homelessness. According to a report by the National Coalition for Homeless Veterans (NCHV), half of all homeless veterans have substance abuse issues. These issues can make it more difficult for struggling individuals to get the help they need, as they can complicate and worsen their situation even further.3

The effects of substance abuse on veterans’ mental health can be particularly severe. The National Vietnam Veterans Readjustment Study, conducted in the 1980s, found that 74% of Vietnam Veterans suffering from posttraumatic stress disorder (PTSD) also had SUD. This suggests that veterans are self-medicating their PTSD symptoms with substances, leading to further mental health issues and a higher risk of becoming homeless.4

In addition to increasing the risk of veteran homelessness, substance abuse is also linked to poorer long-term outcomes such as reduced quality of life, greater physical health problems, and higher mortality rates. A 2019 report from the Substance Abuse and Mental Health Services Administration (SAMHSA) found that 6.2% or 1.3 million veterans older than 18 struggle with substance abuse, highlighting the need for effective addiction treatment services tailored specifically to this population.5

What are the Causes of Veteran Homelessness?

There are a multitude of factors that contribute to homelessness among veterans, including mental health issues such as PTSD and different forms of SUDs. Veterans may experience PTSD as a result of their military service and this could lead them to become homeless. SUDs are also part of the mix; alcohol abuse and addiction can have severe impacts on a veteran’s ability to sustain employment or stable housing. Unfortunately, these issues can get out of hand very quickly if not addressed in an appropriate manner.6

Another primary cause of veteran homelessness is the lack of affordable housing and a proper support system. Veterans may struggle to find stable housing due to limited rental assistance programs or difficulty earning enough money for monthly rent payments. Further exacerbating this issue is the growing income inequality between the wealthiest citizens in America and those with lower incomes; this inequality leaves more people without access to affordable housing options, leaving them vulnerable to becoming homeless if they struggle with financial hardship.6

Poor access to quality healthcare also contributes significantly to veteran homelessness. Without sufficient medical coverage, even minor physical or mental health issues can become too expensive for a veteran who has already experienced financial instability due to unemployment or underemployment. And while some programs like the VA exist that provide healthcare services for veterans at no cost, a lack of knowledge about these services combined with insufficient funding means many veterans go without necessary medical treatment until it’s too late, oftentimes leading them into homelessness as a result.6

Risk Factors Within the Homeless Veteran community

Transition stress, substance abuse, lack of income, lack of family/social support and mental health changes can all be risk factors within the homeless veteran community.6

Transition stress can be one of the most significant risks for homeless veterans. Moving from active duty to civilian life can be quite an adjustment, especially if they haven’t lived as a civilian in some time. Not having access to military resources and feeling that disconnection from their former lifestyle can leave them with feelings of isolation and uncertainty over their new lives as civilians. This transition period also often coincides with other life changes such as moving to a new area or finding employment, furthering their sense of instability and increasing their risk for homelessness.
Substance abuse is another major factor contributing to homelessness among veterans. Many veterans return home dealing with PTSD, which may lead them to self-medicate using drugs or alcohol as a coping mechanism. Substance abuse hinders their ability to seek stable employment or social support, making them even more vulnerable to becoming homeless.
Lack of income is also an important factor in regard to homelessness within the veteran community, as financial stability plays an integral role in keeping struggling individuals off the streets. Unfortunately, many veterans are unemployed upon returning home or unable to find jobs suitable for their experience level due to their age or disability status, which puts them at higher risk for poverty and ultimately homelessness. Some struggling individuals may have another source of income such as VA benefits or pensions.
An additional risk factor is a lack of family/social support. Many veterans are estranged from family members due to disagreement over lifestyle choices, communication issues caused by physical distance over long periods during military service, or mental illness brought about by PTSD which creates difficulty forming relationships with others upon returning home. Without these familial bonds many feel alone and without purpose which leads them down the path towards homelessness without anyone who will truly understand what they are going through.
Mental health changes are yet another repercussion related to military service that contributes significantly towards veteran homelessness. Combat situations can take an immense toll on both physical and mental well-being leaving many soldiers suffering from depression, anxiety disorders or PTSD upon returning home. Lacking proper medical attention, these conditions can worsen over time eventually pushing individuals away from friends/family into further isolation.

What’s the Role of Substance Abuse in Veteran Homelessness?

Substance abuse plays an important role in exacerbating veteran homelessness by creating impediments to financial stability, as well as leading to personal and professional life issues that further impede successful reentry into civilian life.5

The use of drugs and alcohol can lead to impulsive decision-making and impaired judgment, leading struggling veterans to make bad decisions financially. For example, individuals who struggle with SUDs may spend their savings on drugs or alcohol rather than investing it in essential items like housing or transportation. This kind of behavior can create a financial burden that prevents struggling individuals from affording basic necessities, often resulting in them becoming homeless. Additionally, substance abuse is linked to other kinds of financial instability such as debt accumulation and increased risk of unemployment, due to the inability to maintain steady employment while under the influence of drugs or alcohol.7

The presence of substance abuse may also make it difficult for struggling veterans to successfully transition into civilian life due to the personal issues associated with addiction. SUDs can increase feelings of isolation, making it difficult for veterans who are struggling with addiction to build relationships in their community that could otherwise provide support during times of need. Moreover, addictions tend to alter personalities significantly over time, which can limit social interactions and further reduce opportunities for meaningful connection in veteran communities.8

Finally, a struggling veteran’s ability to reintegrate into society relies heavily on having gainful employment. However, substance abuse can impede performance at work and increase the risk of termination due to lackluster attendance records or impairment while on the job. Issues related to drug testing can also be detrimental if employers have strict rules around drug use; this too could lead to some veterans being unemployable despite their best efforts at recovery from addiction.9

How to help a homeless veteran to avoid substance abuse

There are organizations specifically devoted to helping veterans in need, and these should be the first step for anyone looking to help a homeless veteran struggling with SUD. Veteran-specific treatments could offer specific resources tailored to address the unique issues faced by homeless veterans, such as symptoms of PTSD or other mental health complications that can contribute to addiction.10

Furthermore, stable housing options for homeless veterans that may be accessed through special programs are essential for helping them maintain their sobriety and providing them the opportunity to live independently and safely. With a combination of appropriate programs along with sober living environments, homeless veterans may have a better chance of getting back on the right track and successfully recovering from substance abuse.10

Homeless Veteran Rehab Programs

There are various programs that may help homeless veterans struggling with SUD. Let’s have a look at some of them:10

Health Care for Homeless Veterans (HCHV) is a program offered by the VA that provides comprehensive medical, psychiatric, and substance use disorder services to homeless veterans. This program offers primary care services and mental health treatments, as well as homeless outreach and case management services.
Homeless Patient Aligned Care Teams (HPACTs) is a program that focuses on providing primary care services to homeless veterans in the community. Through this program, healthcare providers work with social workers and case managers to coordinate care for homeless veterans across multiple settings. This helps ensure that patients are receiving comprehensive care while connecting them with other needed resources in their communities.
Domiciliary Residential Rehabilitation Treatment Programs (DRRTP) are programs designed to help homeless veterans who suffer from severe mental health issues or substance abuse disorders transition back into mainstream society. These programs provide therapy sessions, job placement assistance, educational opportunities, and family counseling services to help participants successfully re-enter the community.
General Domiciliary (General Dom) is a program specifically focused on providing rehabilitative and therapeutic services related to physical disabilities experienced by homeless veterans who were discharged from service due to such disabilities. The goal of this program is to enable disabled veterans with limited economic means to live independently in the community.
Psychosocial Residential Rehabilitation Treatment Programs (PRRTP) are programs designed especially for those experiencing serious mental health problems or SUDs that cannot be successfully treated in an outpatient setting. These programs provide individualized treatment plans tailored toward addressing the needs of each unique participant.

Domiciliary PTSD (Dom PTSD) or Post-Traumatic Stress Disorder Residential Rehabilitation Treatment Program offers specialized rehabilitation services tailored specifically towards helping those suffering from PTSD resulting from military service experiences cope with their symptoms through evidence-based therapies. In addition, dom PTSD also provides supportive housing arrangements so that participating individuals can have access to safe environments during their recovery process.
Finally Compensated Work Therapy (CWT)-Transitional Residence (TR) is an innovative program specially created for recently discharged disabled veterans who require assistance in employment preparation processes but do not qualify for traditional VA work therapy benefits due to its more stringent eligibility requirements; CWT-TR offers employment counseling sessions alongside other vocational rehabilitation activities, including job market exploration workshops designed especially for disabled persons along with follow up support.

What Is a Homeless Veteran?