(July 10, 2018) Individuals who have psychotic disorders are more likely to be chronically homeless and unsheltered and existing interventions to increase access to housing for these individuals may not be appropriate, according to new research.
This is relevant to the estimated 2.7 million veterans that served in Iraq and Afghanistan between 2001 and 2014, according to Brown University's Watson Institute. Prevalence estimates suggest that 43,200 of these troops have serious mental illnesses that are left untreated. The symptoms of these diseases often lead to very negative outcomes, including homelessness, substance abuse disorders, acts of violence, incarceration and early-death.
The United States Department of Veterans Affairs (VA) has committed to an initiative to end veterans' homelessness, using a "Housing First" approach in partnership with the Department for Housing and Urban Development.
Housing First is a social service program that provides housing to individuals who are homeless without the traditional treatment or sobriety-dependent clauses, operating under the notion that a stable living situation is needed before treatment or recovery is possible.
New research from the VA and published in Schizophrenia Research this month suggests that veterans with psychotic disorders have different needs and barriers to housing access than other veterans. Veterans with serious mental illness are more likely to be chronically homeless and unsheltered, suggesting a more nuanced approach is needed to ensure all veterans are getting the housing support they need.
The authors found that the more days an individual spends unsheltered, or living in situations not meant for human habitation such as streets, abandoned buildings, parks or cars, the lower their overall cognitive skills, including social skills. Consistent with cognition levels in other individuals with serious mental illness, the authors argue that addressing social cognitive deficits are extremely important when engaging unsheltered veterans with psychotic disorders into housing.
Understanding the consequences of social skills and cognitive deficits on the effectiveness of Housing First is an important next step, according to the authors. Diminished cognitive abilities may reduce an individual's ability to participate in and compliance with treatment services, therefore limiting the effectiveness of a Housing First approach.
Elizabeth Sinclair
Director of Research
References:
- Llerena, K. et al. (2018, July). Clinical and cognitive correlates of unsheltered status in homeless persons with psychotic disorders. Schizophrenia Research.