Am J Psychiatry 1994; 151:421-427
Copyright © 1994 by American Psychiatric Association
A model of homelessness among male veterans of the Vietnam War generation
R Rosenheck and A Fontana
Northeast Program Evaluation Center, VA Medical Center, West Haven, CT 06516.
OBJECTIVE: This study explored a multifactorial model of vulnerability to
homelessness among male veterans of the Vietnam war generation. METHOD:
Data from 1,460 male veterans who participated in the National Vietnam
Veterans Readjustment Study were used to evaluate hypotheses about the
causes of homelessness grouped into four sets of sequential variables: 1)
premilitary risk factors, 2) war related and non-war- related traumatic
experiences, 3) lack of social support at the time of discharge from
military service, and 4) postmilitary psychiatric disorder and social
dysfunction. Structural equation modeling was used to explore the posited
model of risk factors for homelessness. RESULTS: Postmilitary social
isolation, psychiatric disorder, and substance abuse had the strongest
direct effects on homelessness, although substantial indirect effects from
stressors related to being in the war zone and from premilitary conduct
disorder were observed. Several premilitary factors--year of birth,
childhood physical or sexual abuse, other childhood traumas, and placement
in foster care during childhood-- also had direct effects on homelessness.
CONCLUSIONS: Individual vulnerability to homelessness is most likely due to
a multiplicity of psychiatric and nonpsychiatric factors, with independent
influences emerging at each of four discrete time periods. In view of this
complex pattern of influences, prevention efforts directed at individuals
must address a very broad range of adjustment problems.
