Physical health status of homeless Veterans in Canada: a cross-sectional study
Abstract: Introduction: Veteran homelessness is an issue gaining in visibility. Both Veterans and the homeless seem to be more susceptible to an array of physical health issues than the general population. However, very little is known about the health status of homeless Veterans in Canada. A more thorough knowledge of the physical health status of homeless Veterans could help better target services. This study has two objectives: (1) to estimate the prevalence of physical health conditions in a Canadian sample of homeless Veterans with mental illness and (2) to compare the prevalence observed in Veterans with a matched sample of homeless non-Veterans. Methods: The data come from a Canadian multi-site randomized trial, At Home/Chez Soi, that studies the effectiveness and efficiency of a Housing First program combined with a recovery-oriented approach to care. The present article is a cross-sectional analysis of baseline data. The participants are a volunteer sample of 99 homeless or precariously housed Veterans suffering from severe and persistent mental health problems and a matched sample of 99 non-Veterans. The data come from self-reported measures administered at baseline that describe chronic health conditions. Results: Veterans presented with five physical health conditions on average, the more common being dental problems, head injuries, musculoskeletal injuries, and foot problems. Both the number of conditions and the prevalence of each condition were similar to that of a matched comparison group of non-Veterans. Discussion: The number and severity of physical health conditions observed in our sample of homeless Veterans and non-Veterans suggest similar needs for physical health services in addition to housing services. Interventions targeting this population should therefore include a wide array of expertise and interdisciplinary collaboration to fit the various profiles of Veterans and non-Veterans in terms of housing, mental health, and physical health needs.
Abstract: Objective: The present study is a retrospective quasi-experimental study to evaluate the effectiveness of the Warrior PATHH (WP) program at improving posttraumatic growth (PTG) outcomes and reducing PTSD symptoms compared to a waitlist control among a sample of Veterans. Method: Participants (n = 164) were U.S. military Veterans with a history of trauma. Participants were either undergoing the Warrior PATHH program or a waitlist. Primary outcome measures were administered at baseline and at 90-day follow-up and consisted of the Posttraumatic Growth Inventory – Expanded (PTGI-X) and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). Secondary outcome measures assessed psychosocial functioning and included measures of depression and anxiety symptoms, sleep, wellbeing, and social support. Results: Significant differences were observed between groups on the PTGI-X (F(1, 205) = 23.667, p < .001, partial η2 = 0.103), and the PCL-5 (F(1, 205) = 262.460, p < .001, partial η2 = 0.561) with the WP group showing significant positive psychological change following a traumatic event as measured by the PTGI-X and decreased PTSD symptoms as measured by the PCL-5 compared to those in the waitlist condition. Those in the treatment arm also demonstrated gains to psychosocial functioning. Conclusions: Consistent with previous research, participants in the Warrior PATHH program exhibited significant increases in PTG outcomes, decreased PTSD symptoms, and broad improvements to psychosocial functioning. These findings suggest it is an effective training program to foster PTG outcomes among Veterans. This study is unique as it is the first to compare the effects of WP programming with a sample of waitlisted Veterans.