A preliminary investigation of VA PTSD residential treatment for veterans admitted from unstable housing or incarceration

ABSTRACT

VA Posttraumatic Stress Disorder (PTSD) Residential Rehabilitation Treatment Programs (RRTPs) may assuage barriers homeless and justice-involved veterans experience in accessing and benefitting from PTSD treatment. However, the benefit of RRTPs among these veterans has yet to be researched. We conducted an examination of PTSD and depressive symptoms across admission, discharge, and four-month follow-up among 243 veterans admitted from unstable housing and 40 veterans admitted from prison/jail. Both groups experienced reductions in PTSD symptoms from admission to discharge; however, those admitted from unstable housing experienced a recurrence in PTSD symptoms. Veterans admitted from unstable housing experienced reductions in depressive symptoms by discharge, but these symptoms recurred during follow-up. Veterans admitted from jail/prison did not experience significant change in depressive symptoms. This study provides tentative support that homeless and justice-involved veterans can benefit from RRTPs. Understanding of factors driving symptom recurrence, and methods of enhancing post-discharge care, are required for these veterans.

KEYWORDS:

• PTSD
• depression
• residential treatment
• homeless veteran
• justice-involved veteran

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Exploratory crude analyses were conducted between the analytic sample and the larger sample. Analyses examined between-group differences in psychiatric symptoms between those entering from unstable housing or jail/prison to the larger sample. Please see Supplementary Table 1 for findings.

2 We examined the role of discharge to unstable housing. This variable was not found to be a significant correlate of symptom change.

Additional information

Funding

This work was supported in part by the Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Veteran Suicide Prevention and Department of Veterans Affairs (VA). The views expressed are those of the authors and do not necessarily represent the views or policy of the VA or the US government.

Notes on contributors

Ryan Holliday

Ryan Holliday, PhD, is a Clinical Research Psychologist at the Rocky Mountain Mental Illness Research, Education and Clinical Center for Veteran Suicide Prevention and Assistant Professor at the University of Colorado Anschutz Medical Campus. His clinical and research interest focus upon understanding the intersection of trauma, psychosocial stressors (e.g., homelessness and justice involvement), and mental health. He is further interested in translating these findings into evidence-based practice.

Georgina M. Gross

Georgina M. Gross, PhD, is a Clinical Psychologist in PTSD Program Evaluation at the Northeast Program Evaluation Center, Office of Mental Health and Suicide Prevention VACO and VA Connecticut Healthcare System, and Associate Research Scientist at Yale University School of Medicine. Their research includes PTSD treatment utilization and outcomes, suicide prevention, military sexual trauma, and the mental health of LGBTQ Veterans.

Alisha Desai

Alisha Desai, MS, is a Clinical Psychology doctoral candidate at Drexel University and a pre-doctoral psychology intern at Rocky Mountain Regional VA Medical Center. Her clinical and research interests focus on the intersection of trauma, justice-involvement, and substance use disorders among veterans.

Noelle B. Smith

Noelle B. Smith, PhD, is a Clinical Psychologist and the Project Director of the Mental Health Residential Rehabilitation Treatment Program at the VA Northeast Program Evaluation Center. She is also an Assistant Clinical Professor of Psychiatry at the Yale University School of Medicine. Her research and academic interests include PTSD, suicidal thoughts and behaviors, residential treatment programs, and mental health utilization.

Ilan Harpaz-Rotem

Ilan Harpaz-Rotem, PhD, is a Clinical Psychologist, Associate Professor at Yale University School of Medicine Department of Psychiatry, and Investigator at the National Center for PTSD. He also directs the evaluation of VA PTSD treatment programs at the Department of Veterans Affairs, Northeast Program Evaluation Center, and the VA Central Office. His research focuses on how to modify traumatic memories and their associated emotions.