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The Family Ties That Bind: Tangible, Instrumental, and Emotional Support Among Homeless Veterans

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War and Family Life

Abstract

The availability of adequate social support has been associated with a number of positive psychiatric and health outcomes among persons experiencing significant life challenges. While much research has demonstrated risk factors for homelessness among veterans, less attention has been paid to existing networks of natural support, particularly familial support, which may provide a safety net for veterans who might otherwise be homeless and may help those who are currently homeless exit from that condition. This chapter presents findings from a study of the social network characteristics of veterans entering the HUD-VA Supported Housing (HUD-VASH) program in the 1990s. Multiple dimensions of social network structure and function were assessed among a sample of 1,438 veterans enrolled in one of the original 19 HUD-VASH sites nationwide. Network characteristics were examined as a function of the absolute availability of family and/or peers as sources of specific types of tangible, instrumental, and emotional (TIE) support. We then examined between-group differences and similarities on key demographic, clinical, community adjustment, and social variables based on the categorization of source of support. Finally, we compared social support indicators among HUD-VASH veterans to a sample of individuals with severe mental illness receiving mental health services in Connecticut. Similar to reports from studies of a more general sample of homeless individuals, our research found that the vast majority of homeless veterans in our sample identified at least one close person in their lives and that the number of social ties was inversely related to the length of time homeless. Veterans in our sample, however, reported rates of instrumental and emotional support that were 30–50 % higher than those reported among a more general sample of homeless individuals. Results further suggest that the availability of support from family members may be associated with more positive outcomes for these individuals. These findings may suggest critical areas for program development and future research.

The first line of defense against the streets remains the support of kin and friends.

~Kim Hopper (1991).

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References

  • Alexopoulos, G. S., Bruce, M. L., Hull, J., Sirey, J. A., & Kakuma, T. (1999). Clinical determinants of suicidal ideation and behavior in geriatric depression. Archives of General Psychiatry, 56(11), 1048.

    Article  Google Scholar 

  • Bahr, H. M. (1970). Disaffiliated man: Essays and bibliography on skid row, vagrancy, and outsiders. Toronto: University of Toronto Press.

    Google Scholar 

  • Bahr, H. M. (1973). Skid row: An introduction to disaffiliation. New York, NY: Oxford University Press.

    Google Scholar 

  • Bahr, H. M., & Caplow, T. (1973). Old men drunk and sober. New York, NY: New York University Press.

    Google Scholar 

  • Barrera, M. (1986). Distinctions between social support concepts, measures, and models. American Journal of Community Psychology, 14(4), 413–445.

    Article  Google Scholar 

  • Bates, D. S., & Toro, P. A. (1999). Developing measures to assess social support among homeless and poor people. Journal of Community Psychology, 27(2), 137–156.

    Article  Google Scholar 

  • Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social Science & Medicine, 51(6), 843–857.

    Article  Google Scholar 

  • Besharov, D. J. (2003). The past and future of welfare reform. Public Interest, 4–21.

    Google Scholar 

  • Blank, S. R., Hagel, S. C., Duncan, S. A., Chu, S. S., Sebelius, S. K., Napolitano, S. J., …, Shinseki, S. E. K. (2012). Department of labor Secretary Seth D. Harris (Acting).

    Google Scholar 

  • Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310.

    Article  Google Scholar 

  • Desai, R. A., Dausey, D. J., Sernyak, M., & Rosenheck, R. A. (2005). The effects of federal versus state funding and academic affiliation on mental health services. Administration and Policy in Mental Health, 32(3), 267–283. doi:10.1007/s10488-004-0844-3.

    Article  Google Scholar 

  • Edelman, M. W., & Mihaly, L. (1989). Homeless families and the housing crisis in the United States. Children and Youth Services Review, 11(1), 91–108.

    Article  Google Scholar 

  • Edens, E. L., Kasprow, W., Tsai, J., & Rosenheck, R. A. (2011). Association of substance use and VA service‐connected disability benefits with risk of homelessness among veterans. The American Journal on Addictions, 20(5), 412–419.

    Article  Google Scholar 

  • Fargo, J., Metraux, S., Byrne, T., Munley, E., Montgomery, A. E., Jones, H., …, Culhane, D. P. (2012). Prevalence and risk of homelessness among US veterans. Preventing Chronic Disease: Public Health Research, Practice and Policy, 9(11_0112).

    Google Scholar 

  • Fischer, P. J., Shapiro, S., Breakey, W. R., Anthony, J. C., & Kramer, M. (1986). Mental health and social characteristics of the homeless: a survey of mission users. American Journal of Public Health, 76(5), 519–524.

    Article  Google Scholar 

  • Foscarinis, M. (1996). The federal response: The Stewart B. McKinney homeless assistance act. Homelessness in America, pp 160–171.

    Google Scholar 

  • Gamache, G., Rosenheck, R., & Tessler, R. (2001). The proportion of veterans among homeless men: a decade later. Social Psychiatry and Psychiatric Epidemiology, 36(10), 481–485.

    Article  Google Scholar 

  • Greenberg, G. A., & Rosenheck, R. A. (2010). Mental health correlates of past homelessness in the National Comorbidity Study Replication. Journal of Health Care for the Poor and Underserved, 21(4), 1234–1249.

    Google Scholar 

  • Greenblatt, M., Becerra, R. M., & Serafetinides, E. (1982). Social networks and mental health: An overview. The American Journal of Psychiatry, 139(8), 977–984.

    Article  Google Scholar 

  • Homelessness, U. S. I. C. o. (2010). Opening doors: Federal strategic plan to prevent and end homelessness. Washington, DC: Homelessness, U. S. I. C. o.

    Google Scholar 

  • Hopper, K. (1991). Homelessness old and new: The matter of definition. Housing Policy Debate, 2(3), 755–813.

    Article  Google Scholar 

  • Hwang, S. W., Kirst, M. J., Chiu, S., Tolomiczenko, G., Kiss, A., Cowan, L., et al. (2009). Multidimensional social support and the health of homeless individuals. Journal of Urban Health, 86(5), 791–803.

    Article  Google Scholar 

  • Irwin, J., LaGory, M., Ritchey, F., & Fitzpatrick, K. (2008). Social assets and mental distress among the homeless: Exploring the roles of social support and other forms of social capital on depression. Social Science & Medicine, 67(12), 1935–1943. doi:10.1016/j.socscimed.2008.09.008.

    Article  Google Scholar 

  • Johnson, L., Lundström, O., Åberg‐Wistedt, A., & Mathé, A. A. (2003). Social support in bipolar disorder: Its relevance to remission and relapse. Bipolar Disorders, 5(2), 129–137.

    Article  Google Scholar 

  • Johnson, S., Winett, C. A., Meyer, B., Greenhouse, W. J., & Miller, I. (1999). Social support and the course of bipolar disorder. Journal of Abnormal Psychology, 108(4), 558.

    Article  Google Scholar 

  • Kelty, R., Kleykamp, M., & Segal, D. R.. (2010). The military and the transition to adulthood. The Future of Children, 20(1), 181–207. Retrieved from http://www.jstor.org.ezproxy.lib.purdue.edu/stable/27795065.

  • Kenney, C. (2004). Cohabiting couple, filing jointly? Resource pooling and US poverty policies. Family Relations, 53(2), 237–247.

    Google Scholar 

  • Kertesz, S. G., Larson, M. J., Horton, N. J., Winter, M., Saitz, R., & Samet, J. H. (2005). Homeless chronicity and health-related quality of life trajectories among adults with addictions. Medical Care, 43(6), 574–585.

    Article  Google Scholar 

  • La Gory, M., Ritchey, F., & Fitzpatrick, K. (1991). Homelessness and affiliation. The Sociological Quarterly, 32(2), 201–218.

    Article  Google Scholar 

  • Lam, J. A., & Rosenheck, R. (1999). Social support and service use among homeless persons with serious mental illness. International Journal of Social Psychiatry, 45(1), 13–28. doi:10.1177/002076409904500103.

    Article  Google Scholar 

  • Leavy, R. L. (1983). Social support and psychological disorder: A review. Journal of Community Psychology, 11(1), 3–21.

    Article  Google Scholar 

  • Leda, C., & Rosenheck, R. (1992). In a residential treatment program for homeless veterans. The American Journal of Psychiatry, 149, 1219–1224.

    Article  Google Scholar 

  • Leda, C., & Rosenheck, R. (1995). Race in the treatment of homeless mentally ill veterans. The Journal of Nervous and Mental Disease, 183(8), 529–537.

    Article  Google Scholar 

  • Lehman, A. F. (1988). A quality of life interview for the chronically mentally ill. Evaluation and Program Planning, 11(1), 51–62.

    Article  Google Scholar 

  • Lehman, A. F., Postrado, L., & Rachuba, L. (1993). Convergent validation of quality of life assessments for persons with severe mental illnesses. Quality of Life Research, 2(5), 327–333.

    Article  Google Scholar 

  • McLellan, A. T., Luborsky, L., Woody, G. E., & O'Brien, C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: the Addiction Severity Index. The Journal of Nervous and Mental Disease, 168(1), 26–33.

    Article  Google Scholar 

  • O'Connell, M. J., Kasprow, W., & Rosenheck, R. A. (2008). Rates and risk factors for homelessness after successful housing in a sample of formerly homeless veterans. Psychiatric Services (Washington, DC), 59(3), 268–275. doi:10.1176/appi.ps.59.3.268.

    Article  Google Scholar 

  • Paquette, K., & Bassuk, E. L. (2009). Parenting and homelessness: Overview and introduction to the special section. American Journal of Orthopsychiatry, 79(3), 292–298. doi:10.1037/A0017245.

    Article  Google Scholar 

  • Perkins, D. O. (2002). Predictors of noncompliance in patients with schizophrenia. Journal of Clinical Psychiatry, 63(12), 1121–1128.

    Article  Google Scholar 

  • Post, E. P., & Welsh, D. (2007). Social support among veterans with serious mental illness. Social Psychiatry and Psychiatric Epidemiology, 42(8), 639–646.

    Article  Google Scholar 

  • Rogers, E. S., Anthony, W., & Lyass, A. (2004). The nature and dimensions of social support among individuals with severe mental illnesses. Community Mental Health Journal, 40(5), 437–450.

    Article  Google Scholar 

  • Rosenheck, R., Perlick, D., Bingham, S., et al. (2003). Effectiveness and cost of olanzapine and haloperidol in the treatment of schizophrenia: a randomized controlled trial. JAMA, 290(20):2693–2702. doi:10.1001/jama.290.20.2693.

    Google Scholar 

  • Rosenheck, R. A., & Fontana, A. (1994). A model of homelessness among male veterans of the Vietnam War generation. American Journal of Psychiatry, 151, 421–427.

    Article  Google Scholar 

  • Rosenheck, R. A., & Koegel, P. (1993). Characteristics of veterans and nonveterans in three samples of homeless men. Hospital & Community Psychiatry, 44(9), 858–863.

    Google Scholar 

  • Rosenheck, R. A., & Seibyl, C. L. (1997). Effectiveness of treatment elements in a residential–work therapy program for veterans with severe substance abuse. Psychiatric Services, 48(7), 928–935.

    Article  Google Scholar 

  • Rossi, P. H. (1991). Down and out in America: The origins of homelessness. Chicago, IL: University of Chicago Press.

    Google Scholar 

  • Sarason, I. G., Sarason, B. R., & Pierce, G. R. (1990a). Social support, personality, and performance. Journal of Applied Sport Psychology, 2(2), 117–127.

    Article  Google Scholar 

  • Sarason, I. G., Sarason, B. R., & Pierce, G. R. (1990b). Social support: The search for theory. Journal of Social and Clinical Psychology, 9(1), 133–147.

    Article  Google Scholar 

  • Seeman, T. E. (1996). Social ties and health: The benefits of social integration. Annals of Epidemiology, 6(5), 442–451.

    Article  Google Scholar 

  • Terry, D. J., Nielsen, M., & Perchard, L. (1993). Effects of work stress on psychological well‐being and job satisfaction: The stress‐buffering role of social support. Australian Journal of Psychology, 45(3), 168–175.

    Article  Google Scholar 

  • Tessler, R. C., Gamache, G. M., Rossi, P. H., Lehman, A. F., & Goldman, H. H. (1992). The kindred bonds of mentally ill homeless persons. New England Journal of Public Policy, 8(1), 23.

    Google Scholar 

  • Tessler, R. C., Rosenheck, R. A., & Gamache, G. M. (2002). Comparison of homeless veterans with other homeless men in a large clinical outreach program. Psychiatric Quarterly, 73(2), 109–119. doi:10.1023/A:1015051610515.

    Article  Google Scholar 

  • Toro, P. A., Tulloch, E., & Ouellerre, N. (2008). Stress, social support, and outcomes in two probability samples of homeless adults. Journal of Community Psychology, 36(4), 483–498. doi:10.1002/Jcop.20190.

    Article  Google Scholar 

  • Travis, L. A., Lyness, J. M., Shields, C. G., King, D. A., & Cox, C. (2004). Social support, depression, and functional disability in older adult primary-care patients. The American Journal of Geriatric Psychiatry, 12(3), 265–271.

    Article  Google Scholar 

  • Tsai, J., & Rosenheck, R. A. (2013). Conduct disorder behaviors, childhood family instability, and childhood abuse as predictors of severity of adult homelessness among American veterans. Social Psychiatry and Psychiatric Epidemiology, 48(3), 477–486.

    Article  Google Scholar 

  • United States Department of Veterans Affairs. (2009). Secretary Shinseki details plans to end homelessness for veterans. Retrieved from http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1807.

  • United States Department of Veterans Affairs. (2010). Department of Housing and Urban Development-Department of Veterans Affairs supported housing program (HUD-VASH). In I. N. P. E. Center (Ed.). West Haven, CT: Northeast Program Evaluation Center.

    Google Scholar 

  • United States Department of Veterans Affairs. (2011). Health care for homeless veterans programs: Twenty-fourth annual report. In I. N. P. E. Center (Ed.). West Haven, CT: Northeast Program Evaluation Center.

    Google Scholar 

  • Vaux, A. (1992). Assessment of social support. In H. O. F. V. U. Baumann (Ed.), The meaning and measurement of social support (pp. 193–216). Washington, DC: Hemisphere Publishing Corp.

    Google Scholar 

  • Vaux, A., Phillips, J., Holly, L., Thomson, B., Williams, D., & Stewart, D. (1986). The social support appraisals (SS-A) scale: Studies of reliability and validity. American Journal of Community Psychology, 14(2), 195–218. doi:10.1007/BF00911821.

    Article  Google Scholar 

  • Voils, C. I., Steffens, D. C., Flint, E. P., & Bosworth, H. B. (2005). Social support and locus of control as predictors of adherence to antidepressant medication in an elderly population. The American Journal of Geriatric Psychiatry, 13(2), 157–165.

    Article  Google Scholar 

  • Washington, D. L., Yano, E. M., McGuire, J., Hines, V., Lee, M., & Gelberg, L. (2010). Risk factors for homelessness among women veterans. Journal of Health Care for the Poor and Underserved, 21(1), 81–91.

    Google Scholar 

  • Weinreb, L., & Rossi, P. H. (1995). The American Homeless Family Shelter “System”. The Social Service Review, 86–107.

    Google Scholar 

  • Wilkins, K. (2004). Bipolar I disorder, social support and work. Health Report, 15(Suppl), 21–30.

    Google Scholar 

  • Wolch, J. R., Rahimian, A., & Koegel, P. (1993). Daily and periodic mobility patterns of urban homeless. The Professional Geographer, 45, 159–169.

    Google Scholar 

  • Zanis, D. A., McLellan, A. T., & Corse, S. (1997). Is the Addiction Severity Index a reliable and valid assessment instrument among clients with severe and persistent mental illness and substance abuse disorders? Community Mental Health Journal, 33(3), 213–227.

    Article  Google Scholar 

  • Zlotnick, C., Tam, T., & Robertson, M. J. (2003). Disaffiliation, substance use, and exiting homelessness. Substance Use & Misuse, 38(3–6), 577–599. doi:10.1081/Ja-120017386.

    Article  Google Scholar 

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Correspondence to Maria J. O’Connell Ph.D. .

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O’Connell, M.J., Rosenheck, R. (2016). The Family Ties That Bind: Tangible, Instrumental, and Emotional Support Among Homeless Veterans. In: MacDermid Wadsworth, S., Riggs, D. (eds) War and Family Life. Risk and Resilience in Military and Veteran Families. Springer, Cham. https://doi.org/10.1007/978-3-319-21488-7_15

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