Rates and Risk Factors for Homelessness after Successful Housing in a Sample of Formerly Homeless Veterans
Maria J. O'Connell, Wesley Kasprow and Robert A. Rosenheck
Research suggests that subsidized housing combined with mental health services may be an effective intervention for successfully placing individuals who have a mental illness and a history of homelessness into community housing. However, there is limited longitudinal information available about the risk of loss of housing after a successful exit from homelessness. The study presented here examined the risk and predictors of returning to homelessness after successful housing in a sample of 392 formerly homeless veterans involved in an experimental trial of case management plus rent subsidy vouchers, case management only, or standard care. Over the course of a five-year period, 44% of all participants experienced a period of homelessness for at least one day after successful placement into housing. Cox regression analysis found that participants in the case management plus voucher condition had significantly longer periods of continuous housing, compared with participants in the other two groups. Other predictors of decreased housing tenure were drug use and a diagnosis of posttraumatic stress disorder. Subsidized housing vouchers, combined with intensive case management, are advantageous both for facilitating the initial transition from homelessness to being housed and for reducing the risk of discontinuous housing, even among individuals with more severe substance abuse problems.