Impact of active substance abuse on short-term outcomes in a supportive transitional program for homeless veterans

Recent trends in housing policy have recognized the the value of providing housing services to individuals who have a history of substance abuse. However, little research has examined the impact of active substance abuse at the time of housing entry on program outcomes. We examined the short-term outcomes of 11,004 veterans who received supportive transitional housing services in the VA Grant Per Diem (GPD) Program. The GPD program provides transitional housing for up to two years, access to health care services, substance abuse and mental health supports, education and employment assistance, and access to legal aid. We investigated the effect of demographic characteristics, recent work history, recent treatment for psychiatric disorder, and alcohol and illegal substance use in the month prior to program admission as predictors of program completion and recidivism. Results revealed that 47.7% of participants (96.4% male, approximately 50% White nonHispanic) failed to complete the residential program and 19.9% were re-admitted for a subsequent episode of homelessness within 12 months. Logistic regression analyses revealed that any use of illegal substances, but not alcohol abuse, and age were the most highly associated with failure to complete the GPD program. In contrast, alcohol use, but not illegal substance abuse, and age were most highly associated with subsequent re-admission to the GPD program. For both analyses, however, the effect sizes were very small, suggesting that policies to exclude veterans from housing services on the basis of current or recent substance use are not well-supported