Comparison of mental health utilization among homeless veterans following the 2004-2005 florida hurricane seasons

The 2004 and 2005 Hurricanes seasons represented two of the most productive storm seasons in Florida history with 47 named storms and 9 reaching category ≥ 3 status. Hurricanes account for billions of dollars in structural damages, but the cost in terms of human suffering on vulnerable populations is difficult to document. Data from the Veterans Health Administration (VHA) Decision Support System during the VHA Fiscal Years 2004-2006 was used to capture all outpatient mental health encounters focusing on select CPT (Current Procedural Technology) codes for Florida veterans. Mental health encounters were abstracted for a primary diagnosis ICD-9-CM: 290-319. Homeless veterans residing in hurricane affected counties were significantly more likely than veterans residing in counties that were not adversely affected by a hurricane to receive more treatment for anxiety (94.6% vs. 5.8%, p<0.001) and PTSD (20.0% vs. 12.9%, p<0.002). Homeless veterans in hurricane affected counties were significantly more likely to participate in group psychotherapy (32.4% vs. 13.4%, p<0.002), but less likely to participate in individual therapy (3.55% vs. 17.3%, p<0.001). These findings have implications for the service utilization of veterans, provision of VA mental health services, and treatment for homeless veterans. In the event of future hurricanes or other disasters, specific services for homeless veterans require careful consideration. Homeless veterans may be at particular risk for experiencing negative outcomes resulting from disasters due to their pre-existing mental health functional status and lack of resources.