The Role of Military Sexual Trauma History and Frequency of Use of Veterans Health Administration Homeless and Justice Program Services Among Male and Female Homeless Veterans

Military sexual trauma (MST) is a prevalent experience associated with deleterious chronic health and psychiatric conditions. The Department of Veterans Affairs (VA) offers MST-related care free of charge; however, MST history can impact perceptions of trust and safety, affecting willingness to access such care. MST is also more prevalent among Veterans with a history of homelessness and criminal legal involvement. These Veterans are often clinically complex and may benefit from higher rates of VA service use to meet their health and social care needs. No research to date has examined the potential effect of MST history on VA service use among homeless Veterans accessing VA Homeless and Justice programs. To fill this gap, we examined VA health record data from 964,302 Veterans accessing VA Homeless programs, including a subset of 168,094 Veterans who also accessed VA Justice programs. After accounting for age and service-connected disability, both male and female homeless Veterans with MST histories were substantially higher users of VA homeless and justice programs. Such programs may be a critical intercept for identifying and engaging homeless MST survivors in care. Similarly, inclusion of MST-related care in these VA service settings may help in addressing the impact of MST-related conditions. This, in turn, may indirectly address factors that exacerbate risk for homelessness or recidivism; as such, further examination of services for survivors in these settings remains needed.