“You don’t see them on the streets of your town”: challenges and strategies for serving unstably housed veterans in rural areas

Research on policy and programmatic responses to homelessness has focused largely on urban areas, with comparatively little attention paid to the rural context. We conducted qualitative interviews with a nationwide sample of rural-serving agencies receiving grants through the U.S. Department of Veterans Affairs’ Supportive Services for Veteran Families program to better understand the housing needs, available services, needed resources, and challenges in serving homeless and unstably housed veterans in rural areas. Respondents discussed key challenges—identifying unstably housed veterans, providing services within the rural resource context, and leveraging effective collaboration—and strategies to address these challenges. Unmet needs identified included emergency and subsidized long-term housing options, transportation resources, flexible financial resources, and additional funding to support the intensive work required in rural areas. Our findings identify promising programmatic innovations and highlight the need for policy remedies that are responsive to the unique challenges of addressing homelessness and housing instability in rural areas.Accepted manuscrip

Pathways into homelessness among post 9/11 era veterans

This article may not exactly replicate the final version published in the APA journal. It is not the copy of record.Despite the scale of veteran homelessness and government–community initiatives to end homelessness among veterans, few studies have featured individual veteran accounts of experiencing homelessness. Here we track veterans’ trajectories from military service to homelessness through qualitative, semistructured interviews with 17 post-9/11-era veterans. Our objective was to examine how veterans become homeless—including the role of military and postmilitary experiences—and how they negotiate and attempt to resolve episodes of homelessness. We identify and report results in 5 key thematic areas: transitioning from military service to civilian life, relationships and employment, mental and behavioral health, lifetime poverty and adverse events, and use of veteran-specific services. We found that veterans predominantly see their homelessness as rooted in nonmilitary, situational factors such as unemployment and the breakup of relationships, despite very tangible ties between homelessness and combat sequelae that manifest themselves in clinical diagnoses such as posttraumatic stress disorder. Furthermore, although assistance provided by the U.S. Department of Veterans Affairs (VA) and community-based organizations offer a powerful means for getting veterans rehoused, veterans also recount numerous difficulties in accessing and obtaining VA services and assistance. Based on this, we offer specific recommendations for more systematic and efficient measures to help engage veterans with VA services that can prevent or attenuate their homelessness

Needles in a haystack: screening and healthcare system evidence for homelessness

Effectiveness of screening for homelessness in a large healthcare system was evaluated in terms of successfully referring and connecting patients with appropriate prevention or intervention services. Screening and healthcare services data from nearly 6 million U.S. military veterans were analyzed. Veterans either screened positive for current or risk of housing instability, or negative for both. Current living situation was used to validate results of screening. Administrative evidence for homelessness-related services was significantly higher among positive-screen veterans who accepted a referral for services compared to those who declined. Screening for current or risk of homelessness led to earlier identification, which led to earlier and more extensive service engagement

Emotional injury: The hidden cost of workplace violence

Background Review Workplace violence (WPV) is a common, increasing experience in healthcare. Verbal violence is the most common type and is typically considered “not that big of a deal” or “minor” (Hahn et al. 2008, Magnavita 2014). However, verbal violence and harassment are extremely destructive to team member morale and productivity, leading to burnout and aggression in the victim (Brophy et al. 2017, Miller 2008, Phillips 2016). Purpose The workplace violence committee (WPVC) at a 750+ bed, Level 1 trauma center on the south side of Chicago aimed to quantify the number of verbal incidents and their consequences to inform WPVC interventions to reduce WPV and support the health, wellbeing, and retention of team members. Sample and Setting All team members (n=6040) had the option to complete the anonymous survey via email. Methodology The survey was created, distributed, and collated using Qualtrics and exported to Excel for descriptive analysis. Results Of the total team members who completed the survey (n=1018), 67% reported experiencing verbal violence in the past 12 months and 58% of those who experienced verbal violence reported having at least one consequence. The mean reporting rate for verbal violence was 12%. Team members reported 1947 consequences total with 27 per individual at the most. Of those who experienced at least one consequence, 39% reported burnout/career fatigue/job dissatisfaction, 37% reported anxiety, 33% reported crying, and 29% reported feeling less competent or effective. These were the four most common consequences. Implications Most team members in healthcare experience verbal violence that affects their ability to do their jobs and maintain their health (physical and mental). Despite prolific and serious consequences from verbal violence, its consequences are not counted as injuries and are not systematically considered. Quantifying verbal violence and its consequences based on demographics must inform future interventions for WPV prevention, resolution, healing, and retention. References: Brophy, J.T., M.M. Keith, and M. Hurley. (2017). Assaulted and unheard: Violence against healthcare staff. New Solutions: A Journal of Environmental and Occupational Health Policy. 27(4):581-606. DOI: 10.1177/1048291117732301 Hahn, S., V. Hantikainen, I. Needham, G. Kok, T. Dassen, and R.J.G. Halfens. (2013). Patient and visitor violence in the general hospital, occurrence, staff interventions and consequences: A cross-sectional study. Journal of Advanced Nursing. 68(12):2685-2699. DOI: 10.1111/j.1365-2648.2012.05967.x. Magnavita, N. (2014). Workplace violence and occupational stress in healthcare workers: A chicken-and-egg situation – Results of a 6-year follow-up study. Journal of Nursing Scholarship 46(5):366-376. Miller, L. 2008. Workplace Violence: Practical policies and strategies for prevention, response, and recovery. International Journal of Emergency Mental Health 9(4):259-280. Phillips, J.P. (2016.) Workplace violence against health care workers in the United States. The New England Journal of Medicine. 374(17):1661-1669. DOI: 10.1056/NEJMra150199