Homeless Veterans of the All-Volunteer Force: A Social Selection Perspective

Armed Forces and Society

Volumn 29, Issue 4, 2003, Pages

  Tessler, Richard ^a   Rosenheck, Robert ^b   Gamache, Gail ^c  

^a UNIVERSITY OF MASSACHUSETTS   (United States)

^b YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c VETERANS AFFAIRS MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84855627065     PISSN: 0095327X     EISSN: None     Source Type: Journal    
DOI: 10.1177/0095327X0302900403     Document Type: Review

References (45)

1. Robert Rosenheck, Catherine Leda, Linda K. Frishman, Julie Lam, and Anne Chung, "Homeless Veterans," in Homelessness in America: A Reference Bock, ed. J. Baumohl (Phoenix, AZ: Oryx Press, 1996), 97-108.
2. Robert Rosenheck, Linda Frishman, and Anne Chung, "The Proportion of Veterans among Homeless Men," American Journal of Public Health 84, 3 (1994): 466-69; Gail Gamache, Robert Rosenheck, and Richard Tessler, "The Proportion of Veterans among Homeless Men: A Decade Later," Social Psychiatry and Psychiatric Epidemiology 36 (October, 2001): 481-485.
3. Robert Rosenheck, Linda Frishman, and Anne Chung, "The Proportion of Veterans among Homeless Men," American Journal of Public Health 84, 3 (1994): 466-69; Gail Gamache, Robert Rosenheck, and Richard Tessler, "The Proportion of Veterans among Homeless Men: A Decade Later," Social Psychiatry and Psychiatric Epidemiology 36 (October, 2001): 481-485.
4. For an exception to this generalization, see Suzanne L. Wentzel, Lillian Gelberg, Lailee Bakhtiar, Nicholas Caskey, Elizabeth Hardie, Carol Redford, and Nancy Sadler, "Indicators of Chronic Homelessness among Veterans," Hospital & Community Psychiatry 44, 12 (1993): 1172-1176.
5. In this article we refer to the period 1973-1979 as representing the early years of the AVF.
6. The quality of enlistees dropped substantially during the early years of the AVF, as indicated by the distribution of scores on the Armed Forces Qualification Test (AFQT). The lower quality of recruits during this period was amplified by a technical mistake during 1977-1979 when mis-norming of the AFQT led the military to accept a much larger proportion of men with the lowest acceptable aptitude scores (see Gary R. Nelson, "The Supply and Quality of First-Term Enlistees under the All Volunteer Force," in The All-Volunteer Force after a Decade, ed. W. Bowman et al. [Washington, DC: Pergamon-Brassey's, 1986], 31-32; David S. C. Chu and John P. White, "Ensuring Quality People in Defense," in Keeping the Edge: Managing Defense for the Future, ed. A. B. Carter and J. P. White [Cambridge, MA: MIT Press, 2001], 203-234; John T. Warner and Beth J. Asch, "The Record and Prospects of the All-Volunteer Military in the United States," Journal of Economic Perspectives 15 [Spring, 2001]: 169-192).
7. The quality of enlistees dropped substantially during the early years of the AVF, as indicated by the distribution of scores on the Armed Forces Qualification Test (AFQT). The lower quality of recruits during this period was amplified by a technical mistake during 1977-1979 when mis-norming of the AFQT led the military to accept a much larger proportion of men with the lowest acceptable aptitude scores (see Gary R. Nelson, "The Supply and Quality of First-Term Enlistees under the All Volunteer Force," in The All-Volunteer Force after a Decade, ed. W. Bowman et al. [Washington, DC: Pergamon-Brassey's, 1986], 31-32; David S. C. Chu and John P. White, "Ensuring Quality People in Defense," in Keeping the Edge: Managing Defense for the Future, ed. A. B. Carter and J. P. White [Cambridge, MA: MIT Press, 2001], 203-234; John T. Warner and Beth J. Asch, "The Record and Prospects of the All-Volunteer Military in the United States," Journal of Economic Perspectives 15 [Spring, 2001]: 169-192).
8. The quality of enlistees dropped substantially during the early years of the AVF, as indicated by the distribution of scores on the Armed Forces Qualification Test (AFQT). The lower quality of recruits during this period was amplified by a technical mistake during 1977-1979 when mis-norming of the AFQT led the military to accept a much larger proportion of men with the lowest acceptable aptitude scores (see Gary R. Nelson, "The Supply and Quality of First-Term Enlistees under the All Volunteer Force," in The All-Volunteer Force after a Decade, ed. W. Bowman et al. [Washington, DC: Pergamon-Brassey's, 1986], 31-32; David S. C. Chu and John P. White, "Ensuring Quality People in Defense," in Keeping the Edge: Managing Defense for the Future, ed. A. B. Carter and J. P. White [Cambridge, MA: MIT Press, 2001], 203-234; John T. Warner and Beth J. Asch, "The Record and Prospects of the All-Volunteer Military in the United States," Journal of Economic Perspectives 15 [Spring, 2001]: 169-192).
9. William Eaton and Charles Muntaner, "Socioeconomic Stratification and Mental Disorder," in A Handbook for the Study of Mental Health, ed. A. V. Horwitz and T. L. Scheid (Cambridge, UK: Cambridge University Press, 1999), 259-283; Martha L. Bruce, "Divorce and Psychopathology," in Adversity, Stress, and Psychopathology, ed. B. P. Dohrenwend (New York: Oxford University Press, 1998), 219-232.
10. William Eaton and Charles Muntaner, "Socioeconomic Stratification and Mental Disorder," in A Handbook for the Study of Mental Health, ed. A. V. Horwitz and T. L. Scheid (Cambridge, UK: Cambridge University Press, 1999), 259-283; Martha L. Bruce, "Divorce and Psychopathology," in Adversity, Stress, and Psychopathology, ed. B. P. Dohrenwend (New York: Oxford University Press, 1998), 219-232.
11. Bruce P. Dohrenwend, Itzhak Levab, Patrick Shrout, Sharon Schwartz, Guedalia Aven, Bruce Link, Andrew Skodol, and Ann Stueve, "Ethnicity, Socioeconomic Status, and Psychiatric Disorders: A Test of the Social Causation-Social Selection Issue," in Dohrenwend, Adversity, Stress, and Psychopathology, 285-318.
12. This reasoning would extend to punitive (dishonorable) discharges from the military, which are also thought to primarily reflect premilitary vulnerabilities. See Gail Gamache, Robert Rosenheck, and Richard Tessler, "Military Discharge Status of Homeless Veterans with Mental Illness," Military Medicine 165 (November, 2000): 803-808.
13. Jerald Bachman, John D. Blair, and David R. Segal, The All-Volunteer Force: A Study of Ideology in the Military (Ann Arbor, MI: The University of Michigan Press, 1977).
14. Charles Moskos, "Institutional and Occupational Trends in Armed Forces," in The Military: More Than Just a Job, ed. C. Moskos and F. R. Wood (Washington, DC: Pergamon-Brassey's International Defense Publishers, 1988), 15-26.
15. The evidence supporting this reasoning is indirect. For example, although the causal linkages are unclear, many studies have found that more homeless veterans suffer from alcohol problems than do homeless nonveterans (see Robert Rosenheck and Paul Koegel, "Characteristics of Veterans and Nonveterans in Three Samples of Homeless Men," Hospital and Community Psychiatry 44, 9 [1996]: 858-863; Richard Tessler, Robert Rosenheck, and Gail Gamache, "Comparison of Homeless Veterans with Other Homeless Men in a Large Clinical Outreach Program," Psychiatric Quarterly 73 [Summer, 2002]: 109-119; James D. Wright, Peter H. Rossi, Janet W. Knight, Dee Weber-Burdin, Richard Tessler, Chris E. Stewart, Maryanne Geronomo, and Julie Lam, "Homelessness and Health: The Effects of Life Style on Physical Well-Being among Homeless People in New York City," in Research in Social Problems and Public Policy, vol. 4, ed. J. Miller and M. Lewis [Greenwich, CT: JAI Press, 1987], 41-72). Analyses of data from the Epidemiological Catchment Area studies have also revealed much higher prevalence rates for both substance abuse and antisocial personality disorder among veterans of the AVF (see Rosenheck, Frishman, and Chung, "The Proportion of Veterans among Homeless Men").
16. The evidence supporting this reasoning is indirect. For example, although the causal linkages are unclear, many studies have found that more homeless veterans suffer from alcohol problems than do homeless nonveterans (see Robert Rosenheck and Paul Koegel, "Characteristics of Veterans and Nonveterans in Three Samples of Homeless Men," Hospital and Community Psychiatry 44, 9 [1996]: 858-863; Richard Tessler, Robert Rosenheck, and Gail Gamache, "Comparison of Homeless Veterans with Other Homeless Men in a Large Clinical Outreach Program," Psychiatric Quarterly 73 [Summer, 2002]: 109-119; James D. Wright, Peter H. Rossi, Janet W. Knight, Dee Weber-Burdin, Richard Tessler, Chris E. Stewart, Maryanne Geronomo, and Julie Lam, "Homelessness and Health: The Effects of Life Style on Physical Well-Being among Homeless People in New York City," in Research in Social Problems and Public Policy, vol. 4, ed. J. Miller and M. Lewis [Greenwich, CT: JAI Press, 1987], 41-72). Analyses of data from the Epidemiological Catchment Area studies have also revealed much higher prevalence rates for both substance abuse and antisocial personality disorder among veterans of the AVF (see Rosenheck, Frishman, and Chung, "The Proportion of Veterans among Homeless Men").
17. The evidence supporting this reasoning is indirect. For example, although the causal linkages are unclear, many studies have found that more homeless veterans suffer from alcohol problems than do homeless nonveterans (see Robert Rosenheck and Paul Koegel, "Characteristics of Veterans and Nonveterans in Three Samples of Homeless Men," Hospital and Community Psychiatry 44, 9 [1996]: 858-863; Richard Tessler, Robert Rosenheck, and Gail Gamache, "Comparison of Homeless Veterans with Other Homeless Men in a Large Clinical Outreach Program," Psychiatric Quarterly 73 [Summer, 2002]: 109-119; James D. Wright, Peter H. Rossi, Janet W. Knight, Dee Weber-Burdin, Richard Tessler, Chris E. Stewart, Maryanne Geronomo, and Julie Lam, "Homelessness and Health: The Effects of Life Style on Physical Well-Being among Homeless People in New York City," in Research in Social Problems and Public Policy, vol. 4, ed. J. Miller and M. Lewis [Greenwich, CT: JAI Press, 1987], 41-72). Analyses of data from the Epidemiological Catchment Area studies have also revealed much higher prevalence rates for both substance abuse and antisocial personality disorder among veterans of the AVF (see Rosenheck, Frishman, and Chung, "The Proportion of Veterans among Homeless Men").
18. The evidence supporting this reasoning is indirect. For example, although the causal linkages are unclear, many studies have found that more homeless veterans suffer from alcohol problems than do homeless nonveterans (see Robert Rosenheck and Paul Koegel, "Characteristics of Veterans and Nonveterans in Three Samples of Homeless Men," Hospital and Community Psychiatry 44, 9 [1996]: 858-863; Richard Tessler, Robert Rosenheck, and Gail Gamache, "Comparison of Homeless Veterans with Other Homeless Men in a Large Clinical Outreach Program," Psychiatric Quarterly 73 [Summer, 2002]: 109-119; James D. Wright, Peter H. Rossi, Janet W. Knight, Dee Weber-Burdin, Richard Tessler, Chris E. Stewart, Maryanne Geronomo, and Julie Lam, "Homelessness and Health: The Effects of Life Style on Physical Well-Being among Homeless People in New York City," in Research in Social Problems and Public Policy, vol. 4, ed. J. Miller and M. Lewis [Greenwich, CT: JAI Press, 1987], 41-72). Analyses of data from the Epidemiological Catchment Area studies have also revealed much higher prevalence rates for both substance abuse and antisocial personality disorder among veterans of the AVF (see Rosenheck, Frishman, and Chung, "The Proportion of Veterans among Homeless Men").
19. When young enlisted men join the military, it is usually the first time they have been away from home and from their family of origin and friends.
20. Warner and Asch, "The Record and Prospects of the All-Volunteer Military in the United States."
21. Martha R. Burt, Laudan Y. Aron, Toby Douglas, Jesse Valente, Edgar Lee, and Brita Iwen, Homelessness: Programs and the People They Serve: Summary Report of the Findings of the National Survey of Homeless Assistance Providers and Clients (Washington, DC: The Urban Institute, 1999).
22. It is important to note that the subjects of the study were clients of homeless assistance programs. Although this is an efficient way to draw a national sample of homeless persons that is service-based, the sampling approach tends to miss homeless people in communities without many services. The sample is therefore more representative of urban areas that are rich in homeless assistance programs and less representative of veterans (and other homeless men) in rural and suburban areas.
23. Since the survey is cross-sectional, the sample probably overrepresents veterans and other individuals who have been homeless for more than six months and underrepresents people with shorter episodes of homelessness and those who are homeless for the first time. Any characteristic associated with long-term homelessness, including being a veteran under forty-five years of age, will likewise be inflated relative to its true value in the national population of homeless persons.
24. Unfortunately, using the length of the current homeless spell is complicated by the fact that in many cases the spell was ongoing. Thus, it is possible that some percentage of the cases coded as homeless for less than six months would actually continue for more than six months. But most cases of homelessness over six months' duration will also continue to mount. Thus, while there may be errors in individual cases in determining whether the homelessness was long- or short-term, in the aggregate we feel the measurement approach is valid. If the dependent measure had no validity, we would not expect to find support for the hypotheses. Nonetheless, the dependent measure should be interpreted as length of time of homelessness at the time of inter-view rather than duration of homelessness per se.
25. Thomas A. McClellan, John S. Cacciola, and Ian Fureman, "The Addiction Severity Index (ASI) and the Treatment Services Review (TSR)," in Outcomes Assessment in Clinical Practice, ed. L. Sederer and B. Dickey (Baltimore: Williams and Wilkins, 1996), 70-75.
26. It is possible that the proxy measures of functional capacity were poor indicators of past capacity, and some may have been confounded by the homeless condition itself. This may have been a particular limitation of the measures of health, alcohol, drug use, and mental illness, which were all contemporaneous.
27. The sample probably also underrepresents veterans who primarily or exclusively use specialized VA services for homeless men.
28. A limitation of the study is the lack of information on strength of social ties and quality of social relationships, which may be more central than mental illness for young veterans as causes of prolonged homelessness. The connection between family support and duration of homelessness was also limited to financial assistance. Future research should incorporate a broader array of social support and connectedness measures.
29. Ezra Susser, Elmer L. Struening, and Sarah Conover, "Childhood Experiences of Homeless Men," American Journal of Psychiatry 144, 12 (1987): 1599-1601; Ezra Susser, Lin P. Shang, Sarah Conover, and Elmer L. Struening, "Childhood Antecedents of Homelessness in Psychiatric Patients," American Journal of Psychiatry 148, 8 (1991): 1026-1030.
30. Ezra Susser, Elmer L. Struening, and Sarah Conover, "Childhood Experiences of Homeless Men," American Journal of Psychiatry 144, 12 (1987): 1599-1601; Ezra Susser, Lin P. Shang, Sarah Conover, and Elmer L. Struening, "Childhood Antecedents of Homelessness in Psychiatric Patients," American Journal of Psychiatry 148, 8 (1991): 1026-1030.
31. Robert Rosenheck and Alan Fontana, "A Model of Homelessness among Male Veterans of the Vietnam Generation," American Journal of Psychiatry 151 (1994): 421-427.
32. Burt et al., Homelessness: Programs and the People They Serve.
33. This is not the case for low-aptitude veterans who are no better off economically, educationally, or socially than their nonveteran counterparts (see Janice Laurence, Peter Ramsberger, and Monica Gribben, Effects of Military Experience on the Post-Service of Low Aptitude Recruits: Project 100,000 and the ASVAB Misnorming [Washington, DC: Office of the Assistant Secretary of Defense, 1989]; see also Jay Teachman and Vaughn Call, "The Effect of Military Service on Educational, Occupational, and Income Attainment," Social Science Research 25 [1996]: 1-31; Wayne J. Villemez and John D. Kasarda, "Veteran Status and Socioeconomic Attainment," Armed Forces & Society 2 [1976]: 407-420; Yu Xie, "The Socioeconomic Status of Young Male Veterans, 1964-1984," Social Science Quarterly 73 [1992]: 379-396).
34. This is not the case for low-aptitude veterans who are no better off economically, educationally, or socially than their nonveteran counterparts (see Janice Laurence, Peter Ramsberger, and Monica Gribben, Effects of Military Experience on the Post-Service of Low Aptitude Recruits: Project 100,000 and the ASVAB Misnorming [Washington, DC: Office of the Assistant Secretary of Defense, 1989]; see also Jay Teachman and Vaughn Call, "The Effect of Military Service on Educational, Occupational, and Income Attainment," Social Science Research 25 [1996]: 1-31; Wayne J. Villemez and John D. Kasarda, "Veteran Status and Socioeconomic Attainment," Armed Forces & Society 2 [1976]: 407-420; Yu Xie, "The Socioeconomic Status of Young Male Veterans, 1964-1984," Social Science Quarterly 73 [1992]: 379-396).
35. This is not the case for low-aptitude veterans who are no better off economically, educationally, or socially than their nonveteran counterparts (see Janice Laurence, Peter Ramsberger, and Monica Gribben, Effects of Military Experience on the Post-Service of Low Aptitude Recruits: Project 100,000 and the ASVAB Misnorming [Washington, DC: Office of the Assistant Secretary of Defense, 1989]; see also Jay Teachman and Vaughn Call, "The Effect of Military Service on Educational, Occupational, and Income Attainment," Social Science Research 25 [1996]: 1-31; Wayne J. Villemez and John D. Kasarda, "Veteran Status and Socioeconomic Attainment," Armed Forces & Society 2 [1976]: 407-420; Yu Xie, "The Socioeconomic Status of Young Male Veterans, 1964-1984," Social Science Quarterly 73 [1992]: 379-396).
36. This is not the case for low-aptitude veterans who are no better off economically, educationally, or socially than their nonveteran counterparts (see Janice Laurence, Peter Ramsberger, and Monica Gribben, Effects of Military Experience on the Post-Service of Low Aptitude Recruits: Project 100,000 and the ASVAB Misnorming [Washington, DC: Office of the Assistant Secretary of Defense, 1989]; see also Jay Teachman and Vaughn Call, "The Effect of Military Service on Educational, Occupational, and Income Attainment," Social Science Research 25 [1996]: 1-31; Wayne J. Villemez and John D. Kasarda, "Veteran Status and Socioeconomic Attainment," Armed Forces & Society 2 [1976]: 407-420; Yu Xie, "The Socioeconomic Status of Young Male Veterans, 1964-1984," Social Science Quarterly 73 [1992]: 379-396).
37. Paul Starr, The Discarded Army: Veterans After Vietnam (New York: Charterhouse, 1973).
38. Glen H. Elder, Linda K. George, and Michael J. Shanahan, "Psychosocial Stress over the Life Course," in Psychosocial Stress: Perspectives on Structure, Theory, Life-Course, and Methods, ed. H. B. Kaplan (San Diego, CA: Academic Press, 1996), 274-275.
39. Glen H. Elder Jr., "Military Times and Turning Points in Men's Lives," Developmental Psychology 22 (1986): 233-245; Robert J. Sampson and John H. Laub, "Socioeconomic Achievement in the Life Course of Disadvantaged Men: Military Service as a Turning Point, circa 1940-1965," American Sociological Review 61 (June, 1996): 347-367.
40. Glen H. Elder Jr., "Military Times and Turning Points in Men's Lives," Developmental Psychology 22 (1986): 233-245; Robert J. Sampson and John H. Laub, "Socioeconomic Achievement in the Life Course of Disadvantaged Men: Military Service as a Turning Point, circa 1940-1965," American Sociological Review 61 (June, 1996): 347-367.
41. Glen H. Elder, Linda K. George, and Michael J. Shanahan, "Psychosocial Stress over the Life Course," in Psychosocial Stress: Perspectives on Structure, Theory, Life-Course, and Methods, ed. H. B. Kaplan (San Diego, CA: Academic Press, 1996), 274-275.
42. Warner and Asch, "The Record and Prospects of the All-Volunteer Military in the United States."
43. Mark Eitelberg, "The All Volunteer Force After Twenty Years," in Professionals on the Front Line: Two Decades of the All-Volunteer Force, eds. J. E. Fredland, C. Gilroy, R. D. Little, and W. S. Sellman (Washington, DC: Pergamon-Brassey's International Defense Publishers, 1996), 66-98.
44. Mark E. Gebicke, "Military Attrition: Better Screening of Enlisted Personnel Could Save DOD Millions of Dollars," Washington, DC: Senate Committee on Armed Services (March 5, 1997); Mark E. Gebicke, "Military Attrition: DOD Needs to Better Analyze Reasons for Separation and Improve Recruiting Systems," Washington, DC: United States General Accounting Office Testimony (March 12, 1998).
45. Mark E. Gebicke, "Military Attrition: Better Screening of Enlisted Personnel Could Save DOD Millions of Dollars," Washington, DC: Senate Committee on Armed Services (March 5, 1997); Mark E. Gebicke, "Military Attrition: DOD Needs to Better Analyze Reasons for Separation and Improve Recruiting Systems," Washington, DC: United States General Accounting Office Testimony (March 12, 1998).