Mental Illness and Substance Use Disorders Among Homeless Veterans

Mental illness and substance use disorders (SUDs) are strong risk factors for homelessness, regardless of Veteran status. This chapter describes the interplay between mental illness, SUDs, the co-occurrence of these disorders (CoD), and homelessness among Veterans; the authors consider military-specific experiences (e.g., combat) and factors associated with homelessness for both Veteran and non-Veteran adults (e.g., childhood adversity). They present epidemiology data on mental illness and SUDs among homeless Veterans, considering specific diagnoses (e.g., post-traumatic stress disorder) and experiences (e.g., military sexual trauma) that are highly prevalent within or unique to persons who served in the United States Armed Forces. In addition, the authors present qualitative and quantitative data on pathways to homelessness for Veterans with mental illness, SUDs, and/or CoD, considering distinct pathways seen in special populations (e.g., women Veterans, who have high rates of trauma, and the newest cohort of Veterans who served in Iraq or Afghanistan). Last, the authors discuss supported housing outcomes for homeless Veterans with psychiatric disorders and SUDs. They discuss the utility of these programs for homeless Veterans with mental health problems and explore the influence of psychiatric disorders and SUDs among Veterans with poor supported housing outcomes.

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Serious Mental Illness

10.1093/oxfordhb/9780199381708.013.009 ◽

2014 ◽

Author(s):

Kim T. Mueser ◽

Douglas L. Noordsy ◽

Robert E. Drake

Keyword(s):

Mental Illness ◽

Substance Use ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

Serious Mental Illness ◽

Integrated Treatment ◽

Mental Illnesses ◽

Clinical Consequences ◽

Social Difficulties ◽

Serious Mental Illnesses

The high comorbidity between substance use disorders and serious mental illnesses is a significant challenge to traditional treatment systems that have historically treated psychiatric and substance use disorders with different providers and agencies. Defining characteristics of serious mental illness include difficulty with work, performing in school or parenting, social difficulties, and problems caring for oneself. Common serious psychiatric disorders include schizophrenia, schizoaffective disorder, bipolar disorder, and severe major depression, posttraumatic stress disorder, and borderline personality disorder. The epidemiology of substance use disorders in serious mental illness is reviewed, including prevalence, correlates, and onset and course of the disorder. The clinical consequences of substance use disorders in this population are devastating for every possible aspect of the illness. Common factors may increase vulnerability to both substance abuse and psychiatric disorders. The principles of treating co-occurring disorders are based on modern integrated methods, as well as research on the effectiveness of integrated treatment.

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Addiction and Violence Among People with Severe Mental Illnesses: An Updated Literature Review

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2012 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S153-S153

Author(s):

I. Khemiri ◽

F. Fekih Romdhane ◽

A. Belkhiria ◽

J. Lamia ◽

R. Trabelsi ◽

...

Keyword(s):

Substance Abuse ◽

Mental Illness ◽

Substance Use ◽

Mental Disorders ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

Substance Use Disorder ◽

Mental Illnesses ◽

Severe Mental Disorders ◽

Co Morbidity

IntroductionViolence has important relevance for the criminal justice and health care systems especially forensic psychiatry. Previous studies reported the relation between violence, mental illness and substance abuse. We purpose to investigate the association between addiction and violence among people with severe mental illness through a review of literature.Methodwe conducted a Medline and Pubmed literature search of studies published between “2000 and 2015”, combining the terms “psychotic disorders”, “addiction” “substance use disorder”.ResultsThe studies published showed that much of the excessive violence observed in patients with severe psychiatric disorders is due to co-morbid substance use. Increasing violence associated with substance use disorders in these patients had same level than that observed among subjects without severe psychiatric disorders. Increasing violence in subjects with substance use disorder but without severe mental disorders was higher than in patients with only severe mental disorders. In fact, mental disorders could increase the risk of installing on substance use disorders, and therefore increase the risk of partner violence. Among the substances used, if alcohol is frequently identified as a consumer risk for the emergence of violence among subjects with severe psychiatric disorders, stimulants could be causing more violence than alcohol.ConclusionsSevere mental illnesses are associated with violence. However, most of the excess risk appears to be mediated by substance abuse co-morbidity. This finding improves the need of prevention of substance use disorders and emphasizes the fact that patients with severe mental disorders are more often victims than perpetrators of violence.

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