Homeless Veterans with Mental Illness: Predicting and Enhancing Recovery

描述（由申请人提供）： 退伍军人无家可归是一个普遍存在的问题，也是国家层面的高度优先事项。 2010 年联邦预防和消除无家可归战略计划的目标之一是“在五年内预防和消除退伍军人无家可归”。向国会提交的 2009 年年度无家可归者评估报告的补充报告对无家可归的退伍军人的状况进行了惨淡的描述：2009 年 1 月的一个晚上，有 75,609 名退伍军人无家可归。在美国，退伍军人无家可归的比例约为非退伍军人成年人的两倍。住房和城市发展部 (HUD) 与 VA 之间的联合计划通过 HUD - VA 支持性住房 (HUD-VASH) 计划向无家可归的退伍军人提供住房援助和支持服务。这个计划是一项巨大的成就；然而，住房状况是成功融入社区的必要条件，但不是充分条件。社区融合的其他重要方面包括与家人和朋友的社会联系、参与工作和学校以及日常生活活动（购物、交通）。社区融合的这些方面在获得住房后通常保持不变。对于患有精神障碍等严重精神疾病 (SMI) 的人来说，无家可归率比普通人群高 10-20 倍。对于患有 SMI 的无家可归退伍军人群体中功能结果的预测因素知之甚少。该项目的研究目的是确定哪些具体因素因素（即神经认知、社会认知或动机变量）预测患有精神障碍的无家可归退伍军人的功能结果在拟议的 3 年研究中，我们将招募 120 名参加 HUD-VASH 计划的有精神障碍病史的退伍军人，并前瞻性地评估他们在 12 个月内的社区融入情况。 拟议项目的目标是确定结果的主要决定因素。基于 VA 大洛杉矶医疗系统 (GLA) 的 VISN 22 精神疾病研究、教育和临床中心 (MIRECC) 之前关于 SMI 功能结果的预测因素和决定因素的研究。当我们完成这项研究时，我们将了解哪些因素是患有精神疾病的无家可归退伍军人融入社区的关键决定因素，并将获得必要的信息来提出更大规模的干预研究。我们将当前的申请视为致力于改善无家可归退伍军人生活的集中和系统研究计划的开始。患有 SMI 的无家可归退伍军人。

DESCRIPTION (provided by applicant): Homelessness in Veterans is a widespread problem and is a high priority at the national level. The 2010 Federal Strategic Plan to Prevent and End Homelessness has as one of its goals to "Prevent and end homelessness among Veterans in five years." The Supplemental Report to the 2009 Annual Homeless Assessment Report to Congress offered a bleak account of the status of homeless Veterans: On a single night in January 2009, 75,609 Veterans were homeless. Veterans are homeless at about twice the rate of non- Veteran adults in the U.S. A joint program between Housing and Urban Development (HUD) and the VA offers housing assistance and supportive services to homeless Veterans through the HUD - VA Supportive Housing (HUD-VASH) Program. This program is a tremendous accomplishment; however, housing status is a necessary, but not sufficient, condition for successful community integration. Other important facets of community integration include social connections with family and friends, participation in work and school, and activities of daily living (shopping, transportation. These aspects of community integration frequently remain unchanged after housing is achieved. For those with severe mental illness (SMI), such as psychotic disorders, rates of homelessness are 10-20 times higher than in the general population. Little is known about predictors of functional outcome within the very large group of homeless Veterans with SMI. The research aims for this project are to determine which specific factors (i.e., neurocognition, social cognition, or motivational variables) predict functional outcome in homeless Veterans with psychotic disorders. In the proposed 3-year study we will recruit 120 Veterans with a history of a psychotic disorder who are in the HUD- VASH program and assess their community integration over a 12 month period prospectively. The goal is to identify the primary determinant(s) of outcome to be included in a subsequent treatment study. The aims of the proposed project are based on previous research at the VISN 22 Mental Illness Research, Education and Clinical Center (MIRECC) at VA Greater Los Angeles Healthcare System (GLA) on predictors and determinants of functional outcome in SMI. When we complete this study we will know which factors are key determinant(s) of community integration in homeless Veterans with psychotic disorders and will have the necessary information to propose a larger intervention study. We view the current application as the start of a concentrated and systematic research program dedicated to improving the lives of homeless Veterans with SMI.