Identifying Graduation Rates and Practices in the U.S. Department of Housing and Urban Development-Veterans Affairs Supportive Housing Program.

Graduation from permanent supported housing program (PSH) is an important part of individuals' recovery and rehabilitation, yet little research has examined this process. We examined graduation rates, practices and policies in the U.S. Department of Veterans Affairs-Housing and Urban Development Supportive Housing (HUD-VASH) program, the largest PSH program in the United States. We used HUD-VASH administrative data from Fiscal Years 2016-2020 to summarize graduation rates from the program. Using a template analysis approach to open-ended online surveys from 65 HUD-VASH program managers, we identified key themes related to graduation practices. Graduations accounted for 21% of all HUD-VASH exits across all years. Graduation practices and policies varied across HUD-VASH programs, and staff expressed interest in having additional data to support graduation decisions. There may be value in developing standards for graduation criteria that is shared with clients and providers in supported housing programs in order to titrate care appropriately and support client independence.

Justice Involvement and Treatment Use Among Rural Veterans.

Veterans in rural areas and veterans involved in the criminal justice system have experienced less access to, and use of, health care. However, there is limited information on the treatment needs and health care access of justice-involved veterans who live in rural areas. This study used national Veterans Health Administration data from fiscal year 2014 to examine the interactive effect of rural/urban residence and justice involvement on mental health and substance use disorder treatment entry among veterans diagnosed with mental health or substance use disorders. Of veterans residing in rural areas, 15,328 (2.5%) were justice-involved and 607,819 (97.5%) veterans had no known justice involvement. Among veterans in urban areas, 54,525 (4.3%) were justice-involved and 1,213,766 (95.7%) had no known justice involvement. Rural residence was associated with lower access to mental health or substance use disorder treatment in the non-justice-involved sample but not the justice-involved sample. Justice-involvement was associated with higher odds of entering mental health or substance use disorder treatment for veterans in rural and in urban areas. Substance use disorder treatment entry could be improved for all veterans, particularly rural veterans who are not justice-involved. Telehealth, outreach services, and integrated treatment may help address challenges to treatment entry experienced by rural veterans and justice-involved veterans.

A National Study of Veterans Treatment Court Participants: Who Benefits and Who Recidivates.

Although there are now over 400 veterans treatment courts (VTCs) in the country, there have been few studies on participant outcomes in functional domains. Using national data on 7931 veterans in the Veterans Affairs (VA) Veterans Justice Outreach program across 115 VA sites who entered a VTC from 2011 to 2015, we examined the housing, employment, income, and criminal justice outcomes of VTC participants; and identified veteran characteristics predictive of outcomes. VTC participants spent an average of nearly a year in the program and 14% experienced a new incarceration. From program admission to exit, 10% more participants were in their own housing, 12% more were receiving VA benefits, but only 1% more were employed. Controlling for background characteristics, a history of incarceration predicted poor criminal justice, housing, and employment outcomes. Participants with property offenses or probation/parole violations and those with substance use disorders were more likely to experience a new incarceration. Participants with more mental health problems were more likely to be receiving VA benefits and less likely to be employed at program exit. Together, these findings highlight the importance of proper substance abuse treatment as well as employment services for VTC participants so that they can benefit from the diversion process.

Diversion of Veterans With Criminal Justice Involvement to Treatment Courts: Participant Characteristics and Outcomes.

OBJECTIVE: This study compared characteristics and outcomes between veterans who participated in veterans treatment courts (VTCs) and veterans involved in criminal justice who participated in other treatment courts (TCs) or who participated in neither VTCs or TCs. METHODS: Data from 22,708 veterans (N=8,083 VTC participants, 680 participants in other TCs [other-TC participants], and 13,945 participants in neither VTCs nor TCs [non-TC participants]) in the Veterans Justice Outreach (VJO) program were analyzed by using multilevel regression models. RESULTS: VTC participants were more likely than other VJO participants to have served in Iraq or Afghanistan, but there were no sociodemographic disparities in access to VTCs. VTC participants were more likely than non-TC participants to have drug or public-order offenses, and they were more likely than other-TC participants to have DUI offenses. VTC participants had better independent housing outcomes than other VJO participants, and they had better employment outcomes than non-TC participants. However, VTC and other-TC participants were also more likely to have jail sanctions and new incarcerations compared with non-TC participants. CONCLUSIONS: VTCs are a growing service model that serves a broad group of veterans with a range of criminal offenses. Although VTCs show moderate benefits in housing and employment, specialized services are needed to reduce recidivism and maximize these benefits.

A Longitudinal Examination of Veterans Treatment Courts' Characteristics and Eligibility Criteria.

Although the number of Veterans Treatment Courts (VTCs) has been growing at a rapid rate, thus far, VTC components have not been standardized, due in part to a lack of empirical evidence on the extent to which components vary across VTCs nationwide and change over time. This study analyzed data collected by the Department of Veterans Affairs' Veterans Justice Program, on VTCs in 2012 (n = 173 Courts), 2013 (n = 266), and 2014 (n = 351), to describe Court characteristics, participant eligibility criteria, and Courts' mentoring component. Despite growth in VTC numbers, the survey found consistency over time in these aspects of VTCs. Regarding characteristics, the majority of Courts had jurisdiction at the county level. Across survey years, the range of means was 22-24 for veteran participant census, 10-14 for number of months spent in the Court for misdemeanors, and 18-19 for number of months spent in the Court for felonies. Eligibility requirements suggested openness to veterans of different backgrounds and status. Less than two thirds of Courts had the mentoring component; Courts with the mentoring component had a higher participant census and a longer duration of participants' time under Court supervision than Courts without this component. Existing mentoring programs were organized mainly by volunteers. VTCs' adherence to policies supportive of veterans may benefit from having paid mentor coordinators in order to further ensure this hallmark of VTCs.