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Homelessness Among U.S. Veterans: National Trends, Correlates, and Mental Health Burden
Elina A Stefanovics1,2,3, Jack Tsai4,5,6, Ian Fischer4,7
1Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. elina.stefanovics@yale.edu.
None:
Despite well-publicized initiatives to reduce veteran homelessness, current nationally representative data on its prevalence, correlates, and mental health burden are limited. To address this gap, data were analyzed from the 2025-2026 National Health and Resilience in Veterans Study (NHRVS), a nationally representative web-based survey of 2,636 U.S. military veterans. Two-proportion z tests compared lifetime homelessness prevalence across three nationally representative NHRVS cohorts conducted in 2015, 2019-2020, and 2025-2026. Multivariable logistic regression and relative importance analyses examine sociodemographic, military, psychiatric, trauma, and functional correlates of lifetime homelessness. Results revealed that the weighted lifetime homelessness prevalence was 11.4% (95% CI: 9.7-13.1%), which was significantly higher than in 2015 (8.5%; p = .003) but comparable to 2019-2020 (10.2%; p = .11). Most veterans with a homelessness history first experienced homelessness after military discharge (69.6%), with a median duration of 36 months. Relative importance analyses identified lifetime major depressive (11.8%), generalized anxiety (11.2%), and posttraumatic stress (10.7%) disorders, adverse childhood experiences (7.8%), and social anxiety disorder (7.7%) as the strongest correlates of lifetime homelessness. After full adjustment, lifetime homelessness history was associated with significantly elevated odds of current alcohol, drug, and nicotine use disorders (AORs: 1.76, 2.24, 2.84, respectively), at-risk/problem gambling (AOR = 2.13), suicidal ideation (AOR = 1.44), and lifetime suicide attempt (AOR = 1.75). Collectively, results of this study suggest that homelessness among U.S. veterans remains a significant public health concern, with psychiatric disorders and childhood adversity as its strongest correlates. Independent associations with current substance use disorders and suicidal thoughts and behaviors underscore the importance of integrated mental health strategies that concurrently address housing instability, addictive behaviors, and suicide risk in this population.
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