Homelessness Among Veterans: Self-Inflicted or Government Betrayal?

Introduction
Homelessness among veterans is a major problem in United States. There are programs and services to help veterans, but these efforts are inadequate to effectively address the crisis. This paper defines homelessness, examines conditions of homelessness among veterans, identifies current programs that address the problem, presents arguments in favor of the status quo, presents arguments against the status quo, and then concludes with a moral position. Disclaimer: the arguments in this article are solely for academic discussions and do not necessarily reflect the author’s personal beliefs.
The Problem:
Webster’s Advanced Dictionary[1] (2001) defines “homeless” as “having nowhere to live; living on the streets: homeless people.” (p. 354). For this paper, “homelessness among veterans” is defined as a situation whereby a soldier has served in a war zone, returned home, and now has no place of his own to live. Such a former soldier is a homeless veteran.
Homeless veterans live on the streets, in abandoned buildings, vehicles, encampments, shelters, or transitional housing. They do not have a permanent residence under their control. It includes those who fit what Martha Burt, et al. (2004)[2] called “street homeless”, which they defined as single adults who spend a lot of time on the streets; and the “chronically homeless”, which they defined as “being disabled and either continuously homeless for a year or more or having at least four homeless episodes during the last three years.” (p. 2).
As of 2012, experts believed that homeless veterans make up about 11% of the United States homeless population, which is about “31 homeless veterans for every 10,000 veterans.” This figure, according to Edward Carrillo, et al. (2012)[3], is much higher than the rate of homelessness in the society, which is about “21 homeless person for every 10,000 people in the general population.” (p. 248). According to Donna Washington, et al. (2010)[4], female veterans are 400% more likely to become homeless than their non-veteran female counterparts. (p. 82). Wenzel, et al.’ (1993)[5] research asserted that: “Veterans experiencing long-term homelessness were more likely to be white, … to have a poor employment history, to have symptoms of mental and substance abuse disorders, and to have weaker social support.” (pp. 1172-1176).
Homelessness among veterans who recently returned home from war zones is quite high. The numbers are getting higher as more veterans return home from Iraq and Afghanistan. For example, according to Edward Carrillo, et al., (2012), “on a single night in January 2010, the PIT count estimated there were 76,329 homeless veterans…. More than 43,000 (57%) of the veterans were sleeping in emergency shelters or transitional housing and the remaining 32,000 (43%) were sleeping on the streets, in vehicles, in abandoned buildings, or in other places not meant for human habitation.” (pp. 248-249). Other researchers corroborated the enormity of homelessness among veterans. For example, Jennifer Roberts (2013)[6] postulated that, according to the National Council for Homeless Veterans, the Department of Veterans Affairs estimated that 107,000 veterans were homeless on any given night in 2011. (p. 275).
The issue, therefore, is whether the United States Government should allow homelessness among veterans to continue unabated, because it is self-inflicted (which is a social problem that needs no further government intervention); or, whether the government should eliminate homelessness among veterans, because failure to do so constitutes betrayal by the government (a moral problem that requires more concerted and coordinated efforts to eradicate veterans’ homelessness).
Argument: Is It Self-Inflicted?
Homelessness among veterans is self-inflicted. Some argue that military service is responsible for veterans’ homelessness. That is not true. Research shows that an insignificant number of veterans’ homelessness is linked to military service. According to Mares and Rosenheck’s (2004)[7], out of all veterans who perceived that military service increased their risk of becoming homeless, 75% of them were homeless because of their substance abuse problems and not what military service did to them; and this research finding “is consistent with epidemiological data suggesting that military service itself does not substantially increase the risk for becoming homeless among veterans.” (pp. 715-719). Another research by the American Psychiatric Association (1994)[8] also supports the findings that military service is not necessarily responsible for veterans’ homelessness. (pp. 421-427).
Citing a supplemental report by the VA and HUD, Carrillo, et al. (2012) asserted that homeless veterans behave just like other homeless people in the general population, in that they tend “to be transient,” because they “move in and out of medical facilities and shelters.” (p. 248). The report, according to the authors, corroborates many empirical studies by other researchers. This is why it would be impossible to eliminate homelessness among veterans, and why it is futile for the government to continue to spend more on the problem.
A typical example of why homelessness among veterans is self-inflicted, and why the government should not spend more on the problem, is in the case of a homeless veteran called “Sam” in Edward Carrillo, et al.’s (2012)[9] case study. According to the authors, Sam’s counselor secured a Section 8[10] housing voucher for him. But Sam was “hesitant” in accepting the permanent housing offered by Section 8, because he did not want the responsibilities associated with it. Sam further argued that he enjoyed the “comfort level in being homeless” because of his freedom from not worrying about “paying rent, utilities, and other expenses and responsibilities.” (p. 250). Sam also stated that his “biggest problem staying outdoors is where to charge” his cell phone. If Sam’s problem biggest problem, as a homeless veteran, is worrying about “where to charge” his cell phone; then he and other veterans like him do not need any more government assistance. Sam prefers to use more than half of his disability income on alcohol and cigarettes than to use 30% of it on permanent housing. Besides, alcoholism and drug abuse are habits of choice; so, if that is what some veterans choose to do to remain homeless then, by all means, let them be.
The government already spends enough to combat homelessness, and no more spending is necessary due to the enormity of our national debt and current economic crises. For example, Burt, et al.’s (2004)[11] final report indicated that as of the year 2000, homeless assistance programs cost United States $2 billion per year; and it is perhaps more than triple than amount today. (p. 19).
Moreover, additional government intervention is unwarranted because there is a plethora of information about veterans’ homeless programs and services[12] at the state and local level, which are available to any veteran if interested. (Burt, et al., p. xiii). All that the homeless veteran has to do is to apply for them. The government already provides enough programs and services for veterans, and they are focused on prevention, reduction, and eventual alleviation of homelessness among veterans. (Carrillo, et al., pp 246-269; Coll & Weiss,[13] pp. 281-294; Roberts, pp. 270-280). Below are just a few of the numerous existing programs for homeless veterans:

• Free health care services for all veterans for 5 years from the date of discharge. (Roberts, p. 272; Carrillo, 254-255).
• VA operates several programs providing clinical services, residential treatments, and housing for veterans, and it “has developed an elaborate system of contracts with non-profit agencies to supply a variety of housing and service options” for them, including low-demand[14] housing. (Burt, et al., pp. xxi, 22 & 26).
• VA’s programs specifically designed for veterans returning from Iraq and Afghanistan include: Transition Assistance Program (TAP); Disabled Transition Assistance Program (DTAP); Wounded Warrior; and Reintegration Skills Training. (Coll & Weiss, pp. 281-194).
• Temporary and Permanent Housing include: Housing First[15], Section 8, Safe Havens[16], Section 811[17], Permanent Supportive Housing, shelters, transitional housing, etc.
• Counseling services include: Motivational Interviewing (MI), Assertive Community Treatment (ACT), Drugs and Alcohol Treatment modalities, and Vet Centers Readjustment Counseling Services, etc. (Carrillo, et al., pp. 247-261; Roberts, p. 274).
• Other programs include: Montgomery G.I. Bill of 1984[18]; Post 9/11 G.I. Bill of 2009; McKinney-Vento Act[19]; Domiciliary Care for Homeless Veterans (DCHV)[20]; Homeless Persons Reintegration Program (HPRP)[21]; Project CHALENG[22]; Veterans Homelessness Prevention Demonstration Project; National Call Center for Homeless Veterans; Health Care for Reentry Veterans; Veterans Justice Outreach; and VA Transitional Housing; etc. (Carrillo, pp. 254-261; Burt, et al., 68-75; and Coll & Weiss, 291-291).
• In addition to all the programs and services enumerated above, veterans enjoy many more programs and services provided to them by the American society including: employment hiring credits and preferences; apartment rental preferences and discounts; sales discounts; and promotions; etc., which are not available to the general public.

Due to the abundance of programs and services available to veterans, it is inconceivable that any veteran would be homeless, except if such homelessness is caused by the veteran’s personal failure and inability to take advantage of these wonderful programs and services. So, the government should do no more.
Argument: Is It Government Betrayal?
Proponents against government intervention argue that veteran homelessness is self-inflicted, and that there is a plethora of programs and services available to all veterans. But that is not the issue here. The issue is whether United States has taken good care of all the veterans who selflessly sacrificed themselves for the country. And the answer is no. If the government has taken good care of the veterans, there would be no homeless veterans today. The failure/refusal, by the United States, to provide adequate housing assistance to all homeless veterans is the most egregious betrayal of these homeless veterans by the government. They were not homeless before they joined the military; and they should not be left homeless now, after their service to the country.
Military service causes veterans’ homelessness. According to Carrillo, et al. (2012), the “emotional trauma” suffered in war zones by combat veterans are “both a cause and a consequence of homelessness” among veterans. (p. 248). They postulated that many veterans suffer from a “culture shock” and thus experience difficulties in transitioning from military life to civilian life. (pp. 247-248). Although overrepresented in the general population, the proportion of homeless veteran families receiving sheltered services[23] in 2011was much lower than the proportion of non-veteran families receiving sheltered services. They believed HUD and VA estimates indicated that about 20% of non-veteran homeless adults received sheltered services with their families; whereas, only about 4% of homeless veterans received such services with their families. (p. 249). This is not only appalling, it is also disgraceful. The practice is not only gross injustice; it is also betrayal by the government.
Military service in war zones is different than going to work in your office at the Pentagon. According to Jennifer Roberts (2013), every day veterans who serve in the military in war zones, are exposed to a “variety of risks, including physical injury, psychological trauma, environmental agent exposure, and numerous stressors impacting personal life.” (p. 274). Washington, et al.’s (2010)[24] research postulated that the characteristics linked to veterans’ homelessness include anxiety disorder, poor health, disability, post traumatic stress disorder (PTSD), unemployment, and sexual assault during military service. Research findings suggest that these problems are the consequences of their military service to the United States. (pp. 82, 88-91). Therefore, abandoning these selfless soldiers, after returning home, is a travesty of justice and a betrayal.
Coll & Weiss (2013) asserted that the United States’ “engagement in the Global War on Terrorism” was estimated by experts to cause a significant number of “invisible wounds of war,” which would be as high as 300,000 veterans; and that such injuries include Post Traumatic Stress Disorder (PTSD), traumatic brain injury, and “other related mental disorders.” (p. 281). Thus, since the United States government sent these wounded veterans to war, it is under obligation to provide adequate services for them when they return home. Such services include Transition Assistance Program (TAP), the Disabled Transition Assistance Program (DTAP), and the Wounded Warrior program; in order to reintegrate them into the society they once knew and help them transition into civilian life.
Due to their pathologies, medical disabilities, and transportation problems, some veterans are so medically and psychological maladjusted that they are not able to access the treatments and help they need. For example, according to Carrillo et al. (2012), “John Doe is a heterosexual male Vietnam era soldier who is more than 65 years old, has severe chronic untreated arthritic pain, is actively abusing alcohol, has no income, is chronically homeless and has been sleeping on the streets for more than 20 years. He was found in the streets under a bush and smelled of urine and was covered from head to toe with lice and various other mites.” (p. 253). This should not be allowed to happen to anyone who has served in combat for the United States, which is supposed to be the greatest country in the world.
It is misleading to say that some veterans are beyond help or that they do not want the responsibilities of independent living; as the opposing argument proponents suggested. They cite the case studies about John Doe (above) and Sam (discussed earlier) as reasons why the government should not do more in eliminating veterans’ homelessness. Although these two cases, at first glance, appear to be failures; they are actually success stories that the federal government would do well to replicate nationwide. Fortunately, according to the authors, what helped John Doe to eventually get off the streets were the coordinated efforts and collaboration of the Veterans Affairs through community non-profit agencies, VA emergency department medical staff, VA managers, VA Outreach workers, and community emergency response team. As for Sam, he was eventually motivated by his counselor to have a shift in thinking through “Stages of Change dialogue and client-centered treatment planning.” (Carrillo, et al., p. 250). Because of the successful Motivational Interviewing (MI) counseling sessions, Sam was able to enroll in Housing First program and later secured a permanent housing through Section 8. Sam’s successful intervention can be replicated nationwide. Failure to do so is betrayal by the government.
Some argue that we cannot spend more because of our national debt. Such argument is invalid. Studies show that the costs of leaving veterans homeless, especially disabled veterans, are just as high, if not higher, than providing them with permanent supportive housing. Data indicated that the financial costs of homelessness, to the government, are higher than the costs of housing them, because of “the costs of public crisis services used by chronically homeless people who do not have permanent supportive housing.” (Burt, et al., p. 63; Carrillo, et al., p. 265; Rosenheck, et al[25], pp.1256-1264).
Declining wages and rising costs of housing have complicated veteran homelessness and have put permanent housing out of reach for some veterans. Giving these veterans Section 8 vouchers, or other similar housing vouchers, are effective ways to get the veterans off the streets. Several research findings support such programs. For example, Maria O’Connell, et. al. (2008)[26] postulated that the findings of one study, which also corroborated their own findings, indicated that “individuals with access to Section 8 housing were five times more likely than persons without such access to achieve stability in independent housing, regardless of substance abuse diagnosis.” (pp. 268-276).
Sadly, both the federal and state governments have prevented the successful implementation of the beneficial programs and services discussed in this article. Spurred on by big businesses and the super-rich, the politicians (especially Republicans) aggressively defunded programs and services that help the poor, including veterans. Such programs and services include food stamps, Section 8, and Aids to Families with Dependent Children. For example, in the eastern district of Virginia, the waiting lists for Section 8 are three to five years. No new application has been accepted since 2009. Social service agencies in six different cities and counties told Uncle Nosa the same thing. Uncle Nosa is a divorced highly educated (up to PhD level) former law-enforcement officer and businessman, legal professional, and project management professional, with several degrees; but who is now disabled and unable to work. His monthly social security disability (SSDI) income cannot even pay rent, let alone pay for other expenses. Hence he became homeless in late 2009. He was repeatedly denied Medicaid and was told to spend about $2,005 and $2,900 every six months before he could qualify for Medicaid. Two months before he became homeless, he applied for emergency housing assistance and food stamps; but he was denied housing assistance, citing lack of funding. Nevertheless, he was awarded $369 per month for food stamps. Although he appreciated it, Uncle Nosa told the social service worker that he preferred housing assistance to food stamp. They insisted that no housing assistance was available. United Way and other agencies told him the same thing. Two months later, he became homeless and has been homeless ever since. Upon being informed that Uncle Nosa was homeless, social services reduced his food stamps from $369 to $16 per month, stating that the drastic reduction was a result of his self-reported homelessness. That is the kind of logic and bureaucracy that veterans also have to deal with in the United States.
Conclusion
Both sides propounded compelling arguments for their respective positions. Nevertheless, because the United States sent soldiers to war and caused their problems, it should also provide permanent housing for the veterans.
On a final note, it is imperative to underscore that the United States sent people to the moon, explores Mars and other planets, has the most advanced weaponry in existence, dominates the entire world, has the world’s largest economy, spends the largest portion of its annual budget on military defense, has fought the greatest number of wars in history; and war costs a lot of money. Therefore, for this country to be unable or unwilling to adequately care for homeless veterans, who fought these wars, is not only a shame and a travesty of justice, it is also the ultimate betrayal of the veterans by our government.

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O’Connell, M.J.; Kasprow, W.; & Rosenheck, R.A. (2008, March 01). Rates and risk factors for homelessness after successful housing in a sample of formerly homeless veterans. Psychiatry Services, 59(3), pp. 268-275. Retrieved on June 09, 2013, from: http://ps.psychiatryonline.org/article.aspx?articleID=99172.

Roberts, J. (2013). Navigating systems of care. In Allen Rubin, Eugenia L. Weiss, and Jose E. Coll. (Editors, 2013). Handbook of Military Social Work. NJ: John Wiley & Sons, Inc., Chapter 16, pp. 270-280. Retrieved on June 09, 2013, from: http://books.google.com/books?hl=en&lr=&id=BKwZEAAuLBgC&oi=fnd&pg=PA247&dq=homelessness+among+veterans&ots=Lu0ko67x3R&sig=jNl781IBKNVSUAQf24COzS9tEvI#v=onepage&q=homelessness%20among%20veterans&f=false.

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Washington, D.L.; Yano, E.M.; McGuire, J.; Hines, V.; Lee, M.; & Gelberg, L. (2010, February). Risk factors for homelessness among women veterans. Journal of Health Care for the Poor and Underserved, 21(1), pp. 82-91. Retrieved on June 09, 2013, from: http://bpwfoundation.org/documents/uploads/Washington_JHCPU_2010_corrected.pdf .

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Sadler N. (1993, December). Indicators of chronic homelessness among veterans. Hospital & Community Psychiatry, 44(12), pp. 1172-1176. Retrieved on June 09, 2013, from: http://europepmc.org/abstract/MED/8132190/reload=0;jsessionid=KAXE9UdKjuRjmRcfMFEm.6.

[2] Martha Burt, John Hedderson, Jannie Zweig, Mary Jo Ortiz, Laudan Aron-Turnham, and Sabrina M. Johnson. (2004, January). Strategies for reducing chronic street homelessness: Final report. Washington, DC: U. S. Department of Housing and Urban Development, Office of Policy Development & Research. Martha R. Burt, of Urban Institute (UI); John Hedderson, of Walter R. McDonald & Associates, Inc. (WRMA); Janine Zweig, of UI; Mary Jo Ortiz, of WRMA; Laudan Aron-Turnham, of UI; and Sabrina M. Johnson, of WRMA.

[3] Edward V. Carrillo, Joseph J. Costello, and Caleb Yoon Ra. (2012). Homelessness among veterans. In Allen Rubin, Eugenia L. Weiss, and Jose E. Coll. (Editors, 2013). Handbook of Military Social Work. NJ: John Wiley & Sons, Inc., Chapter 15, pp. 247-269.
[4] Donna L. Washington, MD, MPH; Elizabeth M. Yano, PhD, MSPH; James McGuire, PhD, MSW; Vivian Hines, MSW, ACSW; Martin Lee, PhD; and Lillian Gelberg, MD, MSPH. (2010, February). Risk factors for homelessness among women veterans. Journal of Health Care for the Poor and Underserved, 21(1), pp. 82-91.
[5] Suzanne L. Wenzel; Lillian Gelberg; Lailee Bakhtiar; Nicholas Caskey; Elizabeth Hardie; Carol Redford; Nancy Sadler (1993, December). Indicators of chronic homelessness among veterans. Hospital & Community Psychiatry, 44(12), pp. 1172-1176. The authors are researchers at the Department of Sociology, University of California, Los Angeles, CA 90024.
[6] Jennifer Roberts. (2013). Navigating systems of care. In Allen Rubin, Eugenia L. Weiss, and Jose E. Coll. (Editors, 2013). Handbook of Military Social Work. NJ: John Wiley & Sons, Inc., Chapter 16, pp. 270-280.
[7] Alvin S. Mares, PhD, MSW; and Robert A. Rosenheck, MD. (2004, October). Perceived relationship between military service and homelessness among homeless veterans with mental illness. Journal of Nervous & Mental Disease, 192(10), pp. 715-719.
[8] American Psychiatric Association. (1994, March 01). A model of homelessness among male veterans of the Vietnam War generation. American Journal of Psychiatry, 151(3), pp.421-427.
[9] Carrillo, Edward V.; Costello, Joseph J.; & Ra, Caleb Yoon. (2012). Homelessness among veterans. In Allen Rubin, Eugenia L. Weiss, and Jose E. Coll. (Editors, 2013). Handbook of Military Social Work. NJ: John Wiley & Sons, Inc., Chapter 15, pp. 247-269.
[10] HUD Section 8 Housing Choice Voucher, according to the website of the Executive Office of the President of the United States at benefits.gov, is a program that “provides assistance to very low-income families to afford decent, safe, and sanitary housing. Housing can include single-family homes, townhouses and apartments and is not limited to units located in subsidized housing projects.” The site also states the following as the program’s general requirements: “Housing choice vouchers are administered locally by Public Housing Agencies (PHAs). A family that is issued a housing voucher is responsible for finding a suitable housing unit of the family’s choice where the owner agrees to rent under the program. A housing subsidy is paid to the landlord directly by the PHA on behalf of the participating family. The family then pays the difference between the actual rent charged by the landlord and the amount subsidized by the program.” Retrieved on June 17, 2013, from: http://www.benefits.gov/benefits/benefit-details/710.
[11] Martha Burt, John Hedderson, Jannie Zweig, Mary Jo Ortiz, Laudan Aron-Turnham, and Sabrina M. Johnson. (2004, January). Strategies for reducing chronic street homelessness: Final report. Washington, DC: U. S. Department of Housing and Urban Development, Office of Policy Development & Research.
[12] For example, the National Alliance to End Homelessness provides adequate information about State and Local Plans to End Homelessness on its website at: http://www.endhomelessness.org/localplans. (Burt, et al., 2004, p. xiii).
[13] Jose E. Coll, & Eugenia L. Weiss (2013). Transitioning veterans into civilian life. In Allen Rubin, Eugenia L. Weiss, and Jose E. Coll. (Editors, 2013). Handbook of Military Social Work. NJ: John Wiley & Sons, Inc., Chapter 17, pp. 281-295.
[14] According to Burt, et al. (2004), Low-Demand housing is “very successful at attracting chronic street homeless people … these low-demand programs can bring difficult-to-recruit individuals into permanent supportive housing.” (pp. xxi & 26).
[15] Housing First places people “directly from the streets into permanent housing units with appropriate supportive services, including safe haven programs for people with serious mental illness and similar programs for people whose primary problem is addiction.” (Burt, et al, 2004, pp. xx-xxi).
[16] According to Burt, et al. (2004), Safe Havens are a variation of Housing First and they “are very low cost or free housing programs for homeless persons who, at the time, are unwilling or unable to participate in mental health treatment programs or other supportive services. Safe havens provide low demand housing with no limits on length of stay. The Stewart B. McKinney Homeless Assistance Act, as amended in 1992 by Public Law 102-550, authorized the Secretary of the Department of Housing and Urban Development (HUD) to make grants for such housing, but not all the programs we refer to receive these grants.” (pp. 2 & 25).

[17] HUD Section 811 program is similar to HUD Section 8 Choice Voucher and, according to Burt, et al. (2004), it provides “funding to nonprofit organizations to develop rental housing with the availability of supportive services for very low-income adults with disabilities, and provides rent subsidies for the projects to help make them affordable.” (pp. 29 & 75).

[18] Both the Montgomery G.I. Bill and the Post 9/11 G.I. Bill provide financial assistances to all veterans who want to advance their education with college degrees and/or want to purchase a home; and they may also provide rental subsidies to veterans. (Coll & Weiss, 2013, pp. 290-291).
[19] Federal funding through the McKinney-Vento Act is the most common federal funding source for agencies serving the chronically homeless population. Such funding includes programs administered by HUD as part of its supportive emergency services, as well as transitional and permanent supportive housing. Examples include the Emergency Shelter Grants program; Emergency Food and Shelter Program; Supportive Housing Program (for transitional and permanent housing); Shelter Plus Care (permanent housing); Section 8 (permanent housing); Health Care for the Homeless; Section 811; Projects for Assistance in Transition from Homelessness; and several other programs administered by the Veterans Affairs specifically designed to help homeless veterans. (Burt, et al., 2004, pp. 68-75).
[20] According to Edward Carrillo, et al. (2012), Domiciliary Care for Homeless Veterans provides temporary and permanent housing for homeless veterans who are unable to live independently because of medical or psychiatric disabilities. (p. 255).
[21] Edward Carrillo, et al. (2012) affirmed that the Homeless Persons Reintegration Program (HPRP) provides career training and employment services for homeless veterans who are motivated enough to want to secure gainful employment. (pp. 255-256).
[22] Community Homelessness Assessment, Local Education, and Networking Groups, or “Project CHALENG,” was designed by the VA to improve the continuum of services for the homeless veterans, which the local VA office provides through a network of local community agencies serving the homeless population. (Carrillo, et al, 2012, pp. 256-257).
[23] Sheltered services include programs and services that provide temporary, transitional, and/or permanent housing to homeless people.
[24] Donna L. Washington, MD, MPH; Elizabeth M. Yano, PhD, MSPH; James McGuire, PhD, MSW; Vivian Hines, MSW, ACSW; Martin Lee, PhD; and Lillian Gelberg, MD, MSPH. (2010, February). Risk factors for homelessness among women veterans. Journal of Health Care for the Poor and Underserved, 21(1), pp. 82-91.
[25] Robert Rosenheck, MD, & Catherine Leda Seibyl, MSN, MPH. (1998, August). Homelessness: Health service use and related costs. Medicare Care, 36(8), pp. 1256-1264.
[26] Maria J. O’Connell, PhD; Wesley Kasprow, PhD; and Robert A. Rosenheck, MD. (2008, March 01). Rates and risk factors for homelessness after successful housing in a sample of formerly homeless veterans. Psychiatry Services, 59(3), pp. 268-275. The articles states that the authors are affiliated with the Department of Psychiatry at Yale University School of Medicine in Connecticut. Furthermore, Dr. Kasprow and Dr. Rosenheck are also with the Department of Veterans Affairs Northeast Program Evaluation Center in Connecticut; while Dr. O’Connell is with the Yale Program for Recovery and Community Health, also in Connecticut.