Sexual assault in military tied to veterans' homelessness

New research finds that troops who are sexually assaulted are at higher risk for homelessness, with males in greater jeopardy than females.

A study published online Wednesday in JAMA Psychiatry, mirrors earlier research on the association between military sexual assault and suicide: A study published last year indicated that suicidal thoughts and behavior are more prevalent in males who were sexually assaulted while on active duty than females.

In the recent study conducted by VA Salt Lake City Health Care System and the University of Utah School of Medicine researchers, homeless rates among veterans who reported being sexually assaulted while serving increased from 1.6 percent within 30 days of returning from a deployment to 9.6 percent less than five years later.

The rates are nearly double that of veterans who said they weren't sexually assaulted, 0.7 percent within 30 days of returning home, 1.8 percent within one year and 4.3 percent within five years.

Between men and women, homelessness was more pronounced among male sexual assault victims than females, 11.8 percent versus 8.9 percent at the five-year mark.

The authors noted the findings are significant because they could lead to early interventions for homelessness among veterans.

"Future research focusing on the temporal associations among sexual trauma, mental health diagnoses and treatment could yield important information on effective prevention and intervention of post-deployment homelessness," they wrote.

About a quarter of female veterans and 1 percent of male veterans report having been sexually assaulted when on active duty, according to a 2014 Rand Corp. report.

According to Amy Street, deputy director of the women's health sciences division at the VA's National Center for Post-traumatic Stress Disorder, VA screens all veterans for military sexual assault because it is a "strong predictor" for PTSD and other mental health conditions, including suicide.

Street said the mental impact of sexual assault in the military differs from civilian experiences because often, it is compounded by feelings of betrayal by those believed to be a "comrade in arms," or when the command system fails to protect the victim.

And for men, the mental ramifications may be even worse, she added.

"Male and female survivors of [military sexual trauma] look more similar than different … although male survivors do struggle uniquely with concerns about their masculinity, understanding what this says about their sexual orientation, a lot of self-blame, why was I targeted," Street told Senate Armed Services Committee members during a hearing on PTSD on Wednesday.

Getting those who have been assaulted to treatment for related mental health conditions remains a challenge, according to Navy Capt. Michael Colston, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

"The prevalence of sexual assault for women compared to men is 5-to-1 ... one of the things we struggle with is getting men into care," Colston said. "Men are less apt to engage in care for sexual assault. And in therapy, it's something you address way down stream. It's not an initial presenting problem."

Treatment for physical and mental injuries caused by military sexual trauma is available at all VA medical facilities to all veterans, regardless of whether they are eligible for other VA services.

In an editorial published in JAMA Psychiatry alongside the research on the relationship between military sexual assault and homelessness, several PTSD experts said the research underscores the importance of eradicating military sexual assault in the ranks.

"It is imperative to promote a culture within the military in which there is zero tolerance for the perpetration of MST and in which the reporting of MST is facilitated, supported and encouraged," they wrote.

Patricia Kime covers military and veterans health care and medicine for Millitary Times. She can be reached at pkime@militarytimes.com

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