Service Members’ Perspectives on Veteran Homelessness in Maryland and Virginia

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Olasunkanmi G. Amosu

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Walden University

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This is to certify that the doctoral dissertation by

Olasunkanmi G. Amosu

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Richard Worch, Committee Chairperson,

Public Policy and Administration Faculty

Dr. Gerald Regier, Committee Member,

Public Policy and Administration Faculty

Dr. Tamara Mouras, University Reviewer,

Public Policy and Administration Faculty

Chief Academic Officer and Provost

Sue Subocz, Ph.D.

Walden University

2021

Abstract

Service Members’ Perspectives on Veteran Homelessness in Maryland and Virginia

Olasunkanmi G. Amosu

MPA, Bowie State University, 2006

BS, University of Maryland University College, 2004

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Policy and Administration

Walden University

November 2021

Abstract

Homelessness among military veterans (HAMV) is a protracted problem. In November

2009, the U.S. Department of Veterans Affairs pledged to end the issue, but almost 12

years later, HAMV persists despite various solutions proposed. In January 2020, 37,252

veterans were reported as experiencing homelessness in the United States. The creation

of previous solutions did not include the perspectives of service members. The purpose of

this study was to bridge this gap in knowledge by discovering the views of service

members on why veteran colleagues experience homelessness. The theoretical framework

for this study was Allport’s trait theory. A qualitative case study design was employed,

using semistructured interviews with 16 service members located in Maryland and

Virginia. Snowball sampling technique was used to recruit participants for this study.

Using descriptive-focused coding strategy, information from the interviews was coded

and categorized for thematic analysis. Results indicated lack of preparedness to transition

from the military and absence of support from people such as family members as two of

risk factors of HAMV. The implications for social change that could result from the

findings in this study include informing policymakers of the importance of the

perspectives of service members in developing policies and processes to help homeless

veterans. A better understanding of what leads to HAMV could help lead to more

effective solutions to address the problem.

Service Members’ Perspectives on Veteran Homelessness in Maryland and Virginia

Olasunkanmi G. Amosu

MPA, Bowie State University, 2006

BS, University of Maryland University College, 2004

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Policy and Administration

Walden University

November 2021

Dedication

I dedicate this study to Almighty God, who gave me strength and knowledge

every day of my life; my deceased parents, who inspired me to be strong despite many

obstacles in life; my loving wife and children, who supported me every step of the way;

my brothers, sisters, relatives, and friends, who shared their words of advice and

encouragement to finish this study.

Acknowledgments

I want to thank my family members and dissertation supervisory committee

members (chair Dr. Richard H. Worch and member Dr. Jerry P. Regier) who have helped

me reach this point in my academic career.

Table of Contents

List of Tables……………………………………………………………………..iv

Chapter 1: Introduction to the Study ........................................................................1

Background ........................................................................................................1

Problem Statement .............................................................................................2

Purpose of the Study ..........................................................................................3

Research Question .............................................................................................3

Theoretical Framework ......................................................................................3

Nature of this Study ...........................................................................................5

Definitions..........................................................................................................6

Assumptions .......................................................................................................6

Scope and Delimitations ....................................................................................7

Limitations .........................................................................................................7

Significance........................................................................................................8

Summary and Transition ....................................................................................9

Chapter 2: Literature Review .................................................................................11

Introduction ......................................................................................................11

Literature Search Strategy................................................................................11

Theoretical Framework ....................................................................................12

Literature Review.............................................................................................15

Correlation Between Failing Mental Health and Homelessness ..........15

Lack of Adequate Resources to Combat the Homelessness ................18

Dire Statistics on Homeless Veterans ..................................................20

Other Factors to Homelessness ............................................................23

Attempts to Lessen Homelessness .......................................................26

Conclusion and Transition ...............................................................................31

Chapter 3: Research Method ..................................................................................32

Introduction ......................................................................................................32

Research Design and Rationale .......................................................................32

Research Method .................................................................................33

Role of the Researcher .....................................................................................34

Methodology ....................................................................................................35

Setting and Sample ..............................................................................35

Data Collection ....................................................................................36

Data Analysis Plan ...............................................................................36

Treatment for Discrepant Cases ...........................................................37

Issues of Trustworthiness .................................................................................37

Credibility ............................................................................................37

Transferability ......................................................................................37

Confirmability ......................................................................................38

Intracoder and Intercoder Reliability ...................................................38

Ethical Procedures ...............................................................................38

Summary ..........................................................................................................39

Chapter 4: Results ..................................................................................................41

Introduction ......................................................................................................41

Pilot Study ........................................................................................................41

iii

Setting ………………………………………………………………………..44

Demographics ..................................................................................................44

Data Collection ................................................................................................44

Discrepant Cases ..............................................................................................63

Summary of information provided to interview questions 5–10 .....................64

Data Analysis ...................................................................................................71

Evidence and Trustworthiness .........................................................................74

Results ………………………………………………………………………..76

Summary ..........................................................................................................80

Chapter 5: Discussion, Conclusions and Recommendations .................................83

Introduction ......................................................................................................83

Interpretation of the Findings...........................................................................84

Limitations .......................................................................................................88

Recommendations ............................................................................................88

Implications for Social Change ........................................................................89

Reflection of the Researcher ............................................................................91

Conclusion .......................................................................................................92

References ..............................................................................................................93

Appendix A: Invitation Letter ..............................................................................108

Appendix B: Interview Protocol ..........................................................................109

Appendix C: CITI Course Completion Certificate ..............................................111

List of Tables

Table 1. Service Members’ Perspectives on the Risk Factors of HAMV ........................ 65

Table 2. Service Members’ Perspectives on Behaviors of Homeless Veterans that could

Lead to the Problem .................................................................................................. 66

Table 3. Service Members’ Perspectives on the Role of VA in Addressing HAMV ....... 67

Table 4. Service Members’ Perspectives on Local Communities Support of Homeless

Veterans … ............................................................................................................... 68

Table 5. Service Members’ Perspectives on the Role of Homeless Veterans in Addressing

the Problem ............................................................................................................... 69

Table 6. Service Members’ Perspectives on Other Programs to Combat HAMV ............ 70

Chapter 1: Introduction to the Study

The predicament of homeless military veterans continues to be a significant

policy issue of the U.S. Department of Veterans Affairs (VA). I conducted this study to

uncover service members’ perspectives on why veteran colleagues end up homeless. The

findings and recommendations from this research could assist the VA in developing

effective programs for ending the problem, thus promoting positive social change. The

subsequent sections of this chapter address the background, problem statement, purpose,

research problem, theoretical framework, methodology, and scope of the study.

Background

Among the homeless population in the United States, 21,021 are military veterans

(Peterson et al., 2015). The number is attributed to the aftermath of the nation’s last three

wars: Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and

Operation New Dawn (OND). Edens et al. (2011) indicated that homelessness is a major

social problem in the United States. The McKinney-Vento Act of 1987 focuses on

providing emergency shelter for homeless individuals. In 2008, Edens et al. estimated

664,000 people in the United States were homeless.

Each year, two to three million Americans experience an episode of homelessness

(Caton et al., 2005). Existing research on veteran homelessness has covered many topics

such as the causes, solutions, and correlation between homelessness and mental health.

Still, the literature has not addressed the perspectives of service members on why veteran

colleagues experience homelessness. This study was needed to facilitate a holistic

approach to developing a robust policy to ending the protracted problem.

Problem Statement

The problem is that solutions previously proposed to end homelessness among

military veterans (HAMV) have not included the perspectives of service members. Glynn

(2013) estimated that over 2.1 million service members were deployed in support of

OEF, OIF, and OND. Kennedy et al. (2007) attributed mental illness among veterans to

these deployments. Metraux et al. (2013) also found a correlation between mental health

and homelessness. Homelessness is a public health concern that needs to be addressed

(Caton et al., 2005; Tsai & Rosenheck, 2015).

Metraux et al. (2013) attributed homelessness among the veterans to

posttraumatic stress disorder (PTSD) following OEF and OIF. According to Tsai et al.

(2014), veterans susceptible to incarceration represent 16% of the nation’s homeless

population. Gamache (2000) identified punitive discharge as one of the risk factors for

veterans’ homelessness. Such discharge could make veterans ineligible for VA benefits,

making it harder to address the problem.

The problem of HAMV is profound and growing. In 2013, approximately 57,849

veterans were homeless, 33 of every 10,000 veterans experienced homelessness at least

one night, and 60 of every 10,000 veterans experienced homelessness in 1 year (Axon et

al., 2016).

The VA declared a goal of ending HAMV in 5 years because 1 in 3 homeless people

were veterans (O’Toole & Pape, 2015).

Purpose of the Study

The purpose of this study is to discover and explore the perspectives of service

members on why veteran colleagues end up homeless. I collected data from service

member participants through interviews. The viewpoints of the members could expand

the understanding of the issue and help influence the legislature pass effective policies to

address the problem. I developed the interview questions to find answers that could be

valuable in finding potential solutions to ending HAMV. Through snowball sampling, I

selected interviewees from service members located in the states of Maryland and

Virginia.

Research Question

What are the Service Members’ Perspectives on Veteran Homelessness in

Maryland and Virginia?

This research question was developed to obtain the service members’ views of

why veteran colleagues experience homelessness. Creswell (2017) stated that a research

question should be unambiguous because it lays the foundation for a study.

Theoretical Framework

Trait theory (TT) was used to provide a foundation for conducting this research. A

trait is defined as “a dynamic trend of behavior which results from the integration of

numerous specific habits of adjustment, and which expresses a characteristic mode of the

individual’s reaction to his surroundings” (Allport, 1927, p. 288). Allport was both the

originator and the principal exponent of the doctrine of traits and, in 1937, defined traits

as “occurrence of actions having the same significance (equivalence of response),

following upon a definable range of stimuli having the same personal significance

(equivalence of stimuli)” (Zuroff, 1986, p. 994). In 1961, Allport stated “no trait theory

can be sound unless it allows for, and accounts for, the variability of a persons conduct”

(Zuroff, 1986, p. 994). Traits are seen “as average levels of responses and as consistent

patterns within delimited ranges of situations” (Zuroff, p. 993).

Nicholson (1998) suggested TT defines personality as the fundamental adjustment

patterns that an individual forms throughout their experiences. Kidder (2005) claimed

traits can be viewed as broad and general guides that lend consistency to behavior in

people and are relatively stable in predicting individuals’ characteristics that influence

behavior. Pettigrew (1999) stated the opponents of TT have argued that Allport held a

static view of traits as pervasive. Zuroff (1986) said the environments could have

transforming effects on persons; thus, traits are not constant but purely descriptive and

summarize a person’s past behavior.

TT was appropriate to this study because it can be used to infer the veterans’

characteristics that may impact their behaviors and thus make them susceptible to

homelessness. A trait is shaped by various habits that can affect veterans’ reactions or

behaviors to their environment. The theory is dynamic and thereby accounts for the

changes in homeless veterans’ conduct; in addition, the display of a given behavior may

be reliant on a given trait. Therefore, TT can be used to provide the rationale for veterans’

behaviors.

Nature of this Study

Using the appropriate sample size in a study is important. No established

guidelines for sample size in qualitative inquiry (Rijnsoever, 2017). However, Rijnsoever

suggested sample sizes between 20 and 30, and typically below 50, can be used in a

qualitative study. The theoretical mechanism for such sample sizes is unknown

(Rijnsoever, 2017). In data analysis, coding is defined as tags or labels on unique pieces

of information in qualitative research (Rijnsoever, 2017). Therefore, the thematic

approach denotes the process of grouping similar codes. A population is the universe of

units of analysis from which a sample can be drawn to conduct research (Rijnsoever,

2017).

I used a snowball sampling technique to obtain participants for this study from

service members stationed in Maryland and Virginia. I distributed recruitment flyers

through friends/colleagues, and some participants recruited colleagues to participate in

this study. I conducted interview sessions with the service member participants to obtain

their viewpoints on why veteran colleagues experience homelessness. A case study

approach was adopted in this study to ensure service members shared their perspectives

on HAMV. The research data were analyzed by identifying the different relevant data

from the interview transcriptions. Following the process, themes were assigned to the

various ideas during the coding process.

Definitions

Discharge: Service members either retiring or separating from the military

service. International Classification of Diseases, Ninth Revision, Clinical Modification

(ICD-9-CM) code of V60.0 suggests a lack of housing.

Service member: A member of uniformed services consisting of the armed forces.

Assumptions

To some, the military is synonymous with bravery. Service members are trained

to be courageous; therefore, the assumption was made that they may be reluctant to

partake in mental health treatment because of the stigma associated with it. In addition,

the stigma associated with being homeless may prevent some veterans from seeking

assistance. Some veterans may be unwilling to seek help because of the perceived

humiliation related to conditions like mental illness. Some veterans might misconstrue

seeking assistance with being weak and less brave. This assumption provides context of

this study because of its impact on the assessment of various VA programs like Health

Care for Homeless Veterans, which coordinates treatment and rehabilitative services for

the veterans.

Another assumption was that homelessness is confined to big cities like Los

Angeles. Therefore, the discussion relating to homeless veterans is focused on urban

areas and less on rural areas. The dichotomy in the allocation of resources adds to the

plight of the veterans residing in non-urban areas.

Scope and Delimitations

Among other topics, in this study, I addressed the perspectives of service

members on why veteran colleagues experience homelessness. Service members’

viewpoints could provide rich information that may be valuable to develop policies to

address homelessness. Service member participants were recruited in Maryland and

Virginia. Service members in other states were excluded from this study.

I did not examine the roles of advocacy groups like the National Coalition for

Homeless Veterans in addressing homelessness. The decision not to explore such groups

was because they may be influenced by promoting a political agenda of a particular party.

Therefore, the involvement of such a group could impair the study’s validity and

reliability. Furthermore, closely associated with TT is psychoanalytic theory,

psychoanalytic theory was not considered for this study.

Limitations

Service members are a protected population, gaining access to them could have

been a challenge. Also, my affiliation with the population under study could have created

a conflict of interest. For example, as a service member, investigating why military

veterans are homeless could be a source of bias. I addressed the prejudice by recording

the interview sessions and taking notes.

Interview as a data collection method consumes time and energy because of the

multiple interviews conducted. I used snowball sampling that may negatively impact the

transferability of results because participants may not be recruited based on knowledge

about the research topic. Based on these problems, the research dependability could have

been jeopardized. In addition, the risk of assigning a wrong code to data, particularly

when analyzing extensive information, could impair the research findings, thereby

negatively impacting reliability.

Different factors like the deliberate exclusion of some data in the report, lack of

knowledge concerning the guidelines, ineffective recordkeeping, and the development of

the research question to obtain predetermined answers could contribute to bias in the

research. For instance, extracting data from the study because they did not support the

researcher’s hypothesis could render the results questionable. Also, inept recordkeeping

could lengthen the time allocated to data analysis. The biases mentioned above were

prevented or minimized in part by effectively analyzing all the data. Also, adequate

recordkeeping was conducted by safeguarding the data gathered from the interview.

The research question determines the overarching focus of a study. The question

guided the study, in which I sought to gather information from service members on why

veteran colleagues experience homelessness. This study question did not address the

impact of premilitary traumatic events as a risk factor for homelessness. However, such

an event’s impact as a possible deterrent to ending the problem could legitimately be

studied. The completed dissertation will be published in ProQuest, thus meeting the

requirement for publishing academic work.

Significance

With this study, I sought to fill a gap in the existing literature by ascertaining the

perspectives of service members on why veteran colleagues experience homelessness.

The results of the study are vital to public policy and administration because the views of

service members could be useful in explaining potential solutions to the problem.

Furthermore, the research could facilitate policy change in VA because the findings and

recommendations may assist in developing effective programs for HAMV. The results

could influence public policy professionals to understand better how to address the

problem effectively. A better understanding of the phenomenon, increased awareness of

its risk factors, and findings that support policy development could all lead to positive

social change.

In current studies, researchers have discussed different topics like the leading

cause of the problem, programs developed to address it, and the impact of wars on

homelessness. However, no study has been conducted to examine the perspectives of

service members on why veteran colleagues experience homelessness. Therefore, this

study was conducted to discover the members’ opinions, thereby advancing knowledge

on the problem.

Summary and Transition

Military veterans continue to face homelessness and a lack of a permanent home.

Prior researchers have stated that mental illness is the leading risk factor of homelessness

among veterans. In this study, I focused on discovering the perspectives of service

members on why veteran colleagues experience homelessness. I developed the interview

questions to explore the views of the service members based on their lived experiences. I

used a case study approach as the methodology because it is exploratory and enables me

to use interviews as the primary source of data collection.

This chapter provided the rationale for using TT to expand the knowledge on

HAMV. Veterans may be predisposed to homelessness because of traits. The following

topics are discussed in Chapter 2 and Chapter 3: literature reviewed for the theoretical

framework, methodology, different research designs, problem statement, the role of the

researcher, sample selection, data collection procedures, data analysis, trustworthiness,

and protection of the participants’ rights.

Chapter 2: Literature Review

Introduction

Military veterans continue to experience homelessness despite numerous

proposed solutions. Such attempts to end homelessness among military veterans,

however, have not included the perspectives of service members. The purpose of this

study was to ascertain the views of service members on why veteran colleagues

experience homelessness.

Among other topics, I discussed the three types of literature reviews conducted

for this study in this chapter. The first review covers the literature examined to determine

the theoretical framework; the second analysis focuses on the literature studied to

determine the gap in the literature and the problem. Lastly, the third review was

conducted to determine the approach used for the chosen methodology.

Literature Search Strategy

The articles for this study’s theoretical framework were retrieved using search

terms such as Gordon Willard Allport, trait theory, human personality, dispositional

theory, homelessness, and military veterans. Additional key search terms were used

related to veterans’ homelessness, including homeless veterans, risk factors, military

veterans, veterans, problem, HAMV, history of homelessness, homelessness, military

service, veterans homelessness, homelessness and the military, homeless veterans and

risk, lack of resources, public health, homeless veterans and treatment.

Databases searched included ScienceDirect, Expanded Academic ASAP, Psyc

ARTICLES, Social Sciences Citation Index, MEDLINE with Full Text, Research

Starters, EBSCO, and PsycINFO. Additionally, the Emerald Insight, Ovid Nursing

Journals, Project MUSE, SAGE Journals, Google Scholar, Academic Search Complete,

SocINDEX with Full Text, Business Source Complete, and Social Services Abstracts

were used to gather information on the gap in the literature.

The SAGE Research Methods Online and Basics of Qualitative Research:

Techniques and Procedures for Developing Grounded Theory (4th ed.) was used to

gather information on the methodology. Search terms used to identify pertinent

scholarship on methodology were qualitative research, ethnography research approach,

case study research approach, grounded theory research approach, and narrative

research.

Theoretical Framework

This study is based on TT. In defining TT, Nicholson (1998) said personality is

the fundamental adjustment of patterns individuals form throughout their experiences.

Traits “represent individual characteristics, which are either inherited or acquired and

refer to tendencies to act or react in certain ways” (Kidder, 2005, p. 390). Possession of a

trait does not assure predictable behavior; however, an individual with particular

characteristics is likely to react to a given situation in a predictable way (Kidder, 2005).

In essence, traits can be seen as broad and general guides to which consistency in

behavior can be attributed. Traits are relatively stable and predictors of human behavior

despite criticism for potentially ignoring situational factors (Kidder, 2005).

Nicholson (1998) found that Gordon Allport introduced personality as a research

category in U.S. psychology, and his early work prompted the modern psychological

study of personality. Pettigrew (1999) cautioned that Allport held a static view of traits as

pervasive, thereby minimizing the influence of a given situation on behavior. Despite this

criticism, traits are relatively stable in predicting individuals’ characteristics, ultimately

influencing their behaviors (Kinder, 2005). TT infers that the behaviors, personalities,

and characteristics of military veterans may contribute to their susceptibility to

homelessness. The theory is related to the present study because it assumes that the

behavior of military veterans are a risk factor for homelessness. The research question

was created to discover the impediments to ending the problem from the perspectives of

the veterans.

Kidder (2005) applied TT to explain the behaviors of employees who are

detrimental to the development of a given organization and adopted the theory in making

predictions relating to the damaging behaviors that individuals could display at a given

time. Harris et al. (2017) stated that military veterans’ harmful behaviors like sensation-

seeking, aggressive driving behavior, intimate partner violence, substance use, and risky

sexual practices are some of the exacerbating factors to homelessness.

An individual is the embodiment of varied, consistent, and general traits integral

in determining a person’s personality (Nicholson, 1998). Allport’s contributions in

establishing a character as a research category in American psychology could not be

overstated. Behaviors represent a person’s characteristics that are inherited or acquired

and can predict how an individual can act or react in given ways (Kidder, 2005).

Allport’s contributions to the field of psychology are unique and lasting because they

offer different sides of psychology, formulate the discipline’s central future problem, and

recommend innovative approaches to solving problems (Pettigrew, 1999).

Stability of behavior across time and its consistency across situations are essential

features of the trait theory (Lievens et al., 2018). As a result, people tend to demonstrate

substantial flexibility in their behavior across situations. Individuals display different

thoughts, feelings, motivations, and behaviors across time and situations due to their

underlying personality traits; these traits influence different behaviors and life outcomes

(Ryne et al., 2015).

Human personality traits are considered consistent or stable over long periods

(Kang et al., 2016). In 1937, Allport identified trait-descriptive terms and derived a list of

4,504 traits of personality that shape how humans adjust to their environment (Kang et

al., 2016). The list of human personality traits has since been reduced from 4,504 to

2,800. This lexical approach is seen as the main theoretical foundation in the study of

personality (Kang et al., 2016)

Traits can be described as stable deterministic predictors of behavior and change

across generations, the life span, and existing situations. For example, personality

influences typical behavior that is stable and flexible across situations (Ferguson &

Lieven, 2017). The display or possession of a given trait should not be misconstrued as

the determinant of a specific behavior in an individual; however, the possession is a

reliable predictor of an individual’s behavior or underlies the behaviors exhibited by the

individual (Kidder, 2005).

Literature Review

The articles reviewed for this study provided a more profound understanding of

the problem of HAMV. For instance, most scholars believe veterans’ declining mental

health may be a leading cause of homelessness. Some scholars indicated that untimely

access to medical care is a challenge veterans are facing as well. According to Edens et

al. (2011), homelessness is a major social problem in the United States. The McKinney-

Vento Act of 1987 focuses on providing emergency shelter for homeless individuals; in

2008, an estimated 664,000 people were still homeless (Edens et al., 2011). In a given

year, two to three million Americans experience an episode of homelessness (Caton et al.,

2005). Among those experiencing homelessness, 21,021 are military veterans; HAMV

was likely worsened by the nation’s last three wars OEF, OIF, and OND (Peterson et al.,

2015).

The following are the themes and trends I discovered during the literature review:

(a) correlation between failing mental health and homelessness, (b) ineffective resources

concerning homelessness, (c) public outcry prompted by homelessness, (d) exacerbating

factors to homelessness, and (e) attempts to allaying the homelessness.

Correlation Between Failing Mental Health and Homelessness

Failing mental health has been identified as one of the dominant risk factors of

homelessness among veterans. Dinnen et al. (2014) said traumatic brain injuries (TBIs)

are a mental health deprivation that veterans struggle. An estimated 300,000 veterans

suffer from TBI due to OIF and OEF (Dinnen et al., 2014). Furthermore, TBI has been

linked to a decrease in income and social support among veterans and subsequently

increases susceptibility to homelessness among this population (Dinnen et al., 2014).

Diagnosis of mental health disorder, TBI, childhood adversity, and abuse are potent

predictors of homelessness among veterans (Dinnen et al., 2014).

Barnes et al. (2015) reported that 50% of veterans who need homeless services

have a history of TBI. Such an injury impedes a veteran’s participation in the treatment

designed to address it (Barnes et al., 2015). The lengthy history of TBI negatively

impacts social support and contributes to veterans’ challenges in retaining housing.

Barnes et al.’s research is related to the research question in this study because it

addresses the impact of TBI on the participation of the veterans in the treatment plan.

Homeless veterans are at a greater risk for severe medical conditions than the

general population because of mental health and substance-related problems, like

hypertension, diabetes mellitus, upper respiratory infections, and gastrointestinal and

podiatry issues (van den Berk-Clark & McGuire, 2014). Veterans access emergency

room services at a higher rate than other healthcare services because of a lack of trust in

primary healthcare providers and diagnoses of multiple medical conditions (van den

Berk-Clark & McGuire, 2014).

The prevalence of mental illness among veterans has been attributed to the

constant stress they were exposed to while in the military (Crane et al., 2015). Crane et

al., (2015) asserted that the co-occurrence of drug abuse and mental illness is seen as the

dominant type of comorbidity, which can lead to suicidal and destructive behaviors like

poor health, suicide, violence or aggressive behavior, arrest, homelessness, and

unemployment.

Cox et al. (2017) said homeless veterans disproportionately contracted infectious

diseases, developed severe mental illness, and identified as having substance use disorder

compared to their veterans not experiencing homelessness. Homeless veterans require

inpatient medical, surgical, mental health services yet access fewer preventive services

and primary care than housed veterans with the same medical conditions (Cox et al.,

2017). Homeless veterans with a diagnosis of substance abuse respond less favorably to

medical treatment than veterans who are not homeless (Cox et al., 2017). Additionally,

veterans are more susceptible to mental illness and drug abuse, which can cause an

increase in the use of inpatient treatment (Cox et al., 2017).

Substance abuse, severe mental illness, low income, and vulnerability of veterans

to homelessness than non-veterans are some of the dominant risk factors of HAMV (Tsai

& Rosenheck, 2015). Homelessness among military veterans is a public shame and there

is a correlation between homelessness and mental health disorder among the veterans

(Tsai & Rosenheck, 2015).

According to Gaziano et al. (2015), poverty, schizophrenia, alcohol, combat

exposure, substance use disorders, and mental illness contribute to homelessness.

Incarceration and adverse childhood experiences are risk factors for homelessness,

particularly from the late 1970s (Gaziano et al., 2015).

Malte et al. (2017) stated substance use disorders (SUDs) and mental health

problems are the leading risk factors of HAMV. Despite the availability of SUD

treatment to homeless veterans, they are not responding to the treatment as housed (Malte

et al., 2017). Between 70% and 80% of homeless veterans are diagnosed with SUD

which almost triple that of the general public and the rate of cigarette smoking among

homeless veterans is exponentially high (Santa-Ana et al., 2016). Homeless veterans are

disproportionately represented within the tobacco-using homeless population and are

vulnerable to smoking-related morbidity and mortality (Santa-Ana et al., 2016).

Creech et al. (2015) attributed substance abuse, severe mental illness, childhood

trauma, unemployment, disability, and psychotic disorders as risk factors of HAMV.

Post-traumatic stress disorder is a risk of HAMV specifically among the OIF and OEF

veterans (Creech et al., 2015).

Lack of Adequate Resources to Combat the Homelessness

Gawron et al. (2017) said the nearest VA hospital to over 9,000 homeless women

veterans that live in the countryside is more than 40miles. This distance makes it difficult

for veterans to access VA healthcare system promptly. The veterans affairs

administration (VHA) defined excessive travel burden as a distance greater than or equal

to 40miles, and 9,665 homeless women veterans reside more than 40miles from the

closest VA hospital (Gawron et al., 2017).

According to Adler and Pritchett (2015), the Community-Based Outpatient

Clinics (CBOCs) are not equipped to provide adequate dental, optometry care, substance

abuse treatment, and non-healthcare related services like transportation, job training, and

clothing to veterans living in the rural areas.

Homeless veterans face challenge in accessing the resources developed to

alleviate homelessness partly because of the complexity in VA healthcare system

(Metraux et al., 2017). For example, the homelessness screening clinical reminder

(HSCR) is introduced to identify veterans that are prone to homelessness and thereby,

provide homeless prevention and rehousing assistance to them. However, the veterans

might not be taking advantage of the program because of lack of knowledge about the

HSCR.

According to the 2014 report of the VHA Office of Rural Health, approximately

5.3 of the 22 million military veterans live in rural areas. As a result, of the minimal

coordination between the state and local agencies, the homeless veterans are forced to

travel long distances to access care (Tsail et al., 2015). Due to the extensive rural

geographical layout, studying every rural homeless veteran is a challenge, and also, the

veterans have higher rates of medical problems, anxiety, and personality disorders (Tsail

et al., 2015).

Annually, the VA hospitals treat an average 6.5 homeless veterans at end of life

and over 76,000 of the veterans are believed to be homeless in any given night;

approximately twice that number experience homelessness yearly, the mean age at death

among the veterans range from 34 to 47, and the leading causes of death are cancer and

heart disease (Hutt et al., 2015).

Limited access to healthcare, failing mental health, lack of knowledge about heat

related illnesses, unreliable transportation, lack of trust between the veterans and

healthcare practitioners, extreme poverty, psychiatric disorders, deteriorating mental

health, and social isolation are some of the risk factors of HAMV (Nicolay et al., 2016).

For example, heat related illnesses are the dominant risk factors of mortality relating to

natural weather disasters among homeless people (Nicolay et al., 2016).

Tsai et al. (2015) stated language/literacy barriers, lack of transportation, stable

contact information, and absence of outreach activities could limit the enrollment of the

veterans in the programs like Medicaid. Dinnen et al. (2014) remarked that veterans

diagnosed with TBI could display emotional and behavioral problems which can impede

enrollment in programs like rehabilitation service. The veterans may require one-on-one

assistance, which can stress organizational time and resources (Dinner et al. 2014). For

example, social service organizations often lack qualified individual or specialized

training in neurobehavioral issues.

Porter (2014) estimated 154, 000 of the veterans in the U.S. on any given day do

not have shelters. Many veterans are at risk of being homeless because of poverty and

lack of support in their search for employment. Disabilities related to military service and

the absence of sufficient social support are two of the risk factors of HAMV (Porter,

2014).

Dire Statistics on Homeless Veterans

On a single night in January 2015, there were 152,806 unsheltered individuals,

34% accounts for 16,220 veterans that experienced homelessness in that given year

(Montgomery et al., 2016). Axon et al. (2016) said homelessness is a high-priority public

health issue because on a given night in 2013, approximately 610,042 people were

homeless in the United States, including about 57,849 veterans. Furthermore, the authors

pointed out that 33 of every 10,000 veterans experienced homelessness at least one night,

and 60 of every 10,000 veterans experienced homelessness in 1 year. The age-adjusted

mortality of homeless veterans that suffer from chronic health conditions is almost three

times higher than non homeless people.

Tsai et al. (2016) said veterans with lifetime homelessness experience an average

of nearly two years of not having a permanent residence cumulatively and are

disproportionately suffering from depression and anxiety than veterans without lifetime

homelessness. The authors said veterans with lifetime homelessness had experienced a

suicide attempt in the last 24 mounts, have minimal social support, are younger, less

educated, non-white, unemployed, low income, live in a rural area and enlisted

voluntarily.

Schinka et al. (2018) stated the mortality rate of younger and middle-aged

homeless veterans is higher than their colleagues that are not homeless homelessness

considerably contributes to veteran mortality risks in their adulthood. The authors said

environmental toxins, infectious diseases, chronic stress associated with low

socioeconomic status, malnutrition, psychiatric, substance use disorders, and barriers to

access to health care compound the veterans’ medical conditions. According to the

authors, mortality rates in veterans with mental illness are higher than the general public

and non-homeless veterans with a similar diagnosis; therefore, the death rate among

homeless veterans is more significant than their sheltered counterparts.

Noska et al. (2017) said 2.7 to 3.9 million people in the United States are

chronically infected with the Hepatitis C virus (HCV), over 200,000 homeless veterans

are infected with the HCV, and the rates of HCV antibody positivity among homeless

veterans range from 6.6% to 44.0% from 1993 to 2000. Also, the authors said the rates

are higher than that of the general U.S. population and stated that in 2015, 32,449 of the

242,740 homeless veterans that contracted chronic HCV infection utilized the VA

outpatient service.

Metraux et al. (2017) estimated 31,412 to 33,376 veterans deployed during OEF

and OIF experienced homelessness in 2015. Also, mental health, substance abuse,

extreme poverty, and adverse childhood experiences are risk factors for homelessness

among military veterans, particularly the veterans that served after September 2011. The

impact of military service on veteran homelessness is higher, especially when the

veterans are older than 50 years. Also, combat experience and PTSD have shown a

modest link to becoming homeless (Metraux et al., 2017). Palladino et al. (2015) said

suicide is the tenth leading cause of death in the U.S.; its rate among veterans is almost

three times higher in 2013 than the general population and is one of the leading causes of

mortality among homeless veterans.

McCall and Tsai (2018) assessed the impact of homelessness on women veterans

before incarceration by saying that almost one-third of the veterans had a history of

homelessness. Homeless female veterans had experienced trauma, substance abuse while

serving in the military, had a history of childhood adversity, mental health illness, and

experienced unemployment, contributing to homelessness among women veterans.

Women veterans that are head of their families with toddlers are more vulnerable to

homelessness when transitioning to civilian lives (McCall & Tsail, 2018). The article is

related to the research question by remarking that almost 33.33% of women have

experienced homelessness.

Hammett et al. (2015) argued homeless veterans that smoke develops worse

physical conditions and mental health problems than the general public homeless

smokers. The veterans’ smoking habits are linked to military service—also, mental health

and substance abuse as risk factors for homelessness among veterans. Despite the

noticeable reduction in smoking prevalence in the United States, smoking among

homeless veterans is high, health burdens related to veterans have been mainly

overlooked, and veterans might be at higher risk for smoking-related mortality (Hammett

et al., 2015). The article is related to the research question by asserting that veterans that

smoke has less physical stamina and mental health alertness when compare to the

populace of homeless smokers.

Tsai et al. (2015) reported children with homeless veterans that have severe

mental illness could expose themselves and their children to environmental danger. Also,

the authors said psychiatric conditions are prevalent among homeless veterans; these

conditions are exacerbated by the aftermath of the wars in Iraq and Afghanistan. More

women and younger veterans developed PTSD following wars. The article is related to

the research question by saying that the failing mental health among the veterans is due to

the outcome OEF and OIF.

Other Factors to Homelessness

Risky behaviors, marital status, alcoholism, stigma, drug abuse, lack of trust, and

care processes inhibit care delivery to homeless veterans (O’Toole et al., 2015). The

healthcare system did not address the perceived stigma, inflexible care systems, and trust

issues that adversely affect homeless people’s health outcomes. The article is related the

research question by suggesting that the current VA healthcare system did not address

these issues.

The media have the propensity to describe veterans of current wars as unhinged;

therefore, several service members that are diagnosed with a mental health condition may

not seek out its medical care because of fear of confirming these unsavory stereotypes

(Mobbs & Bonanno, 2018). The article is related the research question by noting that the

negative stereotype about the veterans could ultimately prevent them from receiving the

care they need.

Harris et al. (2017) acknowledged risk behaviors like sensation-seeking,

aggressive driving behavior, intimate partner violence, substance use, and risky sexual

practices increase veteran homelessness. Sensation seeking, commonly referred to as

thrill-seeking, is associated with housing instability (Harris et al., 2017). The article is

related to the research question because risk behaviors like substance abuse heighten

homelessness.

Tsai et al. (2017) studied veterans that received care in VA specialty mental

health clinics and veterans that identified sociodemographic and clinical predictors of

homelessness. Tsai et al. asserted that the cohort of veterans who are not married with a

drug use disorder are twice as likely to become homeless within the homeless veterans’

population. Also, the authors believed veterans that suffer from drug use disorder, single,

low income, black, alcoholism, and between the ages of 46–55 are susceptible to

homelessness. The article noted that single homeless veterans are prone to homelessness

when compared to their married colleagues.

From the veterans that deployed between October 1, 2001, and December 31,

despite “only 5.6% (n = 24,992) separated for misconduct, they represented 25.6% of

homeless veterans at first VHA encounter (n = 322), 28.1% within 1 year (n = 1141), and

20.6% within 5 years (n = 709)” (Gundlapalli et al., 2015, p. 832). The authors said bad

conduct discharge from the military increases the likelihood of veterans being homeless.

Tsai and Rosenheck (2015) studied the expenditures of homeless veterans and

whether VA disability compensation is being spent on alcohol and drugs. There is no

evidence that the money is being used to buy alcohol and drugs, but the high rates of

substance use disorders are evident among veterans; therefore, the veterans could be

using the payment to aid their addictive habits (Tsai & Rosenheck, 2015). Also, many

homeless veterans have difficulty with money management (Elbogen et al., 2013).

Oliva et al., 2017 said opioid overdoses kill approximately 91 people per day, and

military veterans have nearly double the risk of inadvertent overdose compared to the

general public. To address the problem, the VHA implements the national Opioid

Overdose Education and Naloxone Distribution program to prevent opioid-related

mortality, and 7,466 homeless veterans received naloxone treatment from August 2013 to

September 2016 (Oliva et al., 2017). The authors suggested that the use of an opioid is

rampant among the general public, particularly among homeless veterans with the risk of

unintended overdoes.

This article focused on the association between human immunodeficiency virus

(HIV) and HAMV. Ghose et al. (2015) female veterans with HIV were at higher risk of

homelessness than their counterparts that are not HIV-positive. The female may be

accessing and benefiting from services to a lesser extent than the men that contracted

HIV; hazardous alcohol use, depression, schizophrenia, and being African American

continued to be significant risk factors for homelessness among veterans with HIV

(Ghose et al., 2015). The article stated that female veterans that are HIV positive are

susceptible to homelessness.

Dunne et al. (2015) believed substance use and mental health problems are

primary risk factors of HAMV. For example, homeless male veterans tend to suffer from

drug addictions, mental health illnesses, and physical health than male nonveterans. In

addition, Dunne et al. (2015) stated homeless veterans are inclined to report current

problems with addictions than nonveterans; however, excessive alcohol consumption by

homeless veterans intensifies the risk of homelessness.

Tsai and Rosenheck (2015) reported that high substance use disorders are

common among homeless veterans and they could be using the remuneration from the

VA to continue the addictive habits, therefore, susceptible to homelessness. The authors

suggested that the use of an opioid is rampant among the general public, particularly

among homeless veterans with the risk of unintended overdoes.

Attempts to Lessen Homelessness

Some of the efforts to address HAMV are street outreach, implementation of

universal screen tools, integration of tobacco cessation education with the treatment of

PTSD, adoption of V60 codes, the partnership between the VA and HUD. For example,

Tsai et al. (2014) stated street outreach is one of the leading direct means of establishing

contact with homeless people; however, the characteristics of the homeless group that the

outreach may contact is not well-understood. In 2011 and 2012, about 70,778 homeless

veterans enrolled in VA homeless services as a result of the street outreach program. As a

result, the outreach is “an especially important approach to engaging chronic street

homeless veterans in services and linking them to permanent supported housing.” (Tsai et

al., p. 694). The article suggested that street outreach increases veteran participation in

programs developed to address homelessness in the past.

In 2013, one-third of recent homeless veterans were not connected to VA

resources designed to improve the veteran housing dilemma. Byrne et al. (2015) inferred

that the VA has no targeted plan to engage the veterans experiencing chronic housing

instability. The article is connected to the research question because it suggested that the

VHA needs to address the problem of those veterans that have been homeless for a long

time.

Kelly et al. (2017) estimated 7,921 veterans diagnosed with PTSD and tobacco

use disorder (TUD) are predisposed to homelessness compared to their colleagues who

do not suffer from similar diagnoses. The authors said veterans with PTSD are prone to

lifetime smoking and difficulty quitting and believed the integration of medical treatment

and tobacco cessation counseling to address the high rates of smoking among veterans

with PTSD would be beneficial. The article is connected to the research question because

it described one of the ways of reducing homelessness among veterans by co-locating the

treatment of PTSD and TUD.

In November 2009, the formal Secretary of VA Eric Shinseki pledged to end

homelessness among the veterans by 2014 partly because 1 in 3 homeless people is a

veteran (O’Toole & Pape, 2015). Consequently, the VA developed various policies to

address the problem. For instance, homeless veterans access to care and services needed

to obtain long-term housing through the Housing and Urban Development (HUD) and

Veterans Affairs Supportive Housing (VASH) partnership that provides up to 2 years of

housing and supportive housing services to homeless veterans. The article is connected to

the research question because it explained the effort of the VA in combating the problem

by expanding access healthcare.

Peterson et al. (2015) explored the utilization of V60 codes that accurately

identify homeless veterans in the VA healthcare system. The codes enhance the VA

preventive efforts for veterans prone to homelessness. The use of these codes alone may

lead to challenges in determining the extent of homelessness among veterans seeking care

in VA medical facilities. The codes ensure compliance with the 2009 HEARTH Act,

which covers the impending loss of housing in 2 weeks and a lack of resources or support

to obtain permanent housing. The article is connected to the research question because it

suggested that the adoption of the V60 codes is required for obtaining accurate data on

homeless veterans.

Santa-Ana et al. (2016) advocated for sustained smoking cessation treatment

programs within the VA healthcare system. For example, the Tobacco Group

Motivational Interviewing (T GMI) motivates and encourages enrollment in tobacco

cessation classes for homeless veterans with substance use and co-existing psychiatric

disorders. Also, the T GMI be introduced with the existing substance use disorder

treatments for veterans with substance abuse disorder treatment. The article is connected

to the research question because it suggested the need to continue to prevent the mortality

related to tobacco use.

Based on the 2012 National Center on Homelessness Among Veterans

assessment, Metraux et al. 2017 stated that the HUD and VASH provide permanent,

subsidized housing with support services to homeless veterans. The article is connected

to the research question because it discussed the impact of the partnership on alleviating

the problem of homelessness among homeless veterans.

Zucchero et al. (2016) described the experiences, perspectives, and

recommendations of community providers who care for homeless veterans who use VA

and non-VA healthcare systems. For example, the partnership is plagued with multiple

challenges like lack of knowledge about the VA health care system because the HCH

providers could not access the VA medical records of patients who received care from

both the HCH program and the VA.

Veterans accounted for 14% of the homeless population in the U.S., the veterans

experience chronic and repeated homelessness, and a combination of substance abuse

treatment and economic supports is seen as a robust method for addressing the problem

(Creech et al., 2015). The article is connected to the research question because it

suggested that the combination of programs, as mentioned earlier, can help combat

homelessness.

In 2015, the HUD estimated homeless veterans accounted for 11% (or 48,000) of

homeless adults (436,000), with male veterans 50% more likely to be homeless than male

nonveterans (Weber et al., 2018). There is no effective plan to address the

multidimensional and complex health needs of this population. Weber et al. there is no

concerted effort to address the healthcare needs of homeless veterans despite the efforts

of the VA in reducing the problem.

The literature review revealed the aftermath of the nation’s wars as one of the

contributing factors to HAMV. Homelessness is seen as a national public health problem.

Behaviors like substance abuse are risk factors for homelessness. The challenge in

accessing medical care for conditions like mental health contributes to the complexity of

the VA healthcare system. To eradicate or minimize the problem, the VA partnered with

HUD to provide housing for homeless veterans, but homelessness continues to be a

menace among military veterans.

The current literature affirmed the correlation between mental health deprivation

and homelessness, public outcry related to the problem, lack of trust, stigma, stereotype

threat, alcohol addiction, and unsavory risky behaviors by the veterans as some of the

exacerbating factors to homelessness, and lack of resources to solving homelessness.

Finally, the existing literature described some attempts to address the problem, like the

outreach program. However, the perspectives of service members on why veteran

colleagues end up homeless have not been studied.

The existing literature on the problem provided information like the correlation

between mental health deprivation and homelessness, inadequate resources to address the

problem, and staggering data related to homeless veterans. However, the literature did not

provide information on the perspectives of service members on why veteran colleagues

end up homeless. This study hopefully filled the gap in the literature.

Conclusion and Transition

The literature review revealed the following themes regarding HAMV: correlation

between mental health and homelessness; public health outcry concerning homelessness;

risk behaviors displayed by the veterans; prior attempts to address the problem; lack of

resources to combat the problem. The existing literature did not provide information on

the perspectives of service members on why veteran colleagues end up homeless. The

ending of HAMV remains one of the VA’s priorities. Despite the VA partnership with

HUD, the department has not successfully provided permanent housing for every

homeless veteran. This study conducted exploratory research using qualitative research,

precisely the case study approach. I discuss the research method for this study in Chapter

Chapter 3: Research Method

Introduction

Homelessness among military veterans (HAMV) is a protracted problem. Twelve

years ago, the VA pledged to end the issue but HAMV persists despite various solutions

proposed. The purpose of this study was to discover and explore the perspectives of

service members on why veteran colleagues experience homelessness. This chapter

includes the research design and rationale, research method, role of the researcher,

methodology (setting and sample, data collection, data analysis plan, and treatment of

discrepant cases) issues of trustworthiness (credibility, transferability, and

confirmability), and addressing the ethical concerns in interviewing members of a

protected population.

Research Design and Rationale

The research question that guided this study was: What are the perspectives of

service members on why veteran colleagues experience homelessness? This central

research question was developed to stimulate the service members’ accounts of why

veteran colleagues end up homeless.

The central phenomenon of this study is HAMV. Glynn (2013) estimated over 2.1

million service members were deployed in support of the last three U.S. wars: OEF, OIF,

and OND. Peterson et al. (2015) attributed approximately 21,021 homeless veterans to

the aftermath of the wars. Also, Kennedy et al. (2007) believed mental health disorders

among military veterans are consequences of these wars.

Research Method

In this study, I examined homelessness among military veterans using a

qualitative case study research method. Creswell (2014) believed interviews are the

primary way to obtain information from participants in qualitative research. Creswell

(2014) believed a case study approach (CSA) could be used to explore a case or a few

cases in research. In the CSA, a researcher uses interviews and reviews of related

documents to collect data. Based on these techniques, the CSA provides the opportunity

to conduct an exploratory study on a given phenomenon. I used the CSA to conduct this

study because other approaches would not have been conducive to the research.

The narrative approach does not provide clear guidelines for analyzing research

and whether to explore stories’ particularity or generality (Squire et al., 2008). In the

ethnographic approach, researchers focus on people associated with the same group who

thus share the same beliefs (Samnani & Singh, 2013). This method was inappropriate for

this study because the cultural and socioeconomic backgrounds of the veterans are

heterogeneous. Creswell (2014) posited that a grounded theory approach (GTA) is used

to explore a particular phenomenon inductively to formulate a theoretical framework to

explain a given event. As a result, GTA was incompatible with this research because the

current study’s theory was predetermined.

A mixed-method researcher “uses both quantitative and qualitative data to

improve understanding of a research problem beyond what is possible with either

approach alone” (Catallo et al., 2013). Mixed-method research combines quantitative

(experiments, surveys) and qualitative (focus on groups, interviews) approaches to

conduct an exploratory study. The method was not compatible with this study because the

current research did not involve quantitative data.

In summary, narrative, ethnographic, and grounded theory were not conducive to

conducting this study for the following reasons: the narrative approach does not provide a

clear direction concerning data analysis. The ethnographic approach is less practical

because the approach is limited in scope. Grounded theory is used to search for a

theoretical framework, whereas this study’s theory was predetermined. Also, Ingham-

Broomfield (2015) stated that approach explores a given event based on the lived

experiences of a particular group. The approach is not suitable for this study because the

service members I interviewed provided their perspectives, not lived experiences, on

HAMV.

Role of the Researcher

I collected, analyzed, and described the research data for this study. Karagiozis

(2018) remarked that a researcher interacts with the participants to collect the data and

interprets the research findings. The researcher communicates the needs of the

participants, like their feelings and thoughts. These roles make the researcher part of the

phenomenon being explored. Ultimately, the researcher is pivotal in presenting findings

to policymakers who may use the data to develop policy—in this instance, that would be

policies to help homeless veterans. Succinctly, Banks et al. (2017) described a researcher

as the intermediary or facilitator of a research study.

After conducting interviews, I reviewed the transcripts from the interviews and

conducted a member-checking process. These actions were necessary to ensure the

findings are based on the research data/information provided during the interview. To

prevent bias in data collection, open-ended questions were asked to understand better the

service member participants’ perspectives on why veteran colleagues experience

homelessness. Furthermore, the eligibility criteria were defined clearly to select

appropriate participants for the study.

Methodology

Setting and Sample

Military veterans were the study’s population. The interview participants were

service members stationed in Maryland and Virginia who volunteered to participate in the

research. Most veterans also volunteered to serve in the military. I interviewed 16 service

members for this study. The number of samples in qualitative research “depends upon the

number required to inform fully all important elements of the phenomenon being studied”

(Sargeant, 2012, p. 1). Sample selection is no longer required “when additional

interviews or focus groups do not result in the identification of new concepts, an endpoint

called data saturation” (Sargeant, p. 1).

The eligibility criteria were current service in the military and assignment in

Maryland and Virginia. The combat or noncombat experience was not considered as part

of the eligibility criteria to partake in this study. Moser and Korstjens (2018) stated that

researchers look for participants who have shared experiences but are varied in

characteristics and individual experiences, such as race and ethnicity. Informal, off-base

snowball sampling through friends/colleagues was used to gain access service members

as potential participants for this study. I emailed the recruitment flyer and invitation letter

to friends/colleagues and invited them to forward the documents to service members

interested in participating in this study.

Data Collection

Data were collected for this study through interviews with service member

participants. Interviews were conducted using an interview protocol developed from the

Center for the Advancement of Engineering Education’s (2009) interview protocol. The

instrument was sufficient to collect the research data because it allowed the veterans to

provide their perspectives on HAMV. The instrument was divided into two parts: a

survey and a short pencil-and-paper task. Previously, the protocol has been used to find

students’ perspectives on teaching inside and outside the classroom. Similarly, in the

present research, I hoped to discover service members’ views on why veterans experience

homelessness. The protocol was modified to make the instrument content- and culture-

specific to HAMV. The following are examples of study interview questions:

1. What are your perspectives on the risk factors of HAMV?

2. Do you think the behaviors (traits) of homeless veterans could lead to the

problem?

Data Analysis Plan

Ultimately, I used a descriptive-focused coding strategy in this study. The initial

data analysis process was based on open coding and axial coding. According to Glaser

and Hon (2016), open coding aims to arrange similar patterns that emerge during data

analysis into groups. Axial coding is necessary to assign a word or phrase to describe the

patterns or themes during data analysis. Kendall (1999) stated axial coding makes

connections between categories of data following open coding. The research data were

analyzed by labeling the concepts and developing themes from the information gathered

during the interview. The analysis was focused on transcribing the data from the

interview and classifying/identifying them by themes. I presented the research findings in

narrative and table forms.

Treatment for Discrepant Cases

Discrepant information contradicts the dominant theme following the data

analysis. Creswell (2014) stated providing discrepant information is one of the eight

strategies to ensuring research findings’ validity. I offered the discrepant cases from the

research data, thereby acknowledging information contrary to its key themes.

Issues of Trustworthiness

Credibility

The interview transcripts and coding sheets were used as reference documents

during the data analysis, thus facilitating this study’s validity. Furthermore, I avoided

drawing premature conclusions based on minimal experience related to the research topic

to boost this study’s credibility. Lastly, the subjects ascertained the accuracy of the

findings by confirming that analysis of the information they provided reflects their

viewpoints.

Transferability

Transferability is established by ensuring that studies’ findings can be transferred

to comparable settings and similar results are discovered. In part, I explained the research

coding process and every step leading to its findings.

Confirmability

Confirmability was established by explaining every element of the interview

protocol and describing all aspects of this study’s data analysis, particularly the coding

process—furthermore, the explanation of the themes obtained from analyzing the data

from the interviews. Additionally, defining and explaining the themes/concepts is vital to

establishing confirmability in research.

Intracoder and Intercoder Reliability

In this study, I searched for and identified themes/patterns by reading relevant

notes/transcripts/manuscripts written following the review of the data from the interview.

More importantly, the coding process was based on the information (perspectives of

service members on why some veteran colleagues are homeless) obtained during the

interview. I ensured every code and its meaning was available following the coding

process.

Ethical Procedures

The psychological risks were reduced by reminding the subjects of their rights to

withdraw from participating in this study if they are uncomfortable. I ensured the

protection of the following risks by complying with this study’s informed consent

guidelines. For instance, social risks are alleviated by protecting participants’ confidential

data from inadvertent disclosure, and economic risks are reduced by protecting the

confidentiality of the subjects. Also, protection against legal risks is related to preserving

the confidentiality of the research data from the researcher when forced to disclose the

participant’s protected identifiable information.

The participants’ anonymities and confidentialities were protected by not

allowing unauthorized access to the research data and not disclosing information like

their names in this study’s report. In addition, the Walden University Institution Review

Board (IRB) granted the approval to collect research data from the participants. The

approval number for this study is 02-10-20-0109151. Lastly, I adhered to the IRB’s

guidelines on protection of human subjects.

The participants’ information such names and research data are secured in a safe

that is accessible only to me. The transcripts from the interview sessions and the

audiotape are mandated to be stored for 5 years and destroyed with a designated shredder

afterwards. The research data will not be used for any purposes other than the research.

Lastly, I used the informed consent form to explain the study’s objectives and how the

results will be published and utilized.

As a service member, investigating why the military veterans are homeless could

cause ethical issues or a source of bias. I addressed the prejudice in part by developing

and adhering to the interview protocol.

Summary

Again, the purpose of this study is to ascertain the perspectives of service

members on why veteran colleagues end up homeless. The case study approach will be

used as this study’s research design. Interviews will be conducted to obtain the service

members’ views on HAMV. The research data will be analyzed by labeling relevant

information and developing themes based on the data. Similar patterns that may emerge

during the opening coding will be classified and themes are expected to be derived from

the patterns. As the researcher, I will collect, analyze, develop themes, and present this

study’s findings.

Chapter 4: Results

Introduction

The purpose of this study was to discover and explore the perspectives of service

members on why their veteran colleagues experience homelessness. Newman and Covrig

(2013) said research questions showed the connection between studies’ purpose and

problem statement. As a result, I developed the interview questions for this study with its

purpose in mind. The interview questions were divided into three sessions: interviewee

background information, interviewee perspectives on HAMV, and closing comments. For

example, session 1 comprised of four questions like reason for joining the military,

session 2 consisted of 6 questions focusing on service members’ perspectives on HAMV,

and session 3 summarized the information provided in the two earlier sessions.

I used qualitative research, precisely the case study method to conduct this

research. I interviewed service members for this study because they share the same

military experience as homeless veterans. For example, in training, culture, possibly

deployed together during peace or wartime with homeless veterans. The service members

could contribute valuable perspectives because of these shared military experiences. The

views participants provided during the interview sessions helped to expand the

knowledge of HAMV.

Pilot Study

Morin (2013) said a pilot study assesses the feasibility of the research. While I

shared the author’s assessment, a pilot study was not used because the cost and data

obtained from the pilot study may not have been worth the resources devoted to the

process. Lastly, the data from the pilot study could have been accidentally included in the

findings of the actual research.

According to Lloyd et al. (2020), the setting for any social research is determined

by the research question it examines. For this research, I conducted one face-to-face

interview and 15 telephone interview sessions. Participants signed the informed consent

form before the beginning of each interview. The demographic of this study were military

veterans. According to U.S. Housing and Urban Development (2021), “37,252 veterans

were experiencing homelessness in the U.S., eight percent of all homeless adults” (p. 52).

Further,

Men accounted for more than nine of every 10 veterans experiencing

homelessness in 2020 (91% or 33,862 veterans), the same as the share of all

veterans in the U.S., which is also 91 percent… African Americans were

considerably overrepresented among the homeless veteran population. Veterans

who were Black or African American comprised one-third of veterans

experiencing homelessness and a quarter of veterans experiencing unsheltered

homelessness compared with 12 percent of all U.S. veterans (U.S. Housing and

Urban Development, 2021, p. 53).

Data collection is a planned activity because it connects the researcher with the

subjects to gather research data to eventually form the study findings (Halcomb & James,

2019). As stated before, interviews were the primary data collection instrument in this

research. Data analysis involves open coding, axial coding, selective coding, and finding

conceptual tools to interpret the patterns (Broom, 2005). For example, open coding is the

reading of research data several times, axial coding is sorting the information relevant to

the interview questions, and selective coding develops themes from the patterns.

I initially conducted the data analysis for this study based on Broom’s (2005)

steps. For example, I read over 100 pages of data collected from the 16 interviews

conducted. Following the reading, I gathered information relevant to the interview

questions from the data collected, and I subsequently developed themes based on the

data. I ultimately used the descriptive-focused coding strategy for this study because the

participants offered direct answers to the interview questions (Adu, 2019).

A study’s trustworthiness is established through credibility, transferability,

dependability, and conformability (Gray & Jones, 2016). I showed credibility in this

study by conducting a literature review on HAMV. The transferability is supported by

explaining the research coding process and every step taken to arrive at the findings. I

demonstrated this study’s dependability by detailing its research design and procedures

for data collection and data analyses. Lastly, I ensured the conformability of this study by

conducting a member check with the participants to verify the findings were based on the

respective information they provided during the interviews.

Some of the results that emerged from the data analysis are (a) dependence on the

military, (b) the Soldier for Life–Transition Assistance Program (SFL–TAP) did not

adequately address employment opportunities, (c) lack of family support, and (d) mental

health issues as PTSD. The military provides security for service members in areas like

guaranteed paychecks and accommodations. After separation from the military, some

veterans encounter challenges maintaining these needs. Also, mental health conditions

continue to be one of the leading risk factors of HAMV. This condition not be alleviated

when access to care is limited.

Setting

No personal or organizational conditions that influenced participants or their

experience at the time of the study may affect the interpretation of the study results.

Demographics

The demographics of the participants in this study are as follows. Participants

were 62.5% male and 37.5% female. In regard to race, 12.5% of the participants

were Caucasian and 87.5% were not Caucasian. Participants combined length of

service was 355 years; the average length of service for each participant was

slightly over 22 years. All participants (100%) indicated they joined the military

either for educational benefit or for a sense of patriotism. In regard to positions

held by participants: 31.25% were commissioned officers (positions of authority);

6.25% were warrant officers (technical foundation of the military); and 62.5%

were noncommissioned officers (obtain authority by promotion through enlisted

ranks). Participants’ professions ranged from clinician to career counselor.

Participants described their overall experiences in the military positively.

All the participants are currently serving in the armed forces of the United States

and thus would be considered colleagues of homeless veterans. Participants were able to

share essential perspectives on the risk factors of HAMV because they experienced the

same training, rules, and regulations that homeless veterans once experienced.

Participants share similar cultures and experiences with homeless veterans.

Data Collection

I asked each participant 10 (4 questions on the subjects’ background information

and 6 questions on participants’ perspectives on HAMV). When asked for their

perspectives on why service members experience homelessness, certain risk factors were

provided: (a) mental health illness (n = 9), (b) lack of a plan to adapt to civilian life (n =

6), (c) financial hardship (n = 5), (d) substance use (n = 5), (e) lack of family support (n =

4), (f) loss of benefits like a steady salary from the military (n = 3), (g) loss of a cohesive

team (n = 3), and (h) ineffective transition programs (n = 2).

Data were collected promptly from subjects because of their frequent mobility.

Bernthal (2015) warned the researcher to complete data collection on time because of the

transient nature of service members due to their careers. I conducted one face-to-face

interview and 15 telephone interviews for this study. The face-to-face interview was in-

person communication with a respondent, while the telephone interviews were

communication with respondents on the telephone. I collected the signed informed

consent forms from the participants before each interview. I discussed the interview

protocol with the participants, informing them of the purpose of the research, questions to

be expected, confidentiality, and the right to withdraw from the interview. On average,

each interview lasted for 1 hour. Interviews were conducted from October 17 to

November 1, 2020.

I recorded interviews with audiotape. This allowed me to concentrate on

interviewing as outlined in the interview protocol. By signing the informed consent form,

the interviewees agreed to the use of the tape. I turned on the audiotape at the beginning

of the interview. The research data from the recordings were transcribed to a Word

document using the application in Microsoft 365. Also, I wrote some notes during the

interviews to record information relevant to the interview questions. The tape, transcribed

texts, and scripts served as materials during coding and analysis. The research data will

be kept in a cabinet with password protection for at least 5 years, as required by the

university, and destroyed afterward. No variations in data collection from the plan

presented in Chapter 3 occurred and no unusual circumstances were encountered in the

collection of data.

Information gathered from my interview with Participant 1 (P1) could be

summarized as follows: Pride, lack of preparedness, and lack of targeted programs are

some of the factors of homelessness among service members. For example, some

veterans expect to be treated with the same respect they experienced in the military. This

type of respect is earned in the private sector, unlike the military that inherently comes

with the ranks (positions). Therefore, the reluctance to accept job opportunities that the

veterans deemed non-prestigious ultimately impedes an uninterrupted source of income

after separating from the military. Also, service members did not devote quality time to

programs like the SFL-TAP designed to promote informed career decisions.

According to P1, some VA programs are developed with no consideration for

services and resources that would benefit homeless veterans in a given geographical

location. P1 inferred the VA programs are not directed to providing financial assistance

to homeless veterans, particularly in areas with a high cost of living. The VA should

direct its resources to get after the problem and fix it so that another veteran does not find

himself homeless.

P1 said homeless veterans should know their local Veterans Affairs’

representatives to acquire information on different VA programs/services. P1 suggested

that receiving medical treatment from the VA is cumbersome, therefore, preventing

homeless veterans from getting medical care. To address HAMV, P1 stated that a system

(database) that will store the veterans’ mailing addresses to send out a wellness check

questionnaire and assess transition to civilian life should be developed. Veterans should

be allowed to continue to benefit from the SFL-TAP.

P1 stated “ego and then just not preparing” for a transition from the military are

two reasons why veterans experience homelessness. P1 remarked that veterans believe

accepting specific job opportunities is inferior. P1 stated “lack of initiative” as one of the

behaviors developed by veterans that eventually could result in their inability to make

decisions in obtaining accommodations after discharge from the military. P1 said, “bad

decisions can lead to” homelessness among military veterans.

P1 defined HAMV as the absence of a place to stay that is considered your own

and stated lack of preparedness, ego, insufficient time to prepare for a transition, lack of

motivation/internal drive towards education are some of the risks factors of HAMV. P1

believed behaviors like lack of initiative and inability to be a self-starter are two of the

traits that can prevent veterans from developing plans necessary to acquiring residence

upon transition from the military could be contributing to HAMV.

P1 joined the military because of peer pressure and the need to continue the

family tradition of serving the country prompted the desire to enlist in the military and

have been serving for 23 years. According to P1, to date, the experience of being in the

military can be characterized as positive.

Information gathered from my interview with Participant 2 (P2) could be

summarized as follows: P2 said "Homelessness is multifactorial in the society" and

"multifactorial in terms of prevalence" among veterans. The P2 remarked drug addiction,

depression, alcoholism, substance abuse, financial hardship, and expensive divorce are a

few of the risk factors of HAMV. For example, P2 stated a personal friend was

transiently homeless due to a costly divorce. According to P2, African American veterans

have a higher propensity to become homeless, and the reason for the widespread has not

been determined. P2 remarked that the absence of leadership structure provided by the

military could cause some veterans to develop self-destructive behaviors, leading to

homelessness. The sudden loss of the teammates after the transition from service can

trigger a depressive cycle in some veterans.

State and local governments assist homeless veterans by providing tax, housing,

and rental incentives to veterans. Also, P2 said the private sector offers lower interest

rates on car and mortgage loans. P2 mentioned that despite the efforts of the local

communities to address HAMV, factors such as mental illness, substance abuse,

alcoholism, personality disorders, and clinical depression hinder the success of such

programs.

P2 said after a transition from the military, the military should maintain the

veterans' contact list (phone numbers). The list will allow the veterans to contact the

military to answer any questions. Counseling should be offered to veterans, advising

them to take advantage of VA programs designed to address homelessness they may

otherwise not enroll in because of personal pride.

P2 joined the military 33 years ago to take advantage of the educational

scholarship offered by the military prompted the decision to join the military. P2

experience in the military has been fantastic because the organization offered to pay off

the participant's student loan, sponsored residency and fellowship programs. P2 said

hesitancy to ask for assistance because of the military's individualism in service members

could contribute to HAMV.

Information gathered from my interview with Participant 3 (P3) could be

summarized as follows: Mental health like post-traumatic stress disorder, lack of social

support from family and friends are some of the risk factors of homelessness among

military veterans. The military promotes independence and bravery in every service

member; thus, homeless veterans are reluctant to seek assistance because “they don’t

want to let people see that side and they feel as though they are saying they can’t handle

it.” Pursuing educational opportunities while in uniform, acquiring a skill set transferable

to the civilian sector, and maximizing the retirement transition resources/services are

necessary to get a good job, significantly decreasing the risk of becoming homeless.

Additionally, the military promotes individualism that makes veterans reluctant to

ask for assistance when needed. The VA is charged with the responsibility “of assisting

military personnel who get out of the military by providing them with resources and

opportunities to ensure that they are on the right path.” The partnership between the VA

and military in transferring medical records for continued treatment and job opportunities

for veterans should be encouraged. Local communities such as Salvation Army and

Churches assist homeless veterans “having problems getting jobs.” Also, there is a policy

in place by the government that gives “veterans preferences whenever they do apply for

jobs.” The absence of “a good job” is a risk factor of HAMV.

P3 joined the military to honor a friend that passed away while serving. Also, for

an educational opportunity through a scholarship from the military. P3 has been serving

for 16 years, and the experience has been positive. P3 said homelessness is “lacking a

place to stay and lacking a physical address.”

Information gathered from my interview with Participant 4 (P4) could be

summarized as follows: Mental health is a significant risk factor of HAMV. This factor is

worsened by a lack of medical treatment, which can lead to homeless. Economic hardship

can cause HAMV. For example, the military provides service members decent basic

salaries with a “lot of perks and benefits associated with” it. These payments are stopped

after separation from the military. Lack of planning for sustaining this level of income

and bad conduct discharge (disqualifies separating service members from applying for

certain benefits with government agencies like the VA.) from the military are factors that

can lead to HAMV.

Furthermore, service members develop substance abuse and alcoholism

behaviors, which impair their “judgment and ability to make sound decisions.” These

behaviors “may spiral out of control where you are released from the military, and then

you carry on with your drug addiction” and eventually become homeless. The VA should

be proactive in identifying veterans at risk of becoming homeless and providing programs

to address the potential problem. Local communities provide shelter for homeless

veterans. Homeless veterans should enroll in educational and training programs within

their local communities for employment opportunities.

P4 said local communities support homeless veterans by providing shelter and

discounts on certain goods and services. P4 stated the veterans should take advantage of

the educational and training opportunities offered in the communities they live. P4

recommended that financial assistance be provided for homeless veterans who are not

qualified for any financial aid from the government like the VA.

P4 joined the military for educational opportunities, discipline, and structure in

the military. Also, the military provides opportunities for “men to learn about leadership,

discipline, and commitment to something greater than himself.” P4 has been serving for

21 years, and the experience in the military has “been a great and exciting journey.”

Information gathered from my interview with Participant 5 (P5) could be

summarized as follows: The risk factors of HAMV range from lack of planning, PTSD,

failed marriage, financial hardship, lack of support from immediate family. The stories of

two veterans that were homeless due to lack of planning were recounted. "Things did not

go the way that they thought that it would go, and they were homeless." Also, the absence

of a military structure that guides the veterans while serving is a risk factor of HAMV.

For example, the military provides steady benefits such as housing allowance and

medical costs to service members.

The VA has programs in place to address HAMV. However, lack of knowledge of

the programs by the homeless veterans inhibits the prevention of homelessness. Although

the SFL-TAP provides services like resume writing, the program does not benefit

veterans who need to compete in the private sector. Local communities such as the

Veterans of Foreign Wars support the homeless veteran population by providing

educational assistance. To prevent HAMV, the veterans "need to do what they're

supposed to do, like go through the training they need to go through" before departure

from the military.

According to P5, VA should intensify its effort in addressing HAMV by

educating the homeless veterans on the various VA programs. Private groups like the

Veterans of Foreign Wars support the homeless veteran population by providing

educational assistance. P5 remarked that homeless veterans should enroll in the training

necessary to gain employment after transitioning from the military. P5 said homeless

veterans could participate in homes building projects and provide funding/grants to build

homes for the veterans. According to the subject, "things did not go the way they thought

they would go, and they were actually homeless. The participant contended the absence

of a military structure that guides the veterans while serving is a risk factor of HAMV.

P5 joined the military for patriotism, educational opportunity, and desire to "see

the world and travel." P5 has served in the military for 21 years. The experience has been

positive because of the opportunity to serve at different levels like operational and

strategic. P5 defined HAMV as "no place to go, no support system."

Information gathered from my interview with Participant 6 (P6) could be

summarized as follows: The experience service members gained while in the military can

“affect their mental health.” One of the risk factors of homelessness among military

veterans (HAMV) is mental health. Also, soldiers did not get the mental health care they

likely need because of the stigma of seeking mental health treatment. Furthermore, the

military provides a support system (housing benefit, employment, and training) to service

members that may not be available upon their transition from the armed service. The

military leaders are focus on coaching subordinate service members at the detriment of

planning for their transition from the military. The readiness “just continuously take care

of the mission, the Army, the soldiers and then put themselves on lower on that priority

list” take away time from leaders to plan their transition.

Also, some veterans cannot get the medical appointments like mental health they

need from the VA healthcare system. Lack of access to medical care can “sets off a

cascade of events that leads to homelessness and then illness too.” The VA’s effort in

educating the homeless veterans on its programs developed to address HAMV is

insufficient. The partnership between the VA and the local community is recommended.

This partnership is necessary to help homeless veterans that do not live in the vicinity of

VA hospitals. Combating HAMV is a collective (government, local community, and

homeless veteran) effort. Therefore, the veterans have to commit to enrolling in VA

programs such as vocational training.

Information gathered from my interview with Participant 7 (P7) could be

summarized as follows: Veterans who “ended up being homeless did not plan to make

that switch” from military to civilian life. For instance, in the military, service members

are entitled to guaranteed paychecks and stable accommodations that they will not be

allowed to after transitioning from the military. Service members do not have plans to

maintain “the same financial structure and stability” the military provides. P7 asserted the

lack of planning, fiscal irresponsibility, and complacency are some of the risk factors of

HAMV. For example, some enlisted soldiers “live beyond their means.” Some service

members are complacent because income from the military is not necessarily tied to

productivity. Therefore, it is almost near impossible to be fired. These behaviors (fiscal

irresponsibility and complacency) are not tolerated in the private sector. Service members

that possess these behaviors could face difficulty in adapting to civilian life.

P7 joined the military as an act of patriotism and a “sense of duty too.” P7 has

been serving in the military for 13 years and said, “It’s has been a worthwhile

experience.” For example, the educational opportunity, acquisition of skills, and

knowledge sets gained in the military have made the experience positive. According to

P7, HAMV can be described as the inability to afford a place to call home after serving in

the armed forces for any given year.

Information gathered from my interview with Participant 8 (P8) could be

summarized as follows: Lack of access to mental health treatment, alcohol/drug addiction

treatments, and the aftermath of emotional events like divorce, loss of a child or parent,

and inability to assimilate into the civilian sector are some of the risk factors HAMV. For

example, service members are “so institutionalized throughout their careers that they

forget how to” adapt to civilian life when they leave the army. The homeless veterans

developed behaviors such as smoking and drug abuse while in the military, and if the

addictions are not treated can eventually be risk factors of HAMV. Furthermore, the

reluctance of some veterans to accept specific job opportunities because they believe the

employments are beneath their social statuses is yet another risk factor of HAMV.

According to P8, the VA continues to address HAMV. For example, in Pittsburg,

Pennsylvania, VA offers counseling on drug and alcohol addictions to homeless veterans.

Also, local communities support homeless veterans. For instance, P8 assisted in serving

meals in a soup kitchen while stationed in Fort Knox. Also, in the town of Louisville by

giving homeless veterans blankets, clothes, and toiletries.

P8 joined the military to try something different and challenging. For the past 24

years, P8 experience in the military is “very good” in part because of the opportunity to

coach soldiers “to make a better life for themselves.” P8 described HAMV as “either lost

everything they have, or they did not know how to manage their lives once they exit the

Army.” HAMV can also occur after they went through a significant emotional event such

as divorce and subsequently lost possessions like accommodation.

Information gathered from my interview with Participant 9 (P9) could be

summarized as follows: Inadequate planning to transition from the military to civilian life

is one of the risk factors of HAMV. For example, some veterans are “ill-prepared” to

separate from the service, resulting in the inability to gain employment required to afford

accommodation and other needs like medical care. Also, some veterans are complacent; a

behavior developed while serving in the military. P9 said the VA continues to provide

services like educational assistance to growing veterans despite limited funding.

According to P9, VA needs more funding to hire people to implement its programs. P9

mentioned that the VA is understaffed, therefore, hinder its ability to address HAMV. P9

inferred that VA ought to intensify its effort to educate homeless veterans on different

programs developed to alleviate homelessness.

To assist VA in addressing the issue, the local communities offer shelter, mental

health counseling, and resilience training. Additionally, affordable housing and

employment opportunities with sufficient income to afford accommodation. P9 said

before service members separated from the military, they should take advantage of the

SFL-TAP. This program provides services such as resume writing classes and different

VA programs available to qualified veterans. P9 suggested affordable housing, training,

job opportunities with “livable income,” and investment in specialized medical treatment

for PTSD to address HAMV.

P9 joined the military to continue the family tradition of serving in the military

and take advantage of the opportunity to attend college. For over 24 years, despite the

challenges in the military, P9 overall experience “has been by and large fairly positive.”

P9 described HAMV as living below the poverty line and lack of “a fixed permanent

dwelling somewhere that you can call your own your own.”

Information gathered from my interview with Participant 10 (P10) could be

summarized as follows: Mental health illness, financial hardship, lack of emotion, and

lack of spiritual support are some of the risk factors of homelessness among military

veterans. Also, service members do not know about VA resources available to them. P10

said the VA continues to implement programs and provides services like healthcare to

homeless veterans. However, P10 believed some veterans' "bad attitude" in VA facilities

prevents the VA staff from assisting these veterans.

Lack of knowledge about VA resources could be because they did not promptly

enroll in the SFL-TAP to obtain information on the resources. Also, some veterans did

not plan their transition from the military by saying, "you plan to come in; you need to

plan the leave." Some veterans experienced difficulty in adjusting to life after separation

from the military. P10 said, "Transition is tough; some people never transition well."

P10 stated that nonprofit organizations like the VFW and American Legion

should intensify their efforts to assist homeless veterans. To do this, local government

"could do a lot more in supporting those groups to support the veterans."

P10 said homeless veterans should take advantage of the medical treatment the

VA provides. For instance, homeless veterans with psychiatric issues should enroll in

mental health counseling offered by the VA. P10 said the military should mandate

participation in the SFL-TAP for every service member separating from the military. The

subject stated, "We need to help our soldiers a little bit more with planning exit."

Furthermore, P10 at the basic training, the instructors should educate service

members on HAMV, the importance of SFL-TAP, and developing an "exit plan." Also,

lack of financial and psychological help, moral support, and emotional and spiritual

support could contribute to HAMV.

P10 joined the military to continue a family tradition, serve in the armed forces,

and take advantage of the educational opportunity offered by the military. P10 served in

the military for 32 years and described the experience as "Varies from good to excellent

and bad to very bad." P10 defined HAMV as a lack of a consistent place to sleep and

perform daily hygiene.

Information gathered from my interview with Participant 11 (P11) could be

summarized as follows: Some service members are homeless because “they just didn’t

have a plan when they got out of service.” Additionally, the participant stated not every

skill service member acquired while in the military “translates over into” lucrative

employment. As a result, job opportunities for these members “were pretty scarce after

they got out of service.” P11 said, “there is not a whole lot of jobs outside of out of the

military for an infantryman.” P11 said the soldier “would have to learn a whole new set

of skills” to find employment. P11 inferred alcoholism is one of the risk factors of

HAMV and remarked that some veterans developed the habit while in the military. P11

mentioned that “alcoholism played a huge part” in the predicament of some of the

homeless veterans the interviewee met. Also, the participant pointed out that some

homeless veterans are “not getting proper medical care for weeks and months.”

P11 remarked that local communities support homeless veterans by providing

them clothing and organizing a food drive. However, the communities are not as helpful

in assisting the veterans in getting a place to live. Furthermore, P11 suggested that the

military provide more educational and job training opportunities to service members.

These opportunities would prepare them to secure “good wage” employment thereby,

providing “finances that they would need to purchase homes before or after transitioning

from the military.

P11 joined the military 23 years ago to “to pay for college.” According to P11, the

experience in the military thus far has “been a pretty pleasant experience” and “entire

experience has been as remarkable.” P11 described HAMV as lack of a physical location

to live each day of their life. For example, in the District of Columbia, “you can actually

see veterans living in tents.” P11 stated that the VA is not “doing enough to help”

Information gathered from my interview with Participant 12 (P12) could be

summarized as follows: Lack of education, mental health illness, loss of family members,

drug abuse, and alcoholism are some of the risk factors of HAMV. Some veterans are

reluctant to seek mental health treatment. The stigma associated with it and the belief that

the condition could be the reason for dishonorable discharge from the military are two

reasons why some veterans do not seek treatment. If released under this condition, they

could be ineligible to apply for benefits they would have otherwise have qualified for.

According to P12, the VA continues to provide medical service to eligible

veterans but cautioned the customer service is poor. Also, P12 said that because of the

scarcity of medical providers at the VA hospitals, veterans “don’t get the quality care

they need,” which could ultimately contribute to HAMV.

P12 said that homeless veterans should enroll in programs like the ones developed

by VA to address HAMV. P12 remarked that SFL-TAP should be extended to secure

employment for service members before the transition from the military regardless of the

types of discharge (honorable or dishonorable). According to P12, “every soldier that exit

has a job before exiting the military.” Also, P12 acknowledged the partnership between

VA and HUD in providing housing opportunities to homeless veterans.

P12 joined the military to fulfill their childhood dream of providing medical care

to soldiers in areas like the battlefield. For over 29 years, P12 experience “has been quite

diverse” by serving as an Army nurse and in different leadership positions.

Information gathered from my interview with Participant 13 (P13) could be

summarized as follows: Mental health illness and difficulty adjusting to life after the

transition from the military are two of the risk factors of homelessness among military

veterans. Also, some veterans depend on the military for housing, a steady salary, and

healthcare. After a transition from the military, some veterans are unable to maintain

similar lifestyles. Furthermore, the SFL-TAP does not “prepare a soldier mentally” to

transition to civilian life. According to P13, some veterans lack the motivation to

compete with people from different walks of life and are not proactive in looking for

employment opportunities and housing after transitioning from the military. P13 stated

that the VA is “doing a good job” providing medical care to homeless veterans and

assisting them in providing permanent housing.

P13 stated that local communities like churches set up soup kitchens to feed

homeless veterans but hope the communities could provide food to more veterans,

suggesting some veterans do not know the kitchens. P13 said some veterans are reluctant

to take advantage of the programs developed to address HAMV as a result of a “certain

level of pride.” The veterans are trained to be brave in the military, and accepting

assistance/help is considered a handout.

P13 joined the military to continue a family tradition and for the opportunities “to

travel and experience something new and something that challenged me because I felt

like I needed a challenge after high school.” P13 has been serving for 22 years. The

participant said despite some challenges encountered in the military, the overall

experience is great. Adding the experience has made P13 a better leader and soldier. As a

career counselor, P13 provides mentorship to new soldiers required to make a career

decision. According to P13, HAMV can be described as lacking a roof, transportation,

and food to eat.

Information gathered from my interview with Participant 14 (P14) could be

summarized as follows: Lack of planning on how to succeed as a civilian, mental health

conditions like PTSD, financial hardship, substance/drug abuse, alcoholism, and

addiction as some of the risk factors of homelessness among military members. Also, the

military instills bravery in soldiers so, seeking help from organizations like the non-

government agency is considered living off others, thereby, less brave or weak. As a

result, some veterans are reluctant to seeking assistance. The VA provides healthcare to

veterans, but access to healthcare needs to be improved. The VA is streamlining access to

care to provide adequate services to homeless veterans.

P14 said organizations like the VFW organizes food drive and offers job training

to homeless veterans locally and nationally. According to P14, homeless veterans should

participate in VA programs developed to address HAMV by enrolling in the programs.

P14 said to address HAMV, services such as financial counseling, transfer of

military experience to civilian employment opportunities, and resume writing should be

expanded. Also, the military should track veterans for five years to know the progress of

their transition from the military to the civilian sector.

P14 joined the military over 20 years ago as an act of patriotism. The participant

experience in the military has been positive partly because, as a combat veteran P14

learned to be a team player. In describing HAMV, P14 said, “it is unfortunate to have

people that give everything to the nations” be homeless after transitioning from the

military.

Information gathered from my interview with Participant 15 (P15) could be

summarized as follows: The repercussions for dishonorably discharged soldiers from the

military following court-martial proceedings could be devastating. For instance, the

soldiers could lose certain VA benefits and face challenges getting a job after separating

from the military. P15 said the consequence of dishonorable discharge from the military

is one of the reasons “we have so many homeless now in the street.” Also, P15 said

alcoholism, the aftermath of divorce, lack of support from family members, and lack of

education are some of the risk factors of HAMV.

P15 believed that organizations like the Salvation Army provide accommodation

and clothes, particularly in the winter, to homeless veterans. The participant said the VA

should partner with the local communities by providing funds to address the HAMV.

Furthermore, P15 stated that the VA needs to intensify its outreach campaign by enrolling

more homeless veterans in programs developed to address HAMV because self-

enrollment in these programs by some of the veterans with mental illnesses could be

challenging. P15 recommended that the VA implements the Home Owners Preserving

Equity initiative like in the state of Maryland to prevent foreclosure and, ultimately,

HAMV.

P15 joined the military as an act of patriotism and self-development. For over 20

years, P15 experience has been positive because the participant has acquired values such

as loyalty and consideration for others.

Information gathered from my interview with Participant 16 (P16) could be

summarized as follows: The transition program offered to separate soldiers by the

military is not adequately implemented. The program mainly provides information on VA

resources. Also, veterans are not provided the same mentorship available to them while in

the military after the transition. For example, the army's leadership structure (squad

leader, platoon sergeant, first sergeant, company commander) ends after separation. Also,

lack of motivation is one of the reasons that could prevent veterans from adapting to

civilian lifestyles. For instance, veterans depend on the military for benefits/services like

livelihood, accommodation, and medical care. P16 believed some veterans face

challenges in maintaining these standards of living after a transition from the military.

P16 said the VA needs to intensify its effort to educate the veterans on the

available programs to address HAMV because veterans are not enrolling in the programs

due to a lack of knowledge about them. The participant believed that homeless veterans

should seek information to enroll in VA programs developed to address HAMV. P15

asserted that local communities do not have programs in place to provide temporary

shelters for homeless veterans. P16 recommended a partnership between the local

communities and the homeless veterans' population to address HAMV further.

P16 joined the military for educational opportunities and served for over 16 years

with a positive experience.

Discrepant Cases

I encountered the following discrepant cases during the coding phase of this

study: altruism-leaders (not taking care of oneself), lousy customer service, group

formation to demand assistance from the government, skills acquired in the military not

transfer to civilian employment, and recruits should develop transition plan from the

military. For example, one participant believed some leaders in the military devote time

to mentoring their subordinates to the detriment of developing plans for their separation.

Creswell stated providing discrepant information is one of the eight strategies to ensuring

research findings’ and results’ validity. He believed presenting negative or discrepant

information acknowledges cases contrary to any given study’s principal themes.

Summary of information provided to interview questions 5–10:

Table 1 shows the results developed from the perspectives of service members on

the risk factors of HAMV, Table 2 indicates the results from the perspectives of service

members on behaviors leading to HAMV, and Table 3 depicts the results developed from

the viewpoints of service members on the role of the VA in addressing HAMV. Also,

Table 4 describes the results generated from the perspectives of service members on local

communities’ support of homeless veterans, and Table 5 portrays the results developed

from the perspectives of service members on the pole of homeless veterans to have a

permanent home. Finally, Table 6 shows the results generated from the views of service

numbers on other programs required to combat HAMV.

Table 1

Service Members’ Perspectives on the Risk Factors of HAMV

Perspectives

Results

No plan

to adapt

civilian

life (6)

Lack of

education

(3)

Ineffectiv

transition

program

(3)

Lack

knowledge

of VA

resources

(1)

Lack of

preparedn

ess

Substan

abuse

(5)

Reliant on

military to

provide

every need

(3)

Aftermat

h of

divorce

(2)

Dishonora

ble

discharge

from

military

(1)

Effect

milita

career

(1)

Unwillingn

ess to seek

help (1)

Conseque

nce of

military

service

Mental

health

illness

(9)

Stigma of

mental

health

illness (1)

Mental

health

decline

Financi

hardshi

p (5)

Loss of

benefits like

steady salary

and

accommodat

ion from the

military (3)

Military

skills not

transition

to civilian

employm

ent (2)

Financial

difficulty

Lack of

family

support

(4)

Loss if

cohesive

team (1)

Lack of

mentorshi

p after

transition

from the

military

(1)

Absence

of support

system

Note. The last column shows the results developed from the corresponding perspectives

of service members on the risk factors of HAMV.

Table 2

Service Members’ Perspectives on Behaviors of Homeless Veterans that could Lead to

the Problem

Perspectives

Results

Egotism-to seek

assistance (1)

Prideful-to

accept certain

employment

(1)

Hesitancy

to ask for

assistance

(1)

Inability to

work with

others (1)

Defiant

“acting

out in a

sense”

(1)

Inhibiting

behaviors

Reliant on

military to

provide every

need (1)

Nonchalant (1)

Laid-back,

not taking

initiative

(1)

Not taking steps

to be self-

sufficient

Alcoholism and

substance abuse

(1)

Alcoholism-

could lead to

dishonorable

discharge (1)

Alcoholism

Fiscal

irresponsibility,

“live beyond

their means” (1)

Fiscal

irresponsibility,

“live beyond

their means”

Altruism-leaders

not taking care

of themselves (1)

Altruism-leaders

not taking care

of themselves

Note. The last column shows the results developed from the corresponding perspectives

of service members on behaviors leading to HAMV.

Table 3

Service Members’ Perspectives on the Role of VA in Addressing HAMV

Perspectives

Results

Lack of quality care

(3)

Access to care

limited (2)

Offer

counseling on

drug and

alcohol

addictions (1)

Improve its

programs (1)

Improvement

on healthcare

Inadequate

information on

resources (4)

Assisting

homeless

veterans to

acquire

permanent

homes (1)

Not helping

homeless

veterans to

purchase

homes (1)

Inadequate

information on

resources

VA is understaffed

(1)

Lack funding

for VA (1)

No financial

assistance to

homeless

veterans in

high cost

living areas

(1)

Under funding

Bad customer

service (1)

Bad customer

service

Note. The last column shows the results developed from the corresponding perspectives

of service members on the role of the VA in addressing HAMV.

Table 4

Service Members’ Perspectives on Local Communities Support of Homeless Veterans

Perspectives

Results

Serve meals (4)

Provide shelter (3)

Provision of meal

and temporary

shelter

Offer educational

counseling (2)

Offer job trainings

(1)

Assist in job search

(1)

Education and job

placement

assistance

Veterans of Foreign

Wars (VFW) assist in

addressing mental health

illness (1)

Resilience training

(1)

Mental health

counseling (1)

Provide counseling

on mental health

Offer discount on certain

goods and services (1)

Offer low interest on

mortgage (1)

Offer savings

programs

Note. The last column shows the results developed from the corresponding perspectives

of service members on local communities’ support of homeless veterans.

Table 5

Service Members’ Perspectives on the Role of Homeless Veterans in Addressing the

Problem

Perspectives

Results

Enroll in VA programs (8)

Take advantage of the

military transition

program (1)

Enroll in government

programs

Get a job (1)

Get a job and be

financially responsible (1)

Seek employment

opportunities

Enroll in education and training

in communities they live (1)

Enrollment in education

and training in

communities they live

Form a group to demand

assistance from the government

(1)

Form a group to demand

assistance from the

government

Note. The last column shows the results developed from the corresponding perspectives

of service members on the role of homeless veterans to have permanent home.

Table 6

Service Members’ Perspectives on Other Programs to Combat HAMV

Perspectives

Results

Allow to

participate in

the transition

program after

separation from

the military (1)

Secure

employment

for veterans

through the

transition

program (1)

Maximize/enforce

participation in

the transition

program (1)

Educate

recruits on

the

importance

transition

program

(1)

Develop

foreclosure

prevention

program

(1)

Develop

program

determine

the root

cause of

problems

like drug

addiction

(1)

Effectively

implement

existing and

establish

programs like

“exist plan”

development by

recruit

Participate in

home building

projects (1)

Partnership

between

local

communities

and

homeless

veterans (1)

Provide career

planning and

stress

management

services (1)

Provide

educational

and job

trainings

for service

members

(1)

Homeless

veterans

participation in

programs like

home building

Financial

counseling and

transfer of

military

experience to

civilian

employment (1)

Provide

financial

assistance

for homeless

veterans (1)

Provide funding to

treat mental health

illness (1)

Provide

funds/grant

to build

homes for

homeless

veterans

(1)

Increase VA

budget

Communication

channel

between the

veterans and

military (3)

Communication

channel

between the

veterans and

military

Note. The last column shows the results developed from the corresponding perspectives

of service numbers on other programs required to combat HAMV

Data Analysis

I followed the five coding steps provided by Adu, 2019. These steps are: decide

on the coding strategy, label the interview questions, search for relevant information in

the data, create/define labels, and assign labels to the relevant information. I used a

descriptive-focused coding strategy to code the data collected for this study. I used this

strategy because the participants offered direct answers to the interview questions on why

their veteran colleagues experience homelessness. Also, the relevant information from the

data provided by the participants to the interview questions were easily recognizable

(Adu, 2019). Using this strategy, I developed a word or phrase to describe relevant

information necessary to answer this study’s interview questions.

I labeled every research question to facilitate the coding process. For example, the

5th research question (What are your perspectives on why your veteran colleagues end up

homeless?) was labeled a cause of homelessness. This process enhanced the

development/arrangement of the codes and, subsequently, themes. After the steps

mentioned above, I used Microsoft Word to review the research data by assigning codes

to depict relevant information to the interview question.

These codes were then categorized to develop themes using the individual-based

sorting strategy. Under this strategy, there are five steps: compiling the codes, arranging

the codes alphabetically, consolidating similar codes with parenthesis, sorting the codes,

and labeling similar codes (clusters), meaning developing themes (Adu, 2019).

See below for four of the steps:

Compile the codes:

Causes of homelessness: Mental health illness

Behaviors of homeless veterans: Inability to work with others

Local communities’ assistance: Offer low interest on mortgage

Arrange the codes alphabetically:

Causes of homelessness: Mental health illness

Behaviors of homeless veterans: Inability to work with others

Local communities’ assistance: Offer low interest on mortgage

Consolidate the codes:

Causes of homelessness: Mental health illness (2)

Behaviors of homeless veterans: Inability to work with others (1)

Local communities’ assistance: Offer low interest on mortgage (1)

Sorting codes:

I then grouped (clustered) with a parenthetical mark ( ) the number of times the

same code appears during the data analysis process. For example, mental health illness

(2).

I established the following codes and categories from interview question 5 (What

are your perspectives on the risk factors of HAMV): no plan to adapt to civilian life, lack

of education, ineffective transition program, lack knowledge of VA resources, mental

health illness, the stigma of mental health illness, financial hardship, loss of benefits like

steady salary/accommodation from the military, military skills not transition to civilian

employment, substance abuse, reliant on the military to provide every need aftermath of

divorce, dishonorable discharge from the military, the effect of a military career,

unwillingness to seek help, lack of family support, loss of cohesive team, and lack of

mentorship after the transition from the military.

From those codes and categories, I developed the following five themes: (a) lack

of preparedness, (b) the consequence of military service, (c) mental health decline, (d)

financial difficulty, and (e) absence of a support system.

I established the following codes and categories from interview question 6 (Do

you think the behaviors (traits) of homeless veterans could lead to the problem?): Defiant

“acting out in a sense,” alcoholism and substance abuse, and alcoholism-could lead to a

dishonorable discharge, egotism-to seek assistance, prideful-to accept certain

employment hesitancy to ask for help, inability to work with others, reliant on the

military to provide every need, calm, laid-back, not taking the initiative, defiant “acting

out in a sense,” fiscal irresponsibility-”live beyond their means,” and altruism-leaders not

taking care of themselves.

From those codes and categories, I developed the following five themes: (a)

inhibiting behaviors, (b) not taking steps to be self-sufficient, (c) alcoholism, (d) fiscal

irresponsibility, and (e) altruism.

As stated previously, altruism (leaders not taking care of themselves), lousy

customer service, and group formation to demand assistance from the government are a

few of the discrepant cases. Also, skills acquired in the military, not transfer to civilian

employment, and recruits should develop “exit plan” to transition from the army were

discrepant cases discovered during the coding phase of this study.

I factored the discrepant cases in developing themes for a given set of codes. For

example, lack of planning emerged as the primary theme from analyzing the responses to

the research question on why veterans become homeless. The discrepant case that recruits

ought to create a transition plan formed part of the theme development.

Evidence and Trustworthiness

I took the following steps to establish this study’s credibility: I reviewed 50

literature on HAMV to gain knowledge on the research topic. Also, using the snowball

technique, the participants that could provide rich information on HAMV based on the

same military experience they shared with the homeless veterans were recruited. These

two processes contributed in part to establishing credibility in this study. Also, I provided

the reference to the information presented in the study. Additionally, I offered every step

to conducting this study’s code strategy and data analysis. I established that the process

and analysis are based on the information provided by the participants by using

audiotape. Lastly, themes are developed after evaluating all the research data.

This study’s transferability is established by ensuring alignment among its

problem, purpose, methodology, and data collection technique. For example, this

research problem is the lack of service members’ views on HAMV; its purpose is to find

their opinions, using qualitative research method, and interview the data collection

instrument. Also, I provided the reasons for choosing this research coding strategy,

developing the themes, and determining the results. By providing the above steps, the

results of this study could be transferred to other research activities using similar

measures and the methodology described in this study.

I ensured dependability in this study by documenting and maintaining every

procedure and document regarding the research; the recruitment flyers, invitation letters,

audiotape, interview transcripts, and the reason for adopting the descriptive-focused

coding strategy. The recruitment flyers and invitation letters were distributed by emailing

my friends/colleagues to invite them forward the flyers and letters to the likely

participants (service members) for the research. Also, I documented the processes of

categorizing the codes, data analysis procedure, themes development. Also, saved the

signed informed consent forms, approved Walden University Form C (Ethics self-check

application for IRB), unconditional approval letter to conduct this study. For example, as

part of the IRB approval process, a detailed data collection plan is required.

Consistency in the results of this study is based on thorough coding and data

analysis. As stated before, I used coding and data analysis methods developed by Adu

(2019). For example, I used a descriptive-focused coding strategy because the

participants offered direct answers to the interview questions on why their veteran

colleagues end homeless. Furthermore, I labeled every research question to facilitate the

coding process. These codes were then categorized to develop themes using the

individual-based sorting strategy.

Also, I conducted a member check step to determine if the results represent the

participants’ opinions during the interview (Birt et al., 2016). I provided all the

participants with the findings developed based on their perspectives during their

interview sessions. I requested that they verify if the findings represented the

perspectives. Except for one (7.25%) participant that has not responded, fifteen (93.75%)

participants responded that the findings represented their perspectives. Also, following

this study’s coding and analysis, the results of why some military veterans are homeless

are based on the information the participants provided during the interview sessions.

Results

Summary of the answers and findings to interview question 5:

(What are your perspectives on the risk factors of HAMV?)

Among the participants interviewed for this study, 37.5% said lack of planning to

adapt to civilian life after the transition from the military, 18.75% of them believed lack

of education, 18.75% of the interviewees stated ineffective transition program. In

comparison, 6.25% of the subjects said lack of knowledge of the VA resources available

to homeless veterans, 31.25% of the participants believed substance abuse, and 18.75%

said reliant on the military to provide every need (accommodation, medical care).

Precisely 12.5% noted the aftermath of emotional events like divorce, 6.25% pointed out

that the consequence of dishonorable discharge from the military, 6.25% said the effect

of a military career, and 6.25% mentioned the unwillingness of homeless veterans to seek

help are some the causes of HAMV.

Furthermore, 56.25% of the subjects said mental health illness, 6.25% commented

on the stigma of mental health illness, and 31.25% cited financial hardship. Also, 18.75%

believed the loss of benefits such as steady salary from the military, 12.5% noted the

skills like infantry is not readily transferred to civilian employment, and 25% maintained

a lack of family. Additionally, 6.25% said the loss of a cohesive team, and 6.25% cited

lack of mentorship after the transition from the military are some of the risk factors of

HAMV.

From the responses to interview question 5, I developed the following five

themes: (a) 81.25% of the participants said lack of preparedness to transition from the

military, (b) 81.25% believed in consequence of military service, (c) 62.5% stated mental

health decline, (d) 62.5% said financial difficulty, and (e) 37.5% thought the absence of a

support system caused HAMV.

Summary of the answers and findings to interview question 6:

(Do you think the behaviors (traits) of homeless veterans could lead to the

problem?)

According to the participants, the following are some of the behaviors that could

lead to HAMV if not controlled: defiant “acting out in a sense,” alcoholism/substance

abuse, egotism (resulting in not seeking assistance when needed), and prideful causing

some veterans not to accept certain employments, Also, hesitancy to ask for help,

inability to work with others, calm, laid-back (not taking the initiative), and fiscal

irresponsibility (“live beyond their means”). Furthermore, altruism (leaders not taking

care of themselves). It should be noted behaviors like alcoholism are not allowed in the

military because service members are held in part to higher standards. So, behaviors such

as alcoholism could lead to a dishonorable discharge from the military, making the

service members involved to be ineligible for certain benefits.

From the responses to interview question 6, I developed the following five

themes: (a) 31.25% of the participants believed in inhibiting behaviors like hesitancy to

seek assistance, (b) 18.75% said not taking steps to be self-sufficient, (c) 12.25% stated

alcoholism, (d) 6.25% mentioned fiscal irresponsibility, and (e) 6.25% cited leaders not

taking care of themselves as some of the behaviors that could ultimately lead to HAMV.

Summary of the answers and findings to interview question 7:

(Assess the U.S. Department of Veterans Affairs’ role in addressing HAMV)

The participants interviewed for this study were asked to assess the VA’s role in

addressing homelessness among their veterans’ colleagues. 25% said the VA is not

providing adequate information on how the homeless veterans can access the resources

available to address the problem. In addition, 6.25% stated the VA should assist the

veterans in acquiring permanent homes. Also, 6.25% believed the department is

understaffed/lacks funding, 18.75% noted the VA does not provide quality medical care

to the veterans, and 12.5% raised concern over access to care.

From the responses to interview question 7, I developed the following four

themes: (a) improvement on healthcare, (b) inadequate information on resources, (c)

underfunding, and (d) lousy customer service. For example, the medical care provided by

the VA ought to be improved by providing quality healthcare, removing the bureaucratic

barrier to access to care, and providing counseling on drug and alcohol addictions. Also,

the VA is called upon to provide adequate information to homeless veterans on the

various resources the department developed to address homelessness.

Summary of the answers and findings to interview question 8:

(How do local communities support your homeless veteran?

The participants were asked to assess the role of local communities in supporting

homeless veterans. According to the subjects, communities serve meals, provide shelter,

offer educational counseling, conduct job training/assist in job search, and provide

resources on mental health treatment through organizations like the Veterans of Foreign

Wars. Furthermore, Local communities offer resilience training, offer a discount on

certain goods and services.

From the responses to interview question 8, I developed the following four

themes: (a) provision of meal and temporary shelter, (b) education, and job placement

assistance, (c) counseling on mental illness, and (e) savings programs to homeless

veterans.

Summary of the answers and findings to interview question 9:

(Which roles do homeless veterans play in addressing the problem?)

The participants were asked to assess the role of homeless veterans in addressing

the problem of homelessness. Half of the subjects said the veterans should enroll in VA

programs developed to address the issue, apply for jobs, enroll in programs offered by the

communities they live in, and form a group in their respective districts to demand

assistance from the government.

From the responses to interview question 9, I developed the following four

themes: (a) participate in government programs, (b) seek employment opportunities, (c)

enroll in education/training within the community, and (e) form a group to demand help

from the VA to address the problem of homelessness.

Summary of the answers and findings to interview question 10:

(Describe other programs you think should be developed to combat HAMV?)

The following are some of programs that the participants suggested to address

HAMV: (a) communication channel between the veterans and military, (b) participation

in the transition program after separation from the military, (c) maximize/enforce

participation in the transition program, (d) educate recruits on the vital transition

program, (e) direct recruits to develop a transition plan, (f) build a foreclosure prevention

program, (g) participate in home building projects, (h) partner with local communities

and homeless veterans, (i) provide career planning and stress management services, (j)

offer more educational and job training for service members, and (k) provide funding to

treat mental health illnesses.

From the responses to interview question 10, I developed the following three

themes: (a) effectively implement existing programs designed to address homelessness,

(b) participation of homeless veterans in programs like home building, and (c) increase in

VA budget.

Summary

This study is conducted to discover service members’ opinions on why veteran

colleagues end up homeless in Maryland and Virginia. After the detailed data analysis

described above in sections 435 to 439, I developed the following five results: lack of

preparedness to transition/adapt to civilian life after separation from the military, the

impact of military service, mental health illness, financial difficulty, and absence of

support system.

The first result of this study is the lack of a plan to function as civilians.

According to the participants, some veterans depend on the military for benefits like

stable salaries, accommodation, and healthcare. After discharge from the service, some

veterans cannot maintain the military’s lifestyle while serving. Also, ineffective transition

programs offered by the army, lack of education, and absence of information on VA

resources further contributed to veterans’ lack of preparedness to adapt appropriately to

civilian life. For example, the transition program does not ensure service members have

the offer of employment before separation from the military. The program partly provides

services such as assistance with resume writing and information on VA resources.

The second result of this study is the consequence of service in the military. One

of the values the military promotes is esprit de corps (comradely). When not adequately

adopted, this value could lead to negative peer pressure resulting in tobacco use and

substance abuse habits. Mental health illnesses like TBI is the third result of this study the

injury is connected to a decrease in income and social support among the veterans and

subsequently increases the susceptibility of the veterans to homelessness.

Financial difficulty is the fourth result of this study. Some veterans are

experiencing an economic problem because they “live beyond their means” and lose of

steady salary after the transition from the military. As stated before, some veterans cannot

maintain the lifestyle the military provides to them while serving.

The absence of a support system is the fifth result of this study. For example, lack

of support from family members like parents/spouse, loss of cohesive team veterans were

part of, and lack of mentorship exposed to while serving in the military. I was surprised

that the lack of preparedness was the main result of this study.

In chapter 5, I will discuss the following topics: interpretations of the above

findings, description of the limitations to trustworthiness, recommendations for further

research, implications of this study regarding positive social change, reflection on my

experience as a researcher like possible personal biases, and concluding statement on this

study.

Chapter 5: Discussion, Conclusions and Recommendations

Introduction

The purpose of this study was to discover and explore the perspectives of service

members on why veteran colleagues experience homelessness. I used a case study design

for this research because it allowed the service members to share their perspectives on

HAMV during interviews. The study was conducted to fill a gap in the existing literature

on HAMV by adding the views of service members. Hopefully, the findings that emerge

from this study can help to facilitate policy development to address HAMV. The results

of this study could be beneficial to the VA and other organizations for developing

policies and procedures to address the problem of HAMV.

I conducted interviews to collect data for this study. I interviewed one participant

face to face and interviewed 15 participants on the phone. I collected signed informed

consent forms from all participants prior to the interviews. I discussed the interview

protocol with the participants, informing them of the purpose of the research, interview

questions to be expected, confidentiality, and the right to withdraw from the interview.

On average, each interview lasted for 1 hour.

Through analysis of the data collected from interviews with service members, risk

factors for HAMV were identified as (a) lack of preparedness, (b) the consequence of

military service, (c) mental health decline, (d) financial difficulty, and (e) absence of

support system. In addition, inhibiting behaviors like pride in not accepting certain

employment options, alcoholism, living beyond one’s means, and leaders taking care of

subordinates at the expense of planning for their own transition from the military were

behaviors identified as having the potential to lead to HAMV.

The findings suggest that VA could improve health care for homeless veterans by

expanding access to care, providing information on existing resources, and requesting

more funding for its programs. Local communities continue to support homeless veterans

by providing meals, temporary shelter, job placement assistance, counseling on mental

health, and savings programs. In addition, homeless veterans should continue to enroll in

government programs, seek employment opportunities, and form a group to demand

assistance from the government to complement these efforts. Lastly, to augment these

efforts, leaders must implement programs effectively and encourage service members,

mainly recruits, to develop a transition plan when separating from the military.

Interpretation of the Findings

Lack of preparedness to transition from the military and consequences of military

service, like the stress on marriage of service members that could lead to divorce, are risk

factors of HAMV. Also, mental health decline, financial difficulty, and the absence of a

support system that some veterans struggle with could contribute to the problem. I based

these assessments on data such as no plan to adapt to civilian life, ineffective transition

plan, lack of knowledge of available VA resources, and lack of mentorship after the

transition from the military.

This study’s findings and the peer-reviewed literature confirmed that mental

health illness is a risk factor for HAMV. The literature revealed that diagnosis of mental

health disorder, TBI, childhood adversity, and abuse were predictors of homelessness

among veterans (Dinnen et al., 2014). To assimilate properly to civilian life after service

in the military can be challenging because some service members do not prepare for the

transition. Some may not take advantage of the educational opportunities available in the

military that could lead to lucrative employment. Lack of jobs for these individuals

means no steady income, which could lead to homelessness.

Inhibiting behaviors like egotism to seek assistance, not taking steps to be self-

sufficient, alcoholism, and fiscal irresponsibility are behaviors that could be risk factors

of HAMV based participants’ perspectives on behaviors that could lead to homelessness.

Pride for not accepting particular employment and hesitancy to ask for assistance both

can contribute to HAMV. Additionally, being reliant on the military to meet an

individual’s needs and defiance are behaviors that could lead to HAMV. This study’s

findings and the literature confirm that financial difficulty is a risk factor of HAMV. For

example, I discovered through the data collected from participants that some service

members live beyond their financial means. Similarly, Elbogen et al., (2013) identified

that many homeless veterans had experienced difficulty managing money.

Alcoholism was identified as a behavior that could potentially contribute to

HAMV based on the perspectives of service members interviewed. In the military,

service members could be separated dishonorably for repeated offenses related to

substance abuse. In most cases, these service members lose benefits they would otherwise

qualify for, which could then contribute to their inability to support themselves and

secure stable housing.

The participants shared the following perspectives on the assessment of the VA in

addressing HAMV: (a) improvement on healthcare, (b) inadequate information on

resources, (c) lack of funding, and (d) bad customer service. For example, 18.75% of the

participants indicated they believe the VA does not provide quality care, 12.50% said

access to care is limited, and 6.25% urged the department to offer counseling on drug and

alcohol addictions to veterans affected by these conditions. In addition, participants

indicated the VA is not providing enough information to homeless veterans on various

programs available to them. Participants said the VA is understaffed and does not provide

financial assistance to homeless veterans to offset the expenses of veterans living in high

cost areas.

This study’s findings support the literature that homeless veterans face a

challenge in accessing healthcare. For example, the literature revealed that access to

medical services like mental health care is impacted negatively by the complexity of the

VA healthcare system. As Gawron et al. (2017) found, the nearest VA hospital to over

9,000 homeless women veterans who live in rural areas is more than 40 miles away,

which can make access to services prohibitive.

Based on participants’ responses, local communities are supporting homeless

veterans by serving meals and providing temporary shelters, job placement assistance,

and counseling on mental health illness. Participants indicated that local organizations

offer homeless veterans numerous resources. Some of these supports are resilience

training and discounts on certain goods and services. Organizations like the VFW provide

various services to homeless veterans. However, the extant literature indicates that

minimal coordination occurs between the state and local agencies, leaving homeless

veterans to travel long distances to access care (Tsail et al., 2015).

Local organizations like the Salvation Army provide temporary shelters and hot

meals. One of the objectives of this organization is to help homeless veterans to become

self-sufficient and obtain affordable housing. Some local churches serve meals to

homeless veterans and other homeless people in the community. Habitat for Humanity

provides services like specialized treatment for PTSD, anxiety, and depression to

veterans.

The participants shared the following perspectives on the roles of homeless

veterans in having permanent homes: (a) enroll in government programs, (b) seek

employment opportunities, (c) participate in the training opportunities that are available

in the local communities, and (d) forming pressure groups. The following are two of the

programs that are available to qualified homeless veterans: (a) PTSD residential

rehabilitation and (b) substance use residential rehabilitation programs. Information about

VA programs could be obtained by calling the VA customer service toll-free number at 1

(877) 424-3838.

Effective implementation of existing programs like the SFL-TAP, development of

“exit plan,” participation in programs like home building, and increase in VA budget to

fund its different programs adequately could help address HAMV

Participants shared the following opinions on other programs required to address

HAMV: (a) participation in the transition programs after separation from the military, (b)

provision of employment assistance to veterans, (c) educate recruits on transition

program, (d) develop a foreclosure prevention program, (e) develop a program to

determine the root cause of problems like drug addiction, (f) participate in home building

projects (g) partnership with local communities to provide career planning assistance, (h)

stress management services, and (i) job training.

Limitations

I changed my partner site as a result of the coronavirus 2019 pandemic. Also, I

changed the research methodology from a phenomenological approach to a more

appropriate approach (case study). I devoted a lot of time to changing partner sites,

research methodology, and applying for a change in research procedure from the Walden

University IRB.

Recommendations

Further research could explore homelessness in specific races/ethnicity in the

military to determine whether a particular group is susceptible to the problem than other

groups. Also, subsequent studies could investigate any correlation between the length of

service (years in the military) and HAMV. Later research could examine why service

members are not prepared to separate from the military. Further study could investigate

the root causes of the risky behaviors discovered in this study. Subsequent research could

examine the factors preventing the equitable distribution of VA resources in addressing

HAMV.

The policymakers at the departments of the Army, VA, and service members need

to pay attention to the results of this study. I would disseminate the results by providing

an executive summary (1 page) to the participants and publishing the dissertation in

ProQuest.

Implications for Social Change

Implications for positive social change include increased awareness of the risk

factors of HAMV that were discovered in this study. Again, the study was conducted to

fill a gap in the existing literature on HAMV by adding the views of service members.

The discovery is essential to public policy and administration because it could facilitate a

better understanding of HAMV. Policymakers could consider the findings of this study

during the policy deliberation on HAMV.

The literature review conducted for this study reveals a correlation between

failing mental health and homelessness. Arguably, the problem of homelessness is

worsening because there are not enough resources to address the issue. In addition, this

study discovers that lack of preparedness to transition from the military is one of the risk

factors HAMV.

This study discovered that lack of preparedness to transition/adapt to civilian life

after separation from the military, the impact of military service, mental health illness,

financial difficulty, and absence of support system are some of the risk factors of HAMV.

The participants believed while serving, veterans depend on the military for

benefits like stable salary, accommodation, and healthcare. After discharge from the

service, some veterans cannot maintain the benefits. Also, ineffective transition programs

offered by the Army, lack of education, and absence of information on VA resources

further contributed to veterans’ lack of preparedness to adapt appropriately to civilian

life.

Dinnen et al. (2014) said veterans diagnosed with mental health conditions such

as TBI struggled with daily activities. The TBI could negatively impact the ability of the

veterans to find and maintain employment. The TBI, if not treated, may ultimately

increase the susceptibility of the veterans to homelessness. Also, this study discovered

that some veterans are experiencing an economic problem because they “live beyond

their means,” one of the participants argued.

Furthermore, lack of social support from family members like parents/spouse, loss

of cohesive team, and lack of mentorship that veterans experienced while in the Army

combined with factors discovered above could lead to homelessness. Overall, it can be

deduced from the above strengths that there is no single risk factor but rather a

combination of risk factors of HAMV.

One of the empirical implications of this study related to positive social change is

the introduction of seminars. These lectures should focus on developing individualized

transition plans and how service members can promptly enroll in the VA programs before

separating from the military. These topics will address some of this study’s participants’

perspectives that veterans do not have plans to adapt to civilian life and lack knowledge

of some VA resources/programs on homeless veterans.

Also, the Army, VA, and groups such as Habitat for Humanity should establish or

strengthen, if any, the existing partnership among them. The partnership would foster

awareness on mental health illness, proven strategies necessary to cope with emotional

significance events like divorce and loss of loved ones. Also, introducing a mentorship

program to coach veterans facing challenges in assimilating to civilian life is vital.

Veterans that have effectively adapted to civilian life should be encouraged to lead this

initiative.

The Army and VA should continue to expand access to care by establishing a

partnership with local healthcare providers, particularly in rural communities. The

partnership is necessary to intensify VA’s outreach campaign on educating homeless

veterans to enroll in different programs developed to address HAMV. Additionally,

service members should develop plans required to adapt to civilian.

Also, local communities like VFW should continue to offer counsel on mental

health illnesses. Churches should continue to serve meals (soup kitchens) to homeless

veterans and set up programs to encourage homeless veterans to be self-sufficient by

enrolling in vocational training. Lastly, homeless veterans should continue to enroll in

government and non-government programs designed to address HAMV.

Reflection of the Researcher

I followed the interview protocol during the data collection by recording every

interview session and ensuring that the coding and data analysis was based on the tape's

transcript. I prevented subjectivity in this research by adopting the descriptive-focused

coding and data analysis strategies introduced by Adu (2019). I conducted a member

checking that resulted in 92.5% of the participants verifying the accuracy of the analyses

of the information from their interview sessions. Lastly, I did not disclose my status as a

service member in my correspondence with the participants to prevent the influence.

Conclusion

Axon et al. (2016) said in 2013, approximately 57,849 veterans were homeless, 33

of every 10,000 veterans experienced homelessness at least one night, and 60 of every

10,000 veterans experienced homelessness in one year. Also, O’Toole and Pape (2015)

remarked 1 in 3 homeless people were veterans. The VA set a goal of ending HAMV in 5

years. Unfortunately, the VA has not achieved the goal. For example, in “a Single Night

in January 2020, 37,252 veterans were experiencing homelessness in the U.S., eight

percent of all homeless adults. Of every 10,000 veterans in the United States, 21 were

experiencing homelessness” (U.S. Housing and Urban Development, 2021, p. 52).

The solutions previously proposed to end HAMV did not include the perspectives

of service members. This study used a qualitative case study methodology, interview as

the data collection instrument, descriptive-focused coding to analyze the research data.

Policymakers could adopt the findings of this study in developing policies and processes

to address HAMV.

The VA ought to improve its healthcare quality and streamline access to care.

Also, the local community should continue to serve meals, provide temporary shelter,

offer job placement assistance, and provide counseling on mental health. Lastly,

effectively implement the existing VA programs developed to address HAMV and

educate homeless veterans to take advantage of these programs.

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Appendix A: Invitation Letter

You are invited to take part in a research study about the Service Members’

Perspectives on Veteran Homelessness in Maryland and Virginia. The researcher is

inviting service members to be in the study.

This study is being conducted by a researcher named Mr. Olasunkanmi Amosu,

who is a doctoral student at Walden University. The study involves just an audio

recorded interview without using your (participant) name. Also, the interview will not use

your (participant) name in the audio recording. Please note, all prospective participants

have the option to accept or decline this invitation. If interested contact me at the

information below.

Name: Mr. Olasunkanmi Amosu

Doctoral Candidate of Public Policy and Administration

School: Walden University

Program with Specialization in Public Policy

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Appendix B: Interview Protocol

Research Title: Service Members’ Perspectives on Veteran Homelessness in Maryland

and Virginia

Interviewer (Researcher) Name: Mr. Olasunkanmi Amosu

Interviewee (Service Member) Name: _________________________________________

Interview Date: ___________________________________________________________

Introductory Protocol

Welcome and thank you for your participation in today’s interview. My name is

Mr. Olasunkanmi Amosu and I am a doctoral student at Walden University conducting

my research project in partial fulfillment of the requirements for the degree of Doctor of

Philosophy (PhD) in Public Policy and Administration. This interview is divided into

three sessions: Service Members’ Background Information, Service Members’

Perspectives on Veteran Homelessness, and Closing Comments. It is planned to last no

longer than one hour. During this time, I have several interview questions I would like to

cover. If time begins to run short, it may be necessary to interrupt you to complete the

questioning.

I would like your permission to tape record this interview, so I may accurately

document the information you convey. If at any time during the interview you wish to

discontinue the use of the recorder or the interview itself, please feel free to let me know.

All of your responses will remain confidential. The purpose of this study is to ascertain

your perspectives on veteran homelessness.

Your participation in this interview is completely voluntary. If at any time you

need to stop or take a break, please let me know. You may also withdraw your

participation at any time without consequence. Do you have any questions or concerns

before we begin? Then with your permission we will begin the interview.

Section 1: Service Members’ Background Information

1. Why did you join the military?

2. How long have you being serving in the military?

3. Briefly describe your experience in the military

4. Describe homelessness among your veteran colleagues

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Section 2: Service Members’ Perspectives on Veteran Homelessness

5. What are your perspectives on the risk factors of HAMV?

6. Do you think the behaviors (traits) of homeless veterans could lead to homelessness?

7. Assess the U.S. Department of Veterans Affairs’ role in addressing HAMV.

8. How do local communities support your homeless veteran?

9. Which roles do homeless veterans play in addressing the problem?

10. Describe some of the programs you think should be developed to combat HAMV?

Section 3: Closing Comments

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Appendix C: CITI Course Completion Certificate