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Background & Statistics
FAQ About Homeless VeteransHomeless Veterans
FactsDemographics of Homeless VeteransIncarcerated
VeteransResearch BriefsSources
FAQ ABOUT HOMELESS VETERANS
Who are homeless veterans?
The U.S. Department of Veterans Affairs (VA) states that the
nation’s homeless veterans are predominantly male, with
roughly 9% being female. The majority are single; live in urban
areas; and suffer from mental illness, alcohol and/or substance
abuse, or co-occurring disorders. About 11% of the adult
homeless population are veterans.
Roughly 45% of all homeless veterans are African American or
Hispanic, despite only accounting for 10.4% and 3.4% of the
U.S. veteran population, respectively.
Homeless veterans are younger on average than the total veteran
population. Approximately 9% are between the ages of 18 and
30, and 41% are between the ages of 31 and 50. Conversely,
only 5% of all veterans are between the ages of 18 and 30, and
less than 23% are between 31 and 50.
America’s homeless veterans have served in World War II, the
Korean War, Cold War, Vietnam War, Grenada, Panama,
Lebanon, Persian Gulf War, Afghanistan and Iraq (OEF/OIF),
and the military’s anti-drug cultivation efforts in South
America. Nearly half of homeless veterans served during the
Vietnam era. Two-thirds served our country for at least three
years, and one-third were stationed in a war zone.
About 1.4 million other veterans, meanwhile, are considered at
risk of homelessness due to poverty, lack of support networks,
and dismal living conditions in overcrowded or substandard
housing.
How many homeless veterans are there?
Although flawless counts are impossible to come by – the
transient nature of homeless populations presents a major
difficulty – the U.S. Department of Housing and Urban
Development (HUD) estimates that 40,056 veterans are
homeless on any given night.
Approximately 12,700 veterans of Operation Enduring Freedom
(OEF), Operation Iraqi Freedom (OIF) and Operation New
Dawn (OND) were homeless in 2010. The number of young
homeless veterans is increasing, but only constitutes 8.8% of
the overall homeless veteran population.
Why are veterans homeless?
In addition to the complex set of factors influencing all
homelessness – extreme shortage of affordable housing, livable
income and access to health care – a large number of displaced
and at-risk veterans live with lingering effects of post-traumatic
stress disorder (PTSD) and substance abuse, which are
compounded by a lack of family and social support networks.
Additionally, military occupations and training are not always
transferable to the civilian workforce, placing some veterans at
a disadvantage when competing for employment.
A top priority for homeless veterans is secure, safe, clean
housing that offers a supportive environment free of drugs and
alcohol.
Doesn’t VA take care of homeless veterans?
To a certain extent, yes. Each year, VA’s specialized
homelessness programs provide health care to almost 150,000
homeless veterans and other services to more than 112,000
veterans. Additionally, more than 40,000 homeless veterans
receive compensation or pension benefits each month.
Since 1987, VA’s programs for homeless veterans have
emphasized collaboration with such community service
providers to help expand services to more veterans in crisis.
VA, using its own resources or in partnerships with others, has
secured nearly 15,000 residential rehabilitative and transitional
beds and more than 30,000 permanent beds for homeless
veterans throughout the nation. These partnerships are credited
with reducing the number of homeless veterans by 70% since
2005. More information about VA homeless programs and
initiatives can be found here.
What services do veterans need?
Veterans need a coordinated effort that provides secure housing,
nutritional meals, basic physical health care, substance abuse
care and aftercare, mental health counseling, personal
development and empowerment. Additionally, veterans need job
assessment, training and placement assistance.
NCHV strongly believes that all programs to assist homeless
veterans must focus on helping them obtain and sustain
employment.
What seems to work best?
The most effective programs for homeless and at-risk veterans
are community-based, nonprofit, “veterans helping veterans”
groups. Programs that seem to work best feature transitional
housing with the camaraderie of living in structured, substance-
free environments with fellow veterans who are succeeding at
bettering themselves.
Government money, while important, is limited, and available
services are often at capacity. It is critical, therefore, that
community groups reach out to help provide the support,
resources and opportunities that most Americans take for
granted: housing, employment and health care. Veterans who
participate in collaborative programs are afforded more services
and have higher chances of becoming tax-paying, productive
citizens again.
What can I do?
Determine the need in your community. Visit with homeless
veteran service providers. Contact your mayor’s office for a list
of providers, or search the NCHV database.
Involve others. If you are not already part of an organization,
align yourself with a few other people who are interested in
attacking this issue.
Participate in local homeless coalitions. Chances are, there is
one in your community. If not, this could be the time to bring
people together around this critical need.
Make a donation to your local homeless veteran service
provider.
Contact your elected officials. Discuss what is being done in
your community for homeless veterans.
back to top
HOMELESS VETERANS FACTS
DEFINITIONS, DEMOGRAPHICS AND ESTIMATED
NUMBERS
What is the definition of "homeless"?
The United States Code contains the official federal definition
of homelessness, which is commonly used because it controls
federal funding streams. In Title 42, Chapter 119, Subchapter 1,
"homeless" is defined as follows:
§11302. General definition of homeless individual
(a) In general
For purposes of this chapter, the term "homeless" or "homeless
individual or homeless person" includes––
an individual who lacks a fixed, regular, and adequate nighttime
residence; and
an individual who has a primary nighttime residence that is––
A. a supervised publicly or privately operated shelter
designed to provide
temporary living accommodations (including welfare hotels,
congregate shelters, and
transitional housing for the mentally ill);
B. an institution that provides a temporary residence for
individuals intended to be
institutionalized; or
C. a public or private place not designed for, or ordinarily
used as, a regular sleeping
accommodation for human beings."
Who is a veteran?
In general, most organizations use U.S. Department of Veterans
Affairs (VA) eligibility criteria to determine which veterans can
access services. Eligibility for VA benefits is based upon
discharge from active military service under other than
dishonorable conditions. Benefits vary according to factors
connected with the type and length of military service. To see
details of eligibility criteria for VA compensation and benefits,
view the current benefits manual here.
DEMOGRAPHICS OF HOMELESS VETERANS
11% of the homeless adult population are veterans
20% of the male homeless population are veterans
68% reside in principal cities
32% reside in suburban/rural areas
51% of individual homeless veterans have disabilities
50% have serious mental illness
70% have substance abuse problems
57% are white males, compared to 38% of non-veterans
50% are age 51 or older, compared to 19% non-veterans
back to top
INCARCERATED VETERANS
In May 2007, the Bureau of Justice Statistics released a special
report on incarcerated veterans. The following are highlights of
the report, “Veterans in State and Federal Prison, 2004,” which
assessed data based on personal interviews conducted in 2004:
Numbers and profiles:
There were an estimated 140,000 veterans held in state and
federal prisons. State prisons held 127,500 of these veterans,
and federal prisons held 12,500.
Male veterans were half as likely as other men to be held in
prison (630 prisoners per 100,000 veterans, compared to 1,390
prisoners per 100,000 non-veteran U.S. residents). This gap had
been increasing since the 1980s.
Veterans in both state and federal prison were almost
exclusively male (99 percent).
The median age (45) of veterans in state prison was 12 years
older than that of non-veterans (33). Non-veteran inmates (55%)
were nearly four times more likely than veterans (14%) to be
under the age of 35.
Veterans were much better educated than other prisoners.
Nearly all veterans in state prison (91%) reported at least a high
school diploma or GED, while an estimated 40% of non-
veterans lacked either.
Military backgrounds:
The U.S. Army accounted for 46% of veterans living in the
United States yet 56% of veterans in state prison.
In 2004, the percentage of state prisoners who reported prior
military service in the U.S. Armed Forces (10%) was half of the
level reported in 1986 (20%).
Most state prison veterans (54%) reported service during a
wartime era, while 20% saw combat duty. In federal prison two-
thirds of veterans had served during wartime, and one quarter
had seen combat.
Six in 10 incarcerated veterans received an honorable discharge.
Mental health:
Veteran status was unrelated to inmate reports of mental health
problems.
Combat service was not related to prevalence of recent mental
health problems. Just over half of both combat and non-combat
veterans reported any history of mental health problems.
Veterans were less likely than non-veteran prisoners to have
used drugs. Forty-two percent of veterans used drugs in the
month before their offense compared to 58% of non-veterans.
No relationship between veteran status and alcohol dependence
or abuse was found.
Convictions and sentencing:
Veterans had shorter criminal histories than non-veterans in
state prison.
Veterans reported longer average sentences than non-veterans,
regardless of offense type.
Over half of veterans (57%) were serving time for violent
offenses, compared to 47% of non-veterans.
Nearly one in four veterans in state prison were sex offenders,
compared to one in 10 non-veterans.
Veterans were more likely than other violent offenders in state
prison to have victimized females and minors.
More than a third of veterans in state prison had maximum
sentences of at least 20 years, life or death.
back to top
SOURCESThe 2016 Annual Homeless Assessment Report
(AHAR) to CongressVeteran Homelessness: A Supplemental
Report to the 2010 Annual Homeless Assessment Report to
Congress; Housing and Urban DevelopmentCongressional
Research Service Report for Congress: Veterans and
Homelessness; Libby Perl; February 2012Homeless Incidence
and Risk Factors for Becoming Homeless in Veterans; VA
Office of Inspector General; May 2012The 2012 Point-in-
Time Estimates of Homelessness, Volume 1 of the 2012 Point-
in-Time Annual Homeless Assessment Report; Housing and
Urban DevelopmentThe 2015 Point-in-Time Estimates of
Homelessness, Volume 1 of the 2015 Point-in-Time Annual
Homeless Assessment Report; Housing and Urban Development
Veteran in crisis? Dial 1.877.424.3838 for 24/7 assistance.
1730 M Street NW, Suite 705 | Washington, DC | 20036 | t-
f. 1.800.VET.HELP | v. 202.546.1969 | f.
202.546.2063 | [email protected]
Problem Solving Skills and Deficits Among Homeless
Veterans With Serious Mental Illness
Sonya Gabrielian, Elizabeth Bromley,
and Alison B. Hamilton
Veterans Affairs Greater Los Angeles, Los Angeles,
California, and University of California, Los Angeles,
David Geffen School of Medicine
Van T. Vu
University of California, San Francisco, School of
Medicine
Adrian Alexandrino Jr.
Gap
Solution
s, Inc., Herndon, Virginia
Ella Koosis
Veterans Affairs Greater Los Angeles, Los Angeles,
California
Alexander S. Young
Veterans Affairs Greater Los Angeles, Los Angeles, California,
and University of California, Los Angeles, David
Geffen School of Medicine
Few interventions train homeless consumers in housing-related
independent living skills. To
inform the development of such interventions for the
Department of Veterans Affairs’ Supported
Housing consumers with serious mental illness, we examined
these consumers’ problem-solving
skills and deficits. We performed semistructured interviews and
cognitive tests with 20 con-
sumers who retained housing for �1 year (“stayers”) and 20
consumers who lost housing in �1
year (“exiters”). Salient types of problems were identified in the
qualitative data; we categorized
problem-solving approaches by complexity level and identified
differences in problem-solving
complexity by consumers’ housing outcomes. Instrumental (e.g.,
money management), interper-
sonal, and health-related problems were prominent in
consumers’ narratives. Cognition was poor
among stayers and exiters. Problem-solving approaches were
highly relevant to day-to-day
functioning in supported housing. There was a trend toward
greater problem-solving complexity
in stayers versus exiters. These data explore potential
challenges faced in supported housing and
help inform the development of a Veterans Affairs-based
housing-focused skills training
intervention.
Public Policy Relevance Statement
Little is known about the problem-solving skills and deficits of
formerly homeless consumers
engaged in supported housing programs. To inform the
development of skills training
interventions for Veterans Affairs-supported housing
participants, this study highlights this
population’s salient types of problems and problem-solving
approaches.
This article was published Online First July 16, 2018.
Sonya Gabrielian, Elizabeth Bromley, and Alison B. Hamilton,
Center
for the Study of Healthcare Innovation, Implementation, and
Policy, Men-
tal Illness Research, Education, and Clinical Center, Veterans
Affairs
Greater Los Angeles, Los Angeles, California, and Department
of Psychi-
atry and Biobehavioral Sciences, University of California, Los
Angeles,
David Geffen School of Medicine; Van T. Vu, Department of
Family and
Community Medicine, University of California, San Francisco,
School of
Medicine; Adrian Alexandrino, Jr., Gap

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ABOUTWho is NCHVStaffBoard of DirectorsAnnual ConferenceHousing Sum.docx

  • 1. ABOUTWho is NCHV?StaffBoard of DirectorsAnnual ConferenceHousing SummitJob OpeningsContact UsNEWS & MEDIABackground & StatisticsMedia InformationPublicationsAll NewsPOLICY & LEGISLATIONWrite-UpsPosition StatementsActive LegislationCongressional TestimonySERVICE PROVIDERSGrantsIn-Kind ResourcesTechnical AssistanceStand DownStart a Vet ProgramTeleconferencesPost- Conference NotesCorporate ConnectionHELP FOR VETERANSLocate OrganizationImmediate HelpStep-by- StepReplacing RecordsFederal BenefitsWomen VeteransIncarcerated VeteransEMPLOYMENTGuides & ResourcesWomen VeteransGrantees & ProfilesJob SeekersGET INVOLVEDHow You Can HelpAdvocacyJoin NCHVDonateBackground & StatisticsMedia InformationPublicationsAll NewsCoalition Call SITE SEARCH
  • 2. Search Background & Statistics FAQ About Homeless VeteransHomeless Veterans FactsDemographics of Homeless VeteransIncarcerated VeteransResearch BriefsSources FAQ ABOUT HOMELESS VETERANS Who are homeless veterans? The U.S. Department of Veterans Affairs (VA) states that the nation’s homeless veterans are predominantly male, with roughly 9% being female. The majority are single; live in urban areas; and suffer from mental illness, alcohol and/or substance abuse, or co-occurring disorders. About 11% of the adult homeless population are veterans. Roughly 45% of all homeless veterans are African American or Hispanic, despite only accounting for 10.4% and 3.4% of the
  • 3. U.S. veteran population, respectively. Homeless veterans are younger on average than the total veteran population. Approximately 9% are between the ages of 18 and 30, and 41% are between the ages of 31 and 50. Conversely, only 5% of all veterans are between the ages of 18 and 30, and less than 23% are between 31 and 50. America’s homeless veterans have served in World War II, the Korean War, Cold War, Vietnam War, Grenada, Panama, Lebanon, Persian Gulf War, Afghanistan and Iraq (OEF/OIF), and the military’s anti-drug cultivation efforts in South America. Nearly half of homeless veterans served during the Vietnam era. Two-thirds served our country for at least three years, and one-third were stationed in a war zone. About 1.4 million other veterans, meanwhile, are considered at risk of homelessness due to poverty, lack of support networks, and dismal living conditions in overcrowded or substandard housing. How many homeless veterans are there? Although flawless counts are impossible to come by – the transient nature of homeless populations presents a major difficulty – the U.S. Department of Housing and Urban Development (HUD) estimates that 40,056 veterans are homeless on any given night. Approximately 12,700 veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) were homeless in 2010. The number of young homeless veterans is increasing, but only constitutes 8.8% of the overall homeless veteran population. Why are veterans homeless?
  • 4. In addition to the complex set of factors influencing all homelessness – extreme shortage of affordable housing, livable income and access to health care – a large number of displaced and at-risk veterans live with lingering effects of post-traumatic stress disorder (PTSD) and substance abuse, which are compounded by a lack of family and social support networks. Additionally, military occupations and training are not always transferable to the civilian workforce, placing some veterans at a disadvantage when competing for employment. A top priority for homeless veterans is secure, safe, clean housing that offers a supportive environment free of drugs and alcohol. Doesn’t VA take care of homeless veterans? To a certain extent, yes. Each year, VA’s specialized homelessness programs provide health care to almost 150,000 homeless veterans and other services to more than 112,000 veterans. Additionally, more than 40,000 homeless veterans receive compensation or pension benefits each month. Since 1987, VA’s programs for homeless veterans have emphasized collaboration with such community service providers to help expand services to more veterans in crisis. VA, using its own resources or in partnerships with others, has secured nearly 15,000 residential rehabilitative and transitional beds and more than 30,000 permanent beds for homeless veterans throughout the nation. These partnerships are credited with reducing the number of homeless veterans by 70% since 2005. More information about VA homeless programs and initiatives can be found here. What services do veterans need?
  • 5. Veterans need a coordinated effort that provides secure housing, nutritional meals, basic physical health care, substance abuse care and aftercare, mental health counseling, personal development and empowerment. Additionally, veterans need job assessment, training and placement assistance. NCHV strongly believes that all programs to assist homeless veterans must focus on helping them obtain and sustain employment. What seems to work best? The most effective programs for homeless and at-risk veterans are community-based, nonprofit, “veterans helping veterans” groups. Programs that seem to work best feature transitional housing with the camaraderie of living in structured, substance- free environments with fellow veterans who are succeeding at bettering themselves. Government money, while important, is limited, and available services are often at capacity. It is critical, therefore, that community groups reach out to help provide the support, resources and opportunities that most Americans take for granted: housing, employment and health care. Veterans who participate in collaborative programs are afforded more services and have higher chances of becoming tax-paying, productive citizens again. What can I do? Determine the need in your community. Visit with homeless veteran service providers. Contact your mayor’s office for a list of providers, or search the NCHV database. Involve others. If you are not already part of an organization, align yourself with a few other people who are interested in attacking this issue. Participate in local homeless coalitions. Chances are, there is
  • 6. one in your community. If not, this could be the time to bring people together around this critical need. Make a donation to your local homeless veteran service provider. Contact your elected officials. Discuss what is being done in your community for homeless veterans. back to top HOMELESS VETERANS FACTS DEFINITIONS, DEMOGRAPHICS AND ESTIMATED NUMBERS What is the definition of "homeless"? The United States Code contains the official federal definition of homelessness, which is commonly used because it controls federal funding streams. In Title 42, Chapter 119, Subchapter 1, "homeless" is defined as follows: §11302. General definition of homeless individual (a) In general For purposes of this chapter, the term "homeless" or "homeless individual or homeless person" includes–– an individual who lacks a fixed, regular, and adequate nighttime residence; and an individual who has a primary nighttime residence that is–– A. a supervised publicly or privately operated shelter designed to provide temporary living accommodations (including welfare hotels, congregate shelters, and transitional housing for the mentally ill);
  • 7. B. an institution that provides a temporary residence for individuals intended to be institutionalized; or C. a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings." Who is a veteran? In general, most organizations use U.S. Department of Veterans Affairs (VA) eligibility criteria to determine which veterans can access services. Eligibility for VA benefits is based upon discharge from active military service under other than dishonorable conditions. Benefits vary according to factors connected with the type and length of military service. To see details of eligibility criteria for VA compensation and benefits, view the current benefits manual here. DEMOGRAPHICS OF HOMELESS VETERANS 11% of the homeless adult population are veterans 20% of the male homeless population are veterans 68% reside in principal cities 32% reside in suburban/rural areas 51% of individual homeless veterans have disabilities 50% have serious mental illness 70% have substance abuse problems 57% are white males, compared to 38% of non-veterans 50% are age 51 or older, compared to 19% non-veterans
  • 8. back to top INCARCERATED VETERANS In May 2007, the Bureau of Justice Statistics released a special report on incarcerated veterans. The following are highlights of the report, “Veterans in State and Federal Prison, 2004,” which assessed data based on personal interviews conducted in 2004: Numbers and profiles: There were an estimated 140,000 veterans held in state and federal prisons. State prisons held 127,500 of these veterans, and federal prisons held 12,500. Male veterans were half as likely as other men to be held in prison (630 prisoners per 100,000 veterans, compared to 1,390 prisoners per 100,000 non-veteran U.S. residents). This gap had been increasing since the 1980s. Veterans in both state and federal prison were almost exclusively male (99 percent). The median age (45) of veterans in state prison was 12 years older than that of non-veterans (33). Non-veteran inmates (55%) were nearly four times more likely than veterans (14%) to be under the age of 35. Veterans were much better educated than other prisoners. Nearly all veterans in state prison (91%) reported at least a high school diploma or GED, while an estimated 40% of non- veterans lacked either. Military backgrounds: The U.S. Army accounted for 46% of veterans living in the United States yet 56% of veterans in state prison. In 2004, the percentage of state prisoners who reported prior military service in the U.S. Armed Forces (10%) was half of the level reported in 1986 (20%). Most state prison veterans (54%) reported service during a wartime era, while 20% saw combat duty. In federal prison two-
  • 9. thirds of veterans had served during wartime, and one quarter had seen combat. Six in 10 incarcerated veterans received an honorable discharge. Mental health: Veteran status was unrelated to inmate reports of mental health problems. Combat service was not related to prevalence of recent mental health problems. Just over half of both combat and non-combat veterans reported any history of mental health problems. Veterans were less likely than non-veteran prisoners to have used drugs. Forty-two percent of veterans used drugs in the month before their offense compared to 58% of non-veterans. No relationship between veteran status and alcohol dependence or abuse was found. Convictions and sentencing: Veterans had shorter criminal histories than non-veterans in state prison. Veterans reported longer average sentences than non-veterans, regardless of offense type. Over half of veterans (57%) were serving time for violent offenses, compared to 47% of non-veterans. Nearly one in four veterans in state prison were sex offenders, compared to one in 10 non-veterans. Veterans were more likely than other violent offenders in state prison to have victimized females and minors. More than a third of veterans in state prison had maximum sentences of at least 20 years, life or death. back to top SOURCESThe 2016 Annual Homeless Assessment Report (AHAR) to CongressVeteran Homelessness: A Supplemental Report to the 2010 Annual Homeless Assessment Report to Congress; Housing and Urban DevelopmentCongressional Research Service Report for Congress: Veterans and Homelessness; Libby Perl; February 2012Homeless Incidence
  • 10. and Risk Factors for Becoming Homeless in Veterans; VA Office of Inspector General; May 2012The 2012 Point-in- Time Estimates of Homelessness, Volume 1 of the 2012 Point- in-Time Annual Homeless Assessment Report; Housing and Urban DevelopmentThe 2015 Point-in-Time Estimates of Homelessness, Volume 1 of the 2015 Point-in-Time Annual Homeless Assessment Report; Housing and Urban Development Veteran in crisis? Dial 1.877.424.3838 for 24/7 assistance. 1730 M Street NW, Suite 705 | Washington, DC | 20036 | t- f. 1.800.VET.HELP | v. 202.546.1969 | f. 202.546.2063 | [email protected] Problem Solving Skills and Deficits Among Homeless Veterans With Serious Mental Illness Sonya Gabrielian, Elizabeth Bromley, and Alison B. Hamilton
  • 11. Veterans Affairs Greater Los Angeles, Los Angeles, California, and University of California, Los Angeles, David Geffen School of Medicine Van T. Vu University of California, San Francisco, School of Medicine Adrian Alexandrino Jr. Gap Solution s, Inc., Herndon, Virginia Ella Koosis Veterans Affairs Greater Los Angeles, Los Angeles, California Alexander S. Young Veterans Affairs Greater Los Angeles, Los Angeles, California, and University of California, Los Angeles, David Geffen School of Medicine
  • 12. Few interventions train homeless consumers in housing-related independent living skills. To inform the development of such interventions for the Department of Veterans Affairs’ Supported Housing consumers with serious mental illness, we examined these consumers’ problem-solving skills and deficits. We performed semistructured interviews and cognitive tests with 20 con- sumers who retained housing for �1 year (“stayers”) and 20 consumers who lost housing in �1 year (“exiters”). Salient types of problems were identified in the qualitative data; we categorized problem-solving approaches by complexity level and identified differences in problem-solving complexity by consumers’ housing outcomes. Instrumental (e.g., money management), interper- sonal, and health-related problems were prominent in consumers’ narratives. Cognition was poor among stayers and exiters. Problem-solving approaches were highly relevant to day-to-day functioning in supported housing. There was a trend toward greater problem-solving complexity in stayers versus exiters. These data explore potential challenges faced in supported housing and
  • 13. help inform the development of a Veterans Affairs-based housing-focused skills training intervention. Public Policy Relevance Statement Little is known about the problem-solving skills and deficits of formerly homeless consumers engaged in supported housing programs. To inform the development of skills training interventions for Veterans Affairs-supported housing participants, this study highlights this population’s salient types of problems and problem-solving approaches. This article was published Online First July 16, 2018. Sonya Gabrielian, Elizabeth Bromley, and Alison B. Hamilton, Center for the Study of Healthcare Innovation, Implementation, and Policy, Men- tal Illness Research, Education, and Clinical Center, Veterans Affairs Greater Los Angeles, Los Angeles, California, and Department of Psychi- atry and Biobehavioral Sciences, University of California, Los
  • 14. Angeles, David Geffen School of Medicine; Van T. Vu, Department of Family and Community Medicine, University of California, San Francisco, School of Medicine; Adrian Alexandrino, Jr., Gap