UCLA/VA Center of Excellence for Training and Research
in Veteran Resilience and Recovery
Tackling Structural Determinants of Homelessness: Training on Eviction and Racial Inequality
The Veterans Affairs Greater Los Angeles Healthcare system implements one of the largest Housing First programs in the United States, a response to the largest population of homeless Veterans in the US. The basic tenant of the Housing First model is that housing ends homelessness. Only once housing is achieved, can addressing other commonly occurring behavioral health conditions like mental health and substance use disorders, proceed successfully (Tsemberis 2004).
The new UCLA Greater Los Angeles VA Center of Excellence For Veteran Resilience and Recovery (“COE”) has the primary mission to “improve health and social outcomes and promote recovery for Veterans who are homeless and at high risk for behavioral health disorders, including mental and substance use disorders.” This proposal addresses the mission by training UCLA and VA staff and community members in addressing eviction – a social outcome (eviction is removal of a tenant by a landlord in a legal process) – to prevent housing loss in those most commonly facing eviction, those with substance use and mental health conditions. In the longterm, we hypothesize that by enhancing the mission of Housing First, focusing on housing outcomes like eviction, existing treatment methodologies for mental health and substance use can be more successful thus enhancing housing stability from both social and behavioral health perspectives
Specific Aims
- Provide training to VA staff and community partners in community-based interventions to address eviction, grounded in a structural understanding of how racism contributes to eviction and homelessness.
- Complete preliminary analysis of the racial/ethnic composition of VAGLAHS homeless programs, and a stratified analysis of evictions by race/ethnicity.
- Conduct a quantitative and qualitative analysis of training content and participant responses and reflections on training content.
PI: Peter Capone-Newton, MD, MPH, PhD
The CTRS is an innovative low barrier housing program that serves a highly vulnerable group of Veterans experiencing homelessness (VEHs). This quality improvement project aims to identify program enhancements (e.g., provider training, clinical processes, Veteran resources) that can be implemented and tested using a rapid-cycle improvement approach that engages the COE. Should results from this project suggest the value of the CTRS for VEHs – within and beyond the COVID-19 pandemic – it will also inform plans to disseminate this innovation at VA facilities throughout the nation.
PIs: Lisa Altman, MD, Sonya Gabrielian, MD, MPH
Improving Outcomes for Veteran Families Experiencing Homelessness
This pilot study will develop a peer-facilitated group intervention to improve community integration and reduce self-stigma among Veterans experiencing homelessness with schizophrenia or other psychotic spectrum disorders.
PI: Ippolytos Kalofonos, MD, PhD
Veteran Voices and Visions: A Peer-facilitated Group Intervention Improving Community Integration for Veterans Experiencing Homelessness and Serious Mental Illness
This pilot study will develop a peer co-facilitated group intervention to improve community integration and reduce self-stigma among Veterans experiencing psychosis. This meaning-centered approach is inspired by the Hearing Voices Movement.
PI: Ippolytos Kalofonos, MD, PhD
Primary Care Treatment of Depression for Veterans with Experiences of Homelessness
Using secondary database analyses, this project examines the quality of depression care provided by homeless-tailored (H-PACT) versus mainstream primary care teams for Veterans with past-year homeless experiences. It is focused on understanding the quality of depression care received by homeless-experienced Veterans newly diagnosed with depression, comparing H-PACT versus mainstream primary care.
PI: Lucinda Leung, MD, PhD