Prevalence of mental health conditions, substance use disorders, suicidal ideation and attempts, and experiences of homelessness among Veterans with criminal-legal involvement: A meta-analysis

Abstract

Veterans with histories of criminal-legal system involvement are considered high-priority within Veterans Health Administration (VHA) and criminal-legal settings. Over several decades, a large literature has accumulated to study these Veterans' needs. To consolidate findings, this meta-analysis provides aggregated prevalence estimates of common mental health conditions, substance use disorders, suicidal thoughts and behaviors, and experiences of homelessness among Veterans with current or prior involvement with the United States criminal-legal system. A total of 79 samples encompassing over 1.2 million Veterans were analyzed. Results estimate 8 in 10 Veterans with criminal-legal involvement experience a mental health condition, 7 in 10 a substance use disorder, 1 in 10 a history of suicidal ideation, and 4 in 10 a history of homelessness. Veterans with current (versus prior) criminal-legal involvement had higher rates of alcohol use, drug use, and current homelessness. Samples consisting of Veterans with a history of incarceration and samples collected in non-VHA settings tended to have lower rates of psychosocial difficulty relative to samples consisting of Veterans with other forms of criminal-legal involvement or collected in VHA settings, respectively. Remaining gaps in the literature include research on criminal-legal involved Veterans under community supervision, and/or from demographic minority groups.