Mental Health and Substance Use Patterns Associated With Lifetime Suicide Attempt, Incarceration, and Homelessness: A Latent Class Analysis of a Nationally Representative Sample of US Veterans

A substantial proportion of U.S. military veterans experience mental health and/or substance use disorders. As public awareness of these difficulties rises, so too does interest in the relation between veteran behavioral health and high-risk events, namely suicide attempts, incarceration, and homelessness. Using latent class analysis and a large, nationally representative sample of community veterans, the current study examined common patterns of veteran behavioral health disorders and the associations between these patterns and high-risk events. Results suggest four classes of veterans, including a "healthy" class (comprising 69% of the total sample), a "substance use disorder" class (16%), a "personality disorder-substance use disorder" class (8%), and a "depressive disorder" class (7%). Veterans in the healthy class had the lowest rates of suicide attempt (2%), incarceration (14%), and homelessness (3%), whereas veterans in the personality disorder-substance use disorder class had the highest rates of these events (27%, 45%, and 22%, respectively). Results attest to the importance of investing clinical resources into addressing the needs of veterans experiencing complex behavioral health patterns, particularly personality and substance use disorders. Implications for the health care of veterans are discussed.