Joint models targeting U.S. Army soldiers at high-risk of post-separation unemployment, homelessness, and suicide-related behaviors

Close to 200,000 United States (U.S.) military service members transition back to civilian life each year 1 . Many of these transitioning service members (TSMs) report feeling unprepared for the challenges of returning to civilian life, including finding employment, managing finances, and addressing health issues 2 , 3 , 4 . Prior longitudinal studies found that approximately one-third of TSMs were not employed about 9 months after separation 5 and that 5% experienced homelessness within 12 months of separation 6 , and a U.S. Department of Veterans Affairs (VA) report documented a suicide rate of 46.2 per 100,000 in the first year after separation 7 , underscoring the substantial challenges and risks faced during the transition back to civilian life. The U.S. Department of Defense (DoD) and VA have developed numerous transition support programs to address these problems 8 , 9 . However, most of these programs have unclear effects 10 . And most are applied with the same intensity to all TSMs without regard to differences in risk. This approach is almost certainly suboptimal, as TSMs at the highest risk often experience complex needs that are not adequately addressed by programs at the relatively low level of intensity of existing transitional services programs 2 , 11 . But more intensive programs, given their greater costs, would need to be targeted at high-risk TSMs to make their use cost-effective. The U.S. Government Accountability Office acknowledged this in a recent report calling for more effective screening prior to separation to determine risk of post-separation negative outcomes 12 .