Joint models targeting U.S. Army soldiers at high-risk of post-separation unemployment, homelessness, and suicide-related behaviors
Transitioning service members (TSMs) leaving military service have high risks of unemployment, homelessness, nonfatal suicide attempt (SA), and suicide death. Data from n = 7188 recently separated TSMs from the U.S. Army were used to update previously developed models for post-separation homelessness and SA based on data at the time of separation and to develop a new unemployment model. Predicted probabilities of suicide from a model developed elsewhere were imputed for comparison purposes. Cross-validated predictions were significant for the homelessness (AU-ROC = 0.68) and SA (AU-ROC = 0.78) models but not the unemployment model (AU-ROC = 0.60). Elevated cross-validated risk was found for the 10% of TSMs at the highest predicted risk of homelessness (SN = 26.6%), 20% for SA (SN = 60.9%), and 10% for suicide death (SN = 34.1%). 28% of TSMs were in the highest risk categories for at least one and 10% for more than one outcome. Findings regarding incomplete overlap highlight the complexities of risk targeting when multiple outcomes are of interest.
Authors
- Joseph C. Geraci (ORCID: https://orcid.org/0000-0001-6070-6812)
- Shelby Borowski (ORCID: https://orcid.org/0000-0002-9558-2175)
- Vincent F. Capaldi (ORCID: https://orcid.org/0000-0003-2235-6350)
- Sarah M. Gildea (ORCID: https://orcid.org/0000-0003-1988-4072)
- Eric Edwards
- David M. Benedek (ORCID: https://orcid.org/0000-0001-9480-1412)
- C.J. Kennedy (ORCID: https://orcid.org/0000-0003-2196-133X)
- Howard Y. Liu (ORCID: https://orcid.org/0000-0002-1172-5176)
- Irving Hwang
- Matthew K. Nock
- Robert J. Ursano
- Ronald C. Kessler
- Nancy A. Sampson
- James A. Naifeh
- Murray B. Stein
- Alex Luedtke
- James Wagner
Institutions
- Henry M. Jackson Foundation (US)
- Harvard University (US)
- Uniformed Services University of the Health Sciences (US)
- University of Michigan (US)
- Families USA (US)
- University of California San Diego (US)
- Massachusetts General Hospital (US)
- VA San Diego Healthcare System (US)
- Doris Miller Department of Veterans Affairs Medical Center (US)
- James J. Peters VA Medical Center (US)
- Human Longevity (United States) (US)
- Bronx Community College (US)
- Columbia University (US)
- Icahn School of Medicine at Mount Sinai (US)
Publication Details
- Journal
- npj Mental Health Research
- Published
- 2026-02-12
- DOI
- https://doi.org/10.1038/s44184-026-00192-8
- Primary Topic
- Homelessness and Social Issues
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- U.S. Department of Defense
- U.S. Department of Veterans Affairs
- Harvard University
- University of Washington
- Uniformed Services University of the Health Sciences
- University of California, San Diego
- Veterans Affairs San Diego Healthcare System
- National Institute of Mental Health