Joyce Tsai
Biographic Data
| ID | 1010900 |
|---|---|
| NAME | Joyce Tsai |
| GIVEN NAMES | Joyce |
| FAMILY NAME | Tsai |
| SIGNATURE | TSAI J |
| AFFILIATIONS | Yale University |
| ORCID | 0000-0002-0329-648X |
| VERIFIED | Yes |
| TOTAL WORKS | 130 |
| TOTAL CITATIONS | 152 |
| AUTHOR COUNT | 130 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2005 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 8 |
Total-cause and cause-specific mortality among U.S. criminal justice-involved veterans
Sex-Specific Associations Between Cannabis Use, Suicidal Intent, and Suicidal Ideation Among Low-Income U.S. Veterans
Homelessness Among U.S. Veterans
Reducing state-level veteran homelessness through the lens of policy capacity
Introduction Along with the U.S. federal government and local jurisdictions, U.S. states play an important role in shaping veteran homelessness policy. These state-level efforts include economic and resource-based public policy that aid in the reduction of veteran homelessness.Method This study is grounded in policy capacity theory and identifies state-level economic and resource-based determinants that reduce veteran homelessness.Results Utilizi…
Identifying predictors of housing distress in later life
Objectives Housing insecurity is increasingly prevalent among older adults in the US, yet the factors that contribute to housing-related distress in this population remain inadequately understood. This study examined how changes in a comprehensive set of physical health, health behaviors, psychosocial, and economic factors are associated with subsequent housing distress, and explored differences by military veteran status. Methods We analyzed thr…
Healthcare Mobility among United States Military Veterans with Experience of Housing Instability
Housing instability, generally, is associated with a lack of access to care. The present study explores healthcare mobility among Veterans experiencing housing instability to identify the magnitude of this phenomenon and whether it is associated with certain patient characteristics or needs. The sample included 486,675 Veterans with 4 or more healthcare visits during the year following identification of homelessness. Analyses compared (a) baselin…
Spiritual Supports for Formerly Unhoused US Veterans
Health Care Outcomes of Homelessness Prevention Programs in Veterans Experiencing Housing Instability
In this study, federal prevention solutions to homelessness were associated with improved health outcomes and lower inpatient costs, which should inform national policy debates within and beyond the VA
Housing distress and subsequent health and well-being among older adults
Housing insecurity is increasing among older adults in the U.S., yet the impact of housing-related distress on health and well-being in this population is understudied. This study uses three waves of prospective data from a national sample of U.S. adults aged 50+ years (Health and Retirement Study, N = 12,998) to examine associations between housing distress and 35 indicators of physical, behavioral, and psychosocial health and well-being four ye…
Mapping food access
Limited access to affordable, nutritious food is a key structural determinant of health inequality. In the United Kingdom, food desert risk is often assumed to mirror socioeconomic deprivation, yet their alignment across small-area geographies remains unclear. To characterize the spatial distribution of food desert risk across England, Wales, and Scotland; quantify its association and concordance with area-level deprivation; and identify deprivat…
Connecting Veterans in Supported Housing to Primary Care in the Veterans Affairs Healthcare System
Background The U.S. Department of Housing and Urban Development‐Veterans Affairs Supportive Housing (HUD‐VASH) program is the largest supported housing program in the country and seeks to provide direct access to supported housing for homeless veterans, many of whom need primary care. Objective This study examined the proportion of veterans in HUD‐VASH empaneled in VA primary care and factors associated with empanelment. Design A retrospective co…
Prior incarceration and functional limitation trajectories in older adults
INTRODUCTION: Functional limitations are a key indicator of ageing, associated with quality of life, independence and the need for caregiving and long-term support. Research shows that formerly incarcerated older adults have more functional limitations than those who have never been incarcerated, yet there is a lack of research on prior incarceration and changes in functional limitations over time. METHODS: Data come from 8377 adults aged ≥55 who…
Provider and Veteran Perspectives on the Resources Needed to Mitigate Veteran Homelessness
We aimed to expand understanding of provider/Veteran attitudes about resources and services that would mitigate Veteran homelessness. We analyzed qualitative data from the 2024 Community Homelessness Assessment, Local Education, and Networking Groups for Veterans survey. In all, 4,990 respondents completed the survey: 2,928 (59%) homeless program service providers, clinicians, and staff and 2,062 (41%) homeless experienced Veterans. Qualitative a…
Development of the Homeless Assistance Safety Perceptions (Hasp) Inventory
Housing status, mental health, and help-seeking among American Indian and Alaska Native Veterans in the Midwest
Objective: This study aims to examine mental health and help-seeking behaviors among homeless and unstably housed (HUH) and stably housed (SH) American Indian and Alaska Native (AIAN) and non-AIAN veterans in the Midwest. Methods: The study cohort consisted of veterans in the Veterans Affairs (VA) service catchment area called the Veterans Integrated Service Network (VISN) 23. Data from the Homeless Operations Management and Evaluation System (HO…
Families served during the first decade of the Supportive Services for Veteran Families program
Homelessness impacts entire families, with potential intergenerational consequences. Addressing family homelessness provides both immediate relief and long-term societal benefits. While various programs exist to mitigate homelessness, the United States (US) Department of Veterans Affairs’ (VA) Supportive Services for Veteran Families (SSVF) program offers a distinctive model for combating homelessness among veterans by supporting their families a…
Traumatic brain injury and VA service use among Native Hawaiian and Pacific Islander Veterans experiencing homelessness
Introduction: United States Veterans experiencing homelessness often have myriad health concerns that can impact their functioning. Native Hawaiian or Pacific Islander (NHPI) homeless Veterans are up to 82% more likely to have a traumatic brain injury (TBI) diagnosis than non-NHPI homeless Veterans, which can further impact these Veterans' psychosocial functioning. The Department of Veterans Affairs (VA) offers services to address the health and …
Rates of Prescription Fentanyl Misuse and Correlated Mental Health, Social, and Service Utilization Factors Among Adults in the United States, 2021
BACKGROUND: Misuse of fentanyl, a powerful synthetic opioid, can lead to severe consequences, including overdose and death. This study examined sociodemographic, mental health, and service utilization factors associated with past-year fentanyl misuse in the United States. METHODS: We utilized the 2021 National Survey on Drug Use and Health, a nationally representative sample of the non-institutionalized U.S. population, to examine differences amo…
Development of a Surveillance System to Identify Incidence of Evictions Among Patients in Veterans Affairs Medical Centers Across the United States
Domains of Housing Instability and Intimate Partner Violence Risk Among U.S. Tenants
While IPV is often studied as a predictor of housing insecurity, few U.S. studies explore how different forms of housing instability may contribute to intimate partner violence (IPV) risk. Using a mixed-methods approach and a cross-sectional design, this study examined the association between four housing instability domains and IPV among a sample of tenants that had either experienced eviction or were at high risk for eviction. Tenants in Harris…
Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders
These findings suggest relationships between SUDs and negative PSH exits differ between racial/ethnic groups and suggest there may be value in culturally specific tailoring and implementation of SUD services for these subgroups
Brief Scoping Review of Community Hubs for the Care of Pregnant Mothers and Their Infants
Mixed-Methods Study of Use and Attitudes About Psychedelics for Therapeutic Purposes Among Low-Income U.S. Veterans Nationally
There is great public and clinical interest in the use of psychedelics for therapeutic purposes. However, there has been little national study of psychedelic use in the U.S. veteran population. This study used quantitative and qualitative data from a nationally representative survey of 1,031 low-income U.S. veterans who participated in the National Veteran Homeless and Other Poverty Experiences (NV-HOPE) Study in 2023. In the total sample, lifeti…
Attitudes and Knowledge about Electroconvulsive therapy among Individuals with Schizophrenia and their Relatives
Perspectives on the Low Demand Transitional Model in Engaging and Housing hard-to-reach Veterans Experiencing Unsheltered Homelessness
Housing Preferences and Choices Among Adults with Mental Illness and Substance Use Disorders
Public exposure and attitudes about homelessness
In this study, we conducted a survey among a large sample of U.S. adults to assess attitudes and beliefs about the causes of homelessness, policies to address homelessness, and programs for homeless individuals. In 2016, we surveyed a national sample of 541 adults from 47 different U.S. states using Amazon Mechanical Turk. Of the total sample, 78% reported that homelessness was a problem in their communities and 60% believed homelessness would in…
Changes in Public Attitudes and Perceptions about Homelessness Between 1990 and 2016
Public attitudes on homelessness can and has influenced policies and services for homeless populations. This study surveyed national public attitudes about homelessness in the 21st century and examined changes in attitudes in the past two decades. An online survey of public attitudes about homelessness was conducted with 541 U.S. adults across 47 states in November 2016 using Amazon Mechanical Turk. Survey results were compared to two public surv…
Model Minority Stereotype
When Health Insurance Is Not a Factor
Objectives. We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. Methods. We used national VA administrative data from fiscal year 2010 for a cross-sectional study comparing homeless (n = 64 091) and nonhomeless (n = 866 621) ED users on sociodemographics, medi…
Latent Homeless Risk Profiles of a National Sample of Homeless Veterans and Their Relation to Program Referral and Admission Patterns
Objectives. We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. Methods. We examined data from the VA’s new Homeless Operations Management and Evaluation System on 120 852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class so…
Is the Housing First Model Effective? Different Evidence for Different Outcomes
Is the Housing First Model Effective? Different Evidence for Different Outcomes Jack Tsai PhD Affiliation Jack Tsai is with the National Center on Homelessness Among Veterans, US Department of Veterans Affairs Central Office; the School of Public Health, University of Texas Health Science Center at Houston; and the Department of Psychiatry, Yale University, New Haven, CT.CopyRightCorrespondence should be sent to Jack Tsai, PhD, Campus Dean and Pr…
Conceptualizing Social Integration Among Formerly Homeless Adults With Severe Mental Illness
The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well‐studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors related to social integration, (b) examine the association between clinical symptoms and social integration…
Longitudinal Association of Therapeutic Alliance and Clinical Outcomes in Supported Housing for Chronically Homeless Adults
Housing Satisfaction Among Chronically Homeless Adults
Uninsured Veterans Who Will Need to Obtain Insurance Coverage Under the Patient Protection and Affordable Care Act
Objectives. We examined the number and clinical needs of uninsured veterans, including those who will be eligible for the Medicaid expansion and health insurance exchanges in 2014. Methods. We analyzed weighted data for 8710 veterans from the 2010 National Survey of Veterans, classifying it by veterans’ age, income, household size, and insurance status. Results. Of 22 million veterans, about 7%, or more than 1.5 million, were uninsured and will n…
A Geographic Analysis of Chronically Homeless Adults Before and After Enrollment in a Multi‐Site Supported Housing Initiative
The current study examined the community characteristics and migration of chronically homeless adults before and after entry into a multi-site supported housing initiative. A total of 394 participants were geocoded at baseline and 12-month follow up. Data from geographic information systems indicate that the median distance participants traveled from their last residence to their residence 1 year after program entry was 4.6 miles and 12% of parti…
Impact of Health Insurance Status and a Diagnosis of Serious Mental Illness on Whether Chronically Homeless Individuals Engage in Primary Care
Objectives. We evaluated the impact of a diagnosis of serious mental illness on use of a primary care provider (vs the emergency department [ED]) as a source of care by people who were chronically homeless. Methods. We used data from 750 chronically homeless adults enrolled in the 11-site Collaborative Initiative to Help End Chronic Homelessness and identified demographic and clinical characteristics independently associated with using a primary …
How often does homelessness precede criminal arrest in veterans? Results from the U.S. survey of prison inmates
1,602) were analyzed from the 2016 Survey of Prison Inmates conducted by the U.S. Bureau of Justice Statistics. In this survey, 27% of incarcerated veterans reported homelessness 12 months before criminal arrest. In multivariable logistic regression analyses, higher odds of experiencing homelessness preceding criminal arrest were associated with younger age, non-White race, substance use disorder (with or without serious mental illness [SMI]), hi…
Service use and barriers to care among homeless veterans
The objective of this study was to examine type of services U.S. veterans seek when they experience homelessness, characteristics associated with service use, and reasons for not using services. Data from a 2021 nationally representative survey of 1004 low-income U.S. veterans were analyzed with descriptive and multivariable analyses. One-quarter of low-income U.S. veterans with experiences of homelessness reported using homeless services while t…
Association between suicide attempts and homelessness in a population-based sample of US veterans and non-veterans
BACKGROUND: Suicide and homelessness share many of the same risk factors, but there is little understanding of how they are related to each other. METHODS: Data on 36 155 US adults (3101 veterans and 33 024 non-veterans) in the National Epidemiological Survey of Alcohol and Related Conditions-III were analysed to examine the association between lifetime homelessness and suicide, net of other factors, in a nationally representative US sample. RESU…
Comparison of Outcomes of Homeless Female and Male Veterans in Transitional Housing
Factors related to Covid-19 vaccine hesitancy among middle-income and low-income adults in the USA
BACKGROUND: Vaccine hesitancy has been an ongoing challenge in campaigns, especially the rapid development and approval of the COVID-19 vaccines. The goal of this study was to understand the characteristics, perceptions and beliefs of COVID-19 vaccination prior to its widespread rollout among middle-income and low-income US adults. METHODS: Using a national sample of 2101 adults who completed an online assessment in 2021, this study examines the …
A psychosocial mediational model of homelessness among U.S. male and female veterans who served in Iraq and Afghanistan
Few studies have focused on homelessness among Operations Iraqi Freedom, Enduring Freedom and New Dawn (OEF/OIF/OND) veterans, especially female veterans. An explanatory model of homelessness was constructed and tested for each gender. Data collected in the United States from 833 OEF/OIF/OND veterans (41.5% female; Mage = 35.22, SD = 8.86) who completed the baseline assessment of the Survey of the Experiences of Returning Veterans between Septemb…
A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska
This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff cond…
Asian American and Pacific Islander Military Veterans in the United States
Objectives. We (1) compared use of various health services nationally between Asian American and Pacific Islander (AA/PI) veterans and veterans of other racial/ethnic groups and (2) specifically compared perceived barriers and stigma related to mental health services. Methods. Using bivariate and multivariable statistics, we analyzed a population-weighted sample of 8315 veterans from the 2010 National Survey of Veterans and a random sample of 567…
Life After Supported Housing
This article presents a case series of three formerly homeless clients who were in the Housing and Urban Development‐Veterans Affairs Supportive Housing (HUD‐VASH) program 20 years ago and describes their progress since. Clients were identified from a 1992 client roster at one of the original HUD‐VASH sites. Clients were interviewed and their medical records were reviewed. The case studies were characterized as “sustained involvement in subsidize…
Incarceration Histories of Homeless Veterans and Progression Through a National Supported Housing Program
Integrated dual disorders treatment
Mental health programs are increasingly combining evidence‐based practices to provide comprehensive services. Individuals with complex services needs, such as those dually diagnosed with mental illness and substance use disorders, are at high risk for numerous negative outcomes and may benefit from such comprehensive programs. This report describes the process and outcomes of a program that formally integrated assertive community treatment, suppo…
Prevalence of Four Types of Social Support and Their Relation to Mental Health among low-income U.S. Veterans
Der Kuckuck and the problem of workers' photography in Austria
In 1929, a group of editors affiliated with the Austrian Social Democratic Party (SDAP) established Der Kuckuck, a magazine modelled in content and format on mainstream boulevard weeklies, but directed specifically at a working-class public. Der Kuckuck was one of the few SDAP publications that attempted to collaborate with its audience, introducing within its first year a photography contest open to all readers. The photography contest became a …
Narrative accounts of illness in schizophrenia
Integrated dual disorders treatment
Mental health programs are increasingly combining evidence‐based practices to provide comprehensive services. Individuals with complex services needs, such as those dually diagnosed with mental illness and substance use disorders, are at high risk for numerous negative outcomes and may benefit from such comprehensive programs. This report describes the process and outcomes of a program that formally integrated assertive community treatment, suppo…
Housing Preferences and Choices Among Adults with Mental Illness and Substance Use Disorders
A Geographic Analysis of Chronically Homeless Adults Before and After Enrollment in a Multi-Site Supported Housing Initiative
The current study examined the community characteristics and migration of chronically homeless adults before and after entry into a multi-site supported housing initiative. A total of 394 participants were geocoded at baseline and 12-month follow up. Data from geographic information systems indicate that the median distance participants traveled from their last residence to their residence 1 year after program entry was 4.6 miles and 12% of parti…
A Geographic Analysis of Chronically Homeless Adults Before and After Enrollment in a Multi‐Site Supported Housing Initiative
The current study examined the community characteristics and migration of chronically homeless adults before and after entry into a multi-site supported housing initiative. A total of 394 participants were geocoded at baseline and 12-month follow up. Data from geographic information systems indicate that the median distance participants traveled from their last residence to their residence 1 year after program entry was 4.6 miles and 12% of parti…
Housing arrangements among a national sample of adults with chronic schizophrenia living in the United States
There has been no recent national description of where and with whom people with chronic mental illness reside. Using data from the Clinical Antipsychotic Trials of Intervention Effectiveness, the living arrangements of 1,446 clients with schizophrenia from 57 sites throughout the United States were characterized over 1 year. At baseline, 46% of participants were living with family members and loved ones, 5% were living with other nonrelatives, 1…
Housing Satisfaction Among Chronically Homeless Adults
Do Faith-Based Residential Care Services Affect the Religious Faith and Clinical Outcomes of Homeless Veterans
Does Housing Chronically Homeless Adults Lead to Social Integration?
OBJECTIVE: Supported housing programs have been successful in helping homeless adults obtain housing. This study examined whether improvements in social integration occur after clients obtain supported housing. METHODS: Measures of social integration were examined for 550 chronically homeless adults with mental illness who participated in the 11-site Collaborative Initiative to Help End Chronic Homelessness. Social integration was conceptualized …
Conceptualizing Social Integration Among Formerly Homeless Adults With Severe Mental Illness
The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well‐studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors related to social integration, (b) examine the association between clinical symptoms and social integration…
Impact of Health Insurance Status and a Diagnosis of Serious Mental Illness on Whether Chronically Homeless Individuals Engage in Primary Care
Objectives. We evaluated the impact of a diagnosis of serious mental illness on use of a primary care provider (vs the emergency department [ED]) as a source of care by people who were chronically homeless. Methods. We used data from 750 chronically homeless adults enrolled in the 11-site Collaborative Initiative to Help End Chronic Homelessness and identified demographic and clinical characteristics independently associated with using a primary …
Comparison of Outcomes of Homeless Female and Male Veterans in Transitional Housing
Longitudinal Association of Therapeutic Alliance and Clinical Outcomes in Supported Housing for Chronically Homeless Adults
Military Sexual Assault and Homeless Women Veterans
National Comparison of Literally Homeless Male and Female VA Service Users
Life After Supported Housing
This article presents a case series of three formerly homeless clients who were in the Housing and Urban Development‐Veterans Affairs Supportive Housing (HUD‐VASH) program 20 years ago and describes their progress since. Clients were identified from a 1992 client roster at one of the original HUD‐VASH sites. Clients were interviewed and their medical records were reviewed. The case studies were characterized as “sustained involvement in subsidize…
When Health Insurance Is Not a Factor
Objectives. We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. Methods. We used national VA administrative data from fiscal year 2010 for a cross-sectional study comparing homeless (n = 64 091) and nonhomeless (n = 866 621) ED users on sociodemographics, medi…
Latent Homeless Risk Profiles of a National Sample of Homeless Veterans and Their Relation to Program Referral and Admission Patterns
Objectives. We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. Methods. We examined data from the VA’s new Homeless Operations Management and Evaluation System on 120 852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class so…
Childhood antecedents of incarceration and criminal justice involvement among homeless veterans
Although criminal justice involvement and incarceration are common problems for homeless veterans, few studies have examined childhood risk factors for criminal justice involvement among veterans. This study examined the association between three types of childhood problems, family instability, conduct disorder behaviors, and childhood abuse, and criminal justice involvement and incarceration in adulthood. Data from 1,161 homeless veterans across…
Incarceration Histories of Homeless Veterans and Progression Through a National Supported Housing Program
Uninsured Veterans Who Will Need to Obtain Insurance Coverage Under the Patient Protection and Affordable Care Act
Objectives. We examined the number and clinical needs of uninsured veterans, including those who will be eligible for the Medicaid expansion and health insurance exchanges in 2014. Methods. We analyzed weighted data for 8710 veterans from the 2010 National Survey of Veterans, classifying it by veterans’ age, income, household size, and insurance status. Results. Of 22 million veterans, about 7%, or more than 1.5 million, were uninsured and will n…
Asian American and Pacific Islander Military Veterans in the United States
Objectives. We (1) compared use of various health services nationally between Asian American and Pacific Islander (AA/PI) veterans and veterans of other racial/ethnic groups and (2) specifically compared perceived barriers and stigma related to mental health services. Methods. Using bivariate and multivariable statistics, we analyzed a population-weighted sample of 8315 veterans from the 2010 National Survey of Veterans and a random sample of 567…
Risk Factors for Homelessness Among US Veterans
Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rig…
A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska
This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff cond…
Medicine (95 works) · Homelessness and Social Issues (78 works) · Psychology (71 works) · Psychiatry (68 works) · Environmental health (50 works) · Gerontology (49 works) · Mental health (44 works) · Gerontology (37 works) · Population (32 works) · Sociology (32 works)