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.