{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:34:45Z","timestamp":1781660085923,"version":"3.54.5"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["D1875-F"],"award-info":[{"award-number":["D1875-F"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Center on Homelessness among Veterans"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The COVID-19 pandemic has had unprecedented effects on mental health and community functioning. Negative effects related to disruption of individuals\u2019 social connections may have been more severe for those who had tenuous social connections prior to the pandemic. Veterans who have recently experienced homelessness (RHV) or have a psychotic disorder (PSY) are considered particularly vulnerable because many had poor social connections prior to the pandemic.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a 15-month longitudinal study between May 2020 \u2013July 2021 assessing clinical (e.g., depression, anxiety) and community (e.g., social functioning, work functioning) outcomes. Eighty-one PSY, 76 RHV, and 74 Veteran controls (CTL) were interviewed over 5 assessment periods. We assessed changes in mental health and community functioning trajectories relative to pre-pandemic retrospective ratings and examined group differences in these trajectories.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>All groups had significantly increased symptoms of depression, anxiety, and concerns with contamination at the onset of the pandemic. However, RHV and PSY showed faster returns to their baseline levels compared to CTL, who took nearly 15 months to return to baseline. With regards to functioning, both RHV and PSY, but not CTL, had significant improvements in family and social networks over time. Work functioning worsened over time only in PSY, and independent living increased over time in both RHV and PSY but not CTL.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>These results reveal that vulnerable Veterans with access to VA mental health and case management services exhibited lower negative impacts of the COVID-19 pandemic on mental health and community functioning than expected.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0273579","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T17:43:35Z","timestamp":1661363015000},"page":"e0273579","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["The impact of the COVID-19 pandemic on mental health and functional outcomes in Veterans with psychosis or recent homelessness: A 15-month longitudinal study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1763-8540","authenticated-orcid":true,"given":"Jonathan K.","family":"Wynn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"McCleery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5943-5215","authenticated-orcid":true,"given":"Derek M.","family":"Novacek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9843-9139","authenticated-orcid":true,"given":"Eric A.","family":"Reavis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damla","family":"Senturk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A.","family":"Sugar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-648X","authenticated-orcid":true,"given":"Jack","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael F.","family":"Green","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"issue":"2","key":"pone.0273579.ref001","doi-asserted-by":"crossref","first-page":"368504211019854","DOI":"10.1177\/00368504211019854","article-title":"COVID-19 pandemic: A review of the global lockdown and its far-reaching effects","volume":"104","author":"H. Onyeaka","year":"2021","journal-title":"Sci Prog"},{"key":"pone.0273579.ref002","doi-asserted-by":"crossref","first-page":"113779","DOI":"10.1016\/j.socscimed.2021.113779","article-title":"Changes in social relationships during an initial \"stay-at-home\" phase of the COVID-19 pandemic: A longitudinal survey study in the U.S","volume":"274","author":"L.M. Philpot","year":"2021","journal-title":"Soc Sci Med"},{"key":"pone.0273579.ref003","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s40812-020-00168-5","article-title":"Employment impact of Covid-19 crisis: From short term effects to long terms prospects","volume":"47","author":"M. Fana","year":"2020","journal-title":"Journal of Industrial and Business Economics"},{"key":"pone.0273579.ref004","author":"C. Pollack","year":"2020","journal-title":"When storms collide: Evictions, COVID-19, and health equity health affairs blog website"},{"issue":"4","key":"pone.0273579.ref005","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1515\/dx-2021-0046","article-title":"An overview of mental health during the COVID-19 pandemic","volume":"8","author":"P.J. Chen","year":"2021","journal-title":"Diagnosis (Berl)"},{"key":"pone.0273579.ref006","article-title":"Increased generalized anxiety, depression and distress during the COVID-19 pandemic: a cross-sectional study in Germany","author":"A. Bauerle","year":"2020","journal-title":"J Public Health (Oxf)"},{"key":"pone.0273579.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S0033291720004432","article-title":"Longitudinal changes in mental health and the COVID-19 pandemic: evidence from the UK Household Longitudinal Study","author":"M. Daly","year":"2020","journal-title":"Psychol Med"},{"issue":"10","key":"pone.0273579.ref008","doi-asserted-by":"crossref","first-page":"e22043","DOI":"10.2196\/22043","article-title":"Mental Health During the COVID-19 Pandemic in the United States: Online Survey","volume":"4","author":"J.S. Jewell","year":"2020","journal-title":"JMIR Form Res"},{"key":"pone.0273579.ref009","doi-asserted-by":"crossref","first-page":"113117","DOI":"10.1016\/j.psychres.2020.113117","article-title":"Loneliness: A signature mental health concern in the era of COVID-19","volume":"290","author":"W.D.S. Killgore","year":"2020","journal-title":"Psychiatry Res"},{"issue":"7","key":"pone.0273579.ref010","doi-asserted-by":"crossref","first-page":"e0236562","DOI":"10.1371\/journal.pone.0236562","article-title":"Acute mental health responses during the COVID-19 pandemic in Australia","volume":"15","author":"J.M. Newby","year":"2020","journal-title":"PLoS One"},{"issue":"1","key":"pone.0273579.ref011","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s12992-020-00589-w","article-title":"Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis","volume":"16","author":"N. Salari","year":"2020","journal-title":"Global Health"},{"key":"pone.0273579.ref012","article-title":"Prevalence, Psychological Responses and Associated Correlates of Depression, Anxiety and Stress in a Global Population, During the Coronavirus Disease (COVID-19) Pandemic","author":"S.M.A. Shah","year":"2020","journal-title":"Community Ment Health J"},{"issue":"19","key":"pone.0273579.ref013","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17196986","article-title":"COVID-19 Pandemic and Mental Health: Prevalence and Correlates of New-Onset Obsessive-Compulsive Symptoms in a Canadian Province","volume":"17","author":"A. Abba-Aji","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"pone.0273579.ref014","doi-asserted-by":"crossref","first-page":"e186","DOI":"10.1016\/S2468-2667(20)30053-0","article-title":"COVID-19: a potential public health problem for homeless populations","volume":"5","author":"J. Tsai","year":"2020","journal-title":"Lancet Public Health"},{"issue":"4","key":"pone.0273579.ref015","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1093\/schbul\/sbaa051","article-title":"The COVID-19 Global Pandemic: Implications for People With Schizophrenia and Related Disorders","volume":"46","author":"N. Kozloff","year":"2020","journal-title":"Schizophr Bull"},{"key":"pone.0273579.ref016","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.jpsychires.2021.03.051","article-title":"Clinical and functional effects of the COVID-19 pandemic and social distancing on vulnerable veterans with psychosis or recent homelessness","volume":"138","author":"J.K. Wynn","year":"2021","journal-title":"J Psychiatr Res"},{"key":"pone.0273579.ref017","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S0033291721002361","article-title":"Mental health impact of the COVID-19 pandemic in U.S. military veterans: a population-based, prospective cohort study","author":"M.L. Hill","year":"2021","journal-title":"Psychol Med"},{"issue":"4","key":"pone.0273579.ref018","doi-asserted-by":"crossref","first-page":"e214972","DOI":"10.1001\/jamanetworkopen.2021.4972","article-title":"Association of Symptoms of Posttraumatic Stress Disorder With Posttraumatic Psychological Growth Among US Veterans During the COVID-19 Pandemic","volume":"4","author":"R.H. Pietrzak","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"7","key":"pone.0273579.ref019","doi-asserted-by":"crossref","first-page":"823","DOI":"10.4088\/JCP.09m05780blu","article-title":"Exploration of the resilience construct in posttraumatic stress disorder severity and functional correlates in military combat veterans who have served since September 11, 2001","volume":"71","author":"K.T. Green","year":"2010","journal-title":"J Clin Psychiatry"},{"key":"pone.0273579.ref020","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.jpsychires.2016.10.017","article-title":"Psychological resilience in U.S. military veterans: A 2-year, nationally representative prospective cohort study","volume":"84","author":"K. Isaacs","year":"2017","journal-title":"J Psychiatr Res"},{"issue":"2","key":"pone.0273579.ref021","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1521\/psyc.2012.75.2.135","article-title":"The role of coping, resilience, and social support in mediating the relation between PTSD and social functioning in veterans returning from Iraq and Afghanistan","volume":"75","author":"J. Tsai","year":"2012","journal-title":"Psychiatry"},{"issue":"9","key":"pone.0273579.ref022","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"K. Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"10","key":"pone.0273579.ref023","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7","volume":"166","author":"R.L. Spitzer","year":"2006","journal-title":"Archives of Internal Medicine"},{"issue":"1","key":"pone.0273579.ref024","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1037\/a0018260","article-title":"Assessment of obsessive-compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive-Compulsive Scale","volume":"22","author":"J.S. Abramowitz","year":"2010","journal-title":"Psychol Assess"},{"issue":"3","key":"pone.0273579.ref025","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1207\/s15327752jpa4203_11","article-title":"Developing a measure of loneliness","volume":"42","author":"D. Russell","year":"1978","journal-title":"J Pers Assess"},{"key":"pone.0273579.ref026","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/BF00756338","article-title":"Assessing levels of adaptive functioning: the Role Functioning Scale","volume":"29","author":"S.H. Goodman","year":"1993","journal-title":"Community Mental Health Journal"},{"key":"pone.0273579.ref027","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1467-9868.2010.00749.x","article-title":"Fast stable restricted maximum likelihood and marginal likelihood estimation of semiparametric generalized linear models","volume":"73","author":"S.N. Wood","year":"2011","journal-title":"Journal of the Royal Statistical Society: Series B (Methodological)"},{"key":"pone.0273579.ref028","volume-title":"R: A language and environment for statistical computing","author":"Team, R.C","year":"2021"},{"issue":"7","key":"pone.0273579.ref029","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/S2215-0366(21)00151-6","article-title":"Mental health responses to the COVID-19 pandemic: a latent class trajectory analysis using longitudinal UK data","volume":"8","author":"M. Pierce","year":"2021","journal-title":"Lancet Psychiatry"},{"issue":"22","key":"pone.0273579.ref030","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1001\/jama.2020.21753","article-title":"Older Adults and the Mental Health Effects of COVID-19","volume":"324","author":"I.V. Vahia","year":"2020","journal-title":"JAMA"},{"issue":"4","key":"pone.0273579.ref031","first-page":"e2020427","article-title":"Report on sadness\/depression, nervousness\/anxiety and sleep problems in the Brazilian adult population during the COVID-19 pandemic","volume":"29","author":"M.B.A. Barros","year":"2020","journal-title":"Epidemiol Serv Saude"},{"issue":"9","key":"pone.0273579.ref032","doi-asserted-by":"crossref","first-page":"e0239698","DOI":"10.1371\/journal.pone.0239698","article-title":"Loneliness in the UK during the COVID-19 pandemic: Cross-sectional results from the COVID-19 Psychological Wellbeing Study","volume":"15","author":"J.M. Groarke","year":"2020","journal-title":"PLoS One"},{"issue":"9","key":"pone.0273579.ref033","doi-asserted-by":"crossref","first-page":"e040620","DOI":"10.1136\/bmjopen-2020-040620","article-title":"Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study","volume":"10","author":"R. Jia","year":"2020","journal-title":"BMJ Open"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0273579","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T17:44:43Z","timestamp":1661363083000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0273579"}},"subtitle":[],"editor":[{"given":"Pedro Vieira da Silva","family":"Magalhaes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,8,24]]},"references-count":33,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0273579","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,24]]}}}