INCOME MAINTENANCE, DEPENDENCE AND SERVICE SYSTEM USE

收入维持、依赖和服务系统的使用

• 批准号: 3378378
• 负责人: SUE E ESTROFF
• 金额: $ 16.05万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 1986
• 资助国家: 美国
• 起止时间: 1986-05-01 至 1991-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3378378
• 关键词: attitude; chronic disease /disorder; decision making; deinstitutionalization; disability insurance; employment /unemployment; health care service utilization; human population study; human subject; income maintenance; longitudinal human study; mental disorders; mental health services; self help; social class; social support network

Recent research indicates that approximately 50% of all chronically mentally ill persons receive Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI), while up to 90% of those in community treatment programs are recipients. Clinicians, patients, policy makers, and family members are all aware of the mixed blessing of income maintenance for the chronically mentally ill. While receipt may enable more independent living outside institutional settings, it may also consciously and unconsciously, decrease participation in the labor force and encourage continuation of disability--the entitling condition. There is a lack of systematic and longitudinal research about the roles, both positive and negative, that income maintenance based on disability, e.g., SSI and SSDI, plays in the lives of the chronically mentally ill. This research project is intended to investigate some of these roles, in particular to describe the natural history of decisions to apply, the short term effects of applicaiton and receipt on the recipient, and the influence of various forms of dependence on decisions to apply and on use of services. A prospective design is proposed, in order to map the sequence of events that lead to participation, to assess the respective contributions of various factors, and their effects over time on the recipients. Retrospective analysis is not adequate to determine the interactions among client, service and treatment system, disabling condition, social and psychological factors, all of which contribute to income maintenance use. These factors include: family relations with and attitudes toward the patient, family resources and attitudes toward disability income; staff realations with the patient and attitudes toward use of income maintenance; level of treatment and service system participation; degree and type of dependence; level of impairment, employment status, and duration of disability. We propose to follow persons discharged from three psychiatric inpatient treatment settings for two years, comparing those who apply for and receive SSI and SSDI and those who do not, and those who use services and participate in treatment and those who do not.

最近的研究表明，大约50%的慢性病患者 精神病患者领取补充保障收入(SSI)和社会保障 安全残疾保险(SSDI)，而社区中高达90%的人 治疗方案是接受者。临床医生、患者、政策制定者、 家庭成员都意识到收入的喜忧参半 慢性精神病患者的赡养费。虽然接收可能会启用 更独立地生活在机构设置之外，它也可能 自觉和不自觉地减少对劳动力的参与 并鼓励继续残疾--这是一种有资格的条件。那里 是缺乏关于角色的系统和纵向研究，两者 积极的和消极的，基于残疾的收入维持，例如， SSI和SSDI，在慢性精神病患者的生活中发挥作用。这 研究项目旨在调查其中的一些角色，在 具体描述要应用的决定的自然历史，简短 领用和收据对受赠人的期限效力及其影响 对要应用和使用的决定的各种形式的依赖 服务。为了绘制该序列，提出了一种前瞻性的设计 导致参与的事件，以评估各自的 各种因素的贡献，以及它们随着时间的推移对 收件人。回溯分析不足以确定 客户、服务和治疗系统之间的交互，禁用 条件、社会和心理因素，所有这些因素都有助于 收入维持用途。这些因素包括：与和的家庭关系 对病人的态度、家庭资源和对病人的态度 伤残收入；工作人员与患者的关系以及对 收入维持、待遇水平和服务制度的使用 参与程度；依赖程度和类型；损害程度， 就业状况和残疾时间。我们建议遵循以下原则 从三个精神科住院治疗场所出院的人 两年，将申请和获得SSI和SSDI的人与 谁不这样做，以及那些使用服务并参与治疗和 那些不这样做的人。