INCOME MAINTENANCE, DEPENDENCE AND SERVICE SYSTEM USE

收入维持、依赖和服务系统的使用

• 批准号: 3378380
• 负责人: SUE E ESTROFF
• 金额: $ 26.11万
• 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/3378380
• 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 精神病患者可获得补充保障收入 (SSI) 和社会福利 安全伤残保险 (SSDI)，而社区中高达 90% 的人 治疗计划是接受者。 临床医生、患者、政策制定者， 家人都知道收入的好坏参半 长期精神疾病患者的维持。 虽然收据可能会启用 在机构环境之外更独立地生活，也可能 有意识和无意识地减少劳动力参与 并鼓励继续残疾——这是应得的条件。 那里 缺乏对角色的系统和纵向研究 积极和消极，基于残疾的收入维持，例如， SSI 和 SSDI 在慢性精神疾病患者的生活中发挥着作用。 这 研究项目旨在调查其中一些角色， 特别是描述应用决策的自然历史，简短 申请和接收对接收者的期限效应以及影响 各种形式的对应用决定和使用的依赖 服务。 提出了前瞻性设计，以绘制序列 导致参与的事件，以评估各自的 各种因素的贡献及其随时间的影响 收件人。 回顾性分析不足以确定 客户、服务和治疗系统之间的相互作用，禁用 条件、社会和心理因素，所有这些因素都会导致 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 残疾收入；工作人员与患者的关系以及对患者的态度 使用收入维持；治疗水平和服务体系 参与；依赖程度和类型；损伤程度， 就业状况和残疾持续时间。 我们建议遵循 从三个精神病住院治疗机构出院的人 两年来，比较那些申请并获得 SSI 和 SSDI 的人和那些 那些不这样做的人，以及那些使用服务并参与治疗和治疗的人 那些不这样做的人。