Disability Benefits and Service Use

残疾福利和服务使用

• 批准号: 6539146
• 负责人: BARTLEY CHRISTOPHER FRUEH
• 金额: $ 7.15万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-04-01 至 2004-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6539146
• 关键词: anxiety disorders; behavioral /social science research tag; disability insurance; education; employment /unemployment; functional ability; health care service utilization; health services research tag; human data; income; marriage /marital status; medical rehabilitation related tag; mental health services; mood disorders; person with disability; posttraumatic stress disorder; psychosis; socioeconomics; substance abuse related disorder; veterans; vocational rehabilitation

The research aim of this proposal is to advance our understanding of the association between disability benefits, service use (medical, mental health, rehabilitation), race, and clinical presentation among trauma victims with severe posttraumatic stress disorder (PTSD) and other associated mental illnesses. It is well accepted that persons with mental illnesses often experience severe occupational impairment and related financial hardships associated with their psychiatric condition. Recent advances in clinical and rehabilitative services, and changes in public opinion and subsequent legislative reform toward welfare and the Work Incentives Improvement Act of 1999, have led policy makers to reconsider multiple aspects of the current disability policies. Unfortunately, rehabilitative efforts have not been shown to significantly increase the work-related income of persons with psychiatric disabilities. Furthermore, we know relatively little about how public disability benefits affect work behavior or use of other services available within various public systems. At present the VA system offers a unique opportunity to study the relationship between clinical symptoms, associated disability, and service use because it is a large, closed system which provides a broad range of medical, mental health, and social services. Furthermore, the clients served by the VA system (i.e., veterans) are of interest in that they represent a population that has high percentages of rural and minority members. Thus, the VA system represents the chance to study a range of variables that are of general interest to policy makers, advocates, and key stakeholders concerned with the welfare of mentally ill persons. In this study we will learn more about the relationship between service use and a number of relevant variables (e.g., race, symptom reporting, disability seeking, employment) by examining archival data, including administrative and medical records, on approximately 450 trauma victims with severe PTSD served within the VA system. These data may have implications for our understanding of service delivery systems for trauma victims with severe PTSD and other associated mental illnesses, including the important interface with associated psychiatric disability and rehabilitation efforts. This proposal is responsive to Health People 2010 and the Bridging Science and Service report recommendation regarding rehabilitation and interventions (recommendation #9).

这项建议的研究目的是增进我们对患有严重创伤后应激障碍(PTSD)和其他相关精神疾病的创伤受害者的残疾福利、服务使用(医疗、心理健康、康复)、种族和临床表现之间的关系的理解。众所周知，患有精神疾病的人往往会经历严重的职业损害和与其精神状况有关的经济困难。最近在临床和康复服务方面的进展，以及公众舆论的变化和随后针对福利和1999年《工作激励改善法》的立法改革，促使政策制定者重新考虑当前残疾政策的多个方面。不幸的是，康复努力并未显示出能显著增加精神病残疾人与工作有关的收入。此外，我们对公共伤残福利如何影响工作行为或各种公共系统内提供的其他服务的使用知之甚少。目前，退伍军人管理局系统提供了一个独特的机会来研究临床症状、相关残疾和服务使用之间的关系，因为它是一个大型、封闭的系统，提供广泛的医疗、心理健康和社会服务。此外，退伍军人制度服务的客户(即退伍军人)令人感兴趣，因为他们代表的人口中农村和少数族裔成员所占比例很高。因此，退伍军人制度代表着研究一系列变量的机会，这些变量对政策制定者、倡导者和关注精神病患者福利的关键利益相关者普遍感兴趣。在这项研究中，我们将通过检查退伍军人管理局系统内约450名患有严重创伤后应激障碍的创伤患者的档案数据，包括行政和医疗记录，进一步了解服务使用与一些相关变量(例如，种族、症状报告、残疾寻求、就业)之间的关系。这些数据可能会对我们理解为患有严重创伤后应激障碍和其他相关精神疾病的创伤受害者提供服务的系统，包括与相关的精神残疾和康复努力的重要接口产生影响。这项提案是对《2010年健康人》和《衔接科学和服务报告》关于康复和干预措施的建议(建议9)作出的回应。