Optimizing Disability Benefit Decisions and Outcomes in First Episode Psychosis

优化首发精神病中的残疾福利决策和结果

• 批准号: 10521916
• 负责人: LISA B. DIXON
• 金额: $ 78.76万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-09 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10521916
• 关键词: Affect; Age; Attention; Award; Black American; COVID-19 pandemic; California; Characteristics; Client; Clinical; Communities; Complex; Consolidated Framework for Implementation Research; Coordinated Specialty Care; Data; Data Collection; Data Set; Decision Making; Deterioration; Development; Disincentive; Economics; Employment; Enrollment; Evaluation; Evidence based practice; Feedback; Funding; Generations; Goals; Impairment; Independent Living; Individual; Interruption; Intervention; Interview; Knowledge; Learning; Link; Medicaid; Medicare/Medicaid; Mental Health Services; Methods; Minority; Modeling; Motivation; National Institute of Mental Health; New York; Outcome; Partnership Practice; Pennsylvania; Persons; Play; Policies; Population; Poverty; Process; Psychoses; Psychotic Disorders; Race; Recovery; Research; Research Personnel; Role; Schizophrenia; Schools; Service delivery model; Services; Shock; Site; Social Security; Structural Racism; Surveys; Texas; Time; Translational Research; United States; United States Social Security Administration; Work; Youth; aged; care recipients; care systems; career development; design; disability; disability impact; early psychosis; evidence base; experience; first episode psychosis; implementation strategy; improved; improved outcome; innovation; minority children; prevent; programs; racial difference; racial discrimination; racial disparity; racial identity; research to practice; social; social determinants; social influence; sociodemographics; young adult

A major NIMH goal for early psychosis treatment is to “prevent deterioration and disability among individuals suffering from psychotic illness”. However, rates of Social Security Administration disability (SSI/DI) enrollment remain high for young people in early psychosis treatment. Existing studies on SSI/DI have limited information on the FEP population. Enrollment in SSI/DI may provide benefits (including cash assistance, access to Medicaid/Medicare, and other social entitlements), but also detrimentally impact identity, vocational aspirations, career development and employment; individuals rarely leave SSAD benefits for full-time work. Racial disparities have also been identified, but remain poorly understood, with respect to the intersections between race, structural racism and the poorer outcomes long-documented among ethnoracialized minorities, particularly Black Americans. It is crucial to generate knowledge with the potential to inform decision-making about the benefits and trade-offs inherent in SSI/DI participation and help optimize outcomes within the context of SSI/DI participation among this population of young people (e.g. generally aged 16-30). The primary goal of this project is to investigate factors influencing decisions to apply for SSI/DI, the impact of these decisions, and the longitudinal relationships between SSI/DI and career development. This information will then be used to develop systematic strategies for improving services, supporting client decision making and optimizing outcomes. The NIMH-funded Early Psychosis Intervention Network (EPINET), spanning 105 coordinated specialty care (CSC) programs across 16 states, affords an exceptional opportunity to better understand these issues. Leveraging the EPINET initiative, this multi-phase, mixed methods study will provide important new knowledge regarding predictors of application and the relationship between SSI/DI and vocational functioning, will facilitate development and evaluation of a multi-level menu of actionable targets and associatedimplementation strategies, for example, specific ways of improving programmatic supports and policy changes designed to strengthen SSAD-related outcomes (translation of research to practice). The project is guided by the multi-level Disability Creation Process (DCP2) framework, and implementation activities by the Consolidated Framework for Implementation Research (CFIR). The proposed project will utilize quantitative data from the EPINET common dataset (n=5000), supplemented with primary quantitative (n = 330) and qualitative (n = 110) data collection in four distinct states. The study aims are to: determine the extent and predictors of SSI/DI application, SSAD enrollment and work/school functioning among clients enrolled in CSC programs, systematically investigate the client experience of SSI/DI decision making (through quantitative and qualitative data) and using implementation mapping to develop strategies to optimize CSC services as they impact SSI/DI. Racial differences and potential disparities will be examined across all three Aims.

早期精神病治疗的主要NIMH目标是“防止细节和残疾 但是，患有精神病的人”。但是，社会保障局残疾的率（SSI/DI） 在早期精神病治疗中，年轻人的入学人数仍然很高。现有关于SSI/DI的研究有限 有关FEP人群的信息。 SSI/DI的注册可能会提供福利（包括现金援助， 获得医疗补助/医疗保险以及其他社会权利），但也会对身份有害，投票 愿望，职业发展和就业；个人很少为全职工作留下SSAD福利。 还已经确定了种族分布，但在交叉点方面仍然很了解 在种族，结构性种族主义和在民族化少数民族中长期以来的较差成果之间， 特别是黑人美国人。产生知识的潜力至关重要 关于SSI/DI参与中固有的利益和权衡，并有助于在上下文中优化结果 SSI/DI在这一年轻人中的参与（例如，通常年龄在16-30岁）。 该项目的主要目标是研究因素影响申请SSI/DI的决策， 这些决定的影响以及SSI/DI与职业发展之间的纵向关系。这 然后，信息将用于制定改善服务的系统策略，支持客户决策 制定和优化结果。 NIMH资助的早期精神病干预网络（EPITSET），跨越105个配位专业 跨16个州的CARE（CSC）计划为更好地理解这些问题提供了一个特别的机会。 利用该倡议，这项多相混合方法研究将提供重要的新知识 相关的应用预测因素以及SSI/DI与职业功能之间的关系，将有助于 多级可行的目标和关联菜单的开发和评估 例如，策略，改善了旨在改善程序化支持和政策更改的特定方法 加强与SSAD相关的结果（将研究翻译成实践）。该项目以多层次为指导 残疾创建过程（DCP2）框架和通过合并框架实施活动 用于实施研究（CFIR）。拟议的项目将利用Epatet的定量数据 常见数据集（n = 5000），补充了主要定量（n = 330）和定性（n = 110）数据 在四个不同的状态中收集。该研究的目的是：确定SSI/DI的程度和预测指标 在参加CSC计划的客户中，应用程序，SSAD注册和工作/学校功能， 系统地研究SSI/DI决策的客户体验（通过定量和定性 数据）并使用实施映射来制定策略以优化CSC服务，以便它们影响它们 SSI/DI。种族差异和潜在差异将在所有三个目标中进行检查。