Frost-Gaskin Mary, O'Kelly Rory, Henderson Claire, Pacitti Richard
MIND in Croydon, Surrey, UK.
Int J Soc Psychiatry. 2003 Dec;49(4):251-63. doi: 10.1177/0020764003494003.
Many psychiatric service users are entitled to welfare benefits, but work from the UK and the USA suggests many are either unaware of their entitlements or find the benefits system difficult to access.
This study has four aims: 1) to assess the extent to which people using a range of community mental health services receive the welfare benefits to which they are entitled; 2) to calculate the impact on income of receiving help from specialist benefits advisors; 3) to ascertain sociodemographic risk factors for under-claiming; and 4) to identify reasons for under-claiming related to the claims system itself, in order to make recommendations for routine practice.
This report makes use of data collected during a welfare benefit uptake project by Mind in Croydon staff (MF-G, RO, RP). Benefit assessments were offered to a total of 153 people attending any Croydon resource centre (run by the Health Service) other than the pilot site, or day centre (run by Social Services) for people with mental health problems. All those who were identified as under-claiming were offered help pursuing claims through to conclusion. We used quantitative methods to address the first three aims; qualitative methods in the form of case studies were used to address the fourth.
One-third (34%) of people seen were getting their correct entitlement and two-thirds (66%) were under-claiming. All those found to be under-claiming who accepted all the help offered (87 out of 99 underclaimants) did gain additional benefits as a result, of a mean annual amount of pound 3079 each. Under-claiming was more frequent in those under 65 years of age, but having had previous advice or having a care manager did not protect against under-claiming. A number of reasons for under-claiming were identified.
For a large and possibly increasing proportion of people using community mental health services, the current benefits system necessitates frequent advice and help by expert advisers to avoid poverty due to underclaiming. The adverse effects on quality of life and mental health may be significant, as are the economic implications of correcting this level of under-claiming.
许多精神科服务使用者有权享受福利，但来自英国和美国的研究表明，许多人要么不知道自己的权利，要么觉得福利系统难以申请。
本研究有四个目的：1）评估使用一系列社区精神卫生服务的人群获得其应享福利的程度；2）计算接受专业福利顾问帮助对收入的影响；3）确定申领不足的社会人口风险因素；4）找出与申领系统本身相关的申领不足原因，以便为常规实践提出建议。
本报告利用了克罗伊登心理健康协会工作人员（MF-G、RO、RP）在一个福利申领项目中收集的数据。对除试点地点外的任何克罗伊登资源中心（由卫生服务机构运营）或为有心理健康问题的人设立的日间中心（由社会服务机构运营）的总共153人进行了福利评估。所有被确定为申领不足的人都得到了帮助，直至申领结束。我们使用定量方法来实现前三个目标；采用案例研究形式的定性方法来实现第四个目标。
接受评估的人中有三分之一（34%）获得了正确的应享福利，三分之二（66%）申领不足。所有被发现申领不足且接受了所有提供帮助的人（99名申领不足者中的87名）因此确实获得了额外福利，平均每人每年3079英镑。65岁以下的人申领不足的情况更为频繁，但之前接受过建议或有护理经理并不能防止申领不足。确定了一些申领不足的原因。
对于使用社区精神卫生服务的很大一部分且可能不断增加的人群来说，当前的福利系统需要专家顾问频繁提供建议和帮助，以避免因申领不足而陷入贫困。对生活质量和心理健康的不利影响可能很大，纠正这种申领不足水平的经济影响也是如此。
