Mathematica Policy Research, Inc., Washington, DC, USA.
Psychiatr Serv. 2010 May;61(5):495-9. doi: 10.1176/ps.2010.61.5.495.
In recent years, welfare caseloads have declined dramatically, leaving on the rolls recipients with mental disorders or other challenges that may affect their ability to work. This study identified Temporary Assistance for Needy Families (TANF) recipients (that is, welfare recipients) who use mental health services, compared them with Supplemental Security Income (SSI) recipients, and estimated the number of TANF recipients who might qualify for SSI.
Based on data from the 2003 Medicaid Analytic eXtract (MAX) files from four states, this analysis included female Medicaid beneficiaries aged 19 to 64 in fee-for-service payment systems receiving SSI (N=65,303) or TANF (N=22,691).
Thirteen percent of TANF beneficiaries and 32% of SSI beneficiaries with Medicaid claims had a mental disorder. Common disorders among TANF beneficiaries included neurotic and other depressive disorders and major depression and affective psychoses. Eleven percent of TANF recipients had levels of service use comparable with those of SSI recipients.
The proportion of TANF recipients using mental health services was lower than the proportion of TANF recipients identified through surveys as having a mental disorder, most likely because some TANF recipients had mental disorders that were undiagnosed and untreated. Among those using services, some had patterns of use indicating potential eligibility for SSI, but most appeared to have more modest limitations.
近年来，福利救济金的发放数量大幅减少，导致领取救济金的人中患有精神障碍或其他可能影响其工作能力的疾病。本研究旨在确定使用心理健康服务的“补充营养援助计划”（Temporary Assistance for Needy Families，TANF）受助者（即领取福利救济金的人），并将他们与“补充保障收入”（Supplemental Security Income，SSI）受助者进行比较，同时估计有多少 TANF 受助者可能符合 SSI 的条件。
本研究基于来自四个州的 2003 年 Medicaid 分析提取（Medicaid Analytic eXtract，MAX）文件中的数据，分析了在按服务收费的支付系统中接受 SSI（N=65303）或 TANF（N=22691）的年龄在 19 至 64 岁的女性 Medicaid 受益人的数据。
有 13%的 TANF 受益人和 32%的有 Medicaid 索赔的 SSI 受益患有精神障碍。TANF 受益人的常见障碍包括神经症和其他抑郁障碍、重度抑郁症和情感性精神病。有 11%的 TANF 受助者的服务使用水平与 SSI 受助者相当。
使用心理健康服务的 TANF 受助者比例低于通过调查确定的患有精神障碍的 TANF 受助者比例，这很可能是因为一些 TANF 受助者的精神障碍未被诊断和治疗。在使用服务的人群中，一些人的使用模式表明他们可能有资格获得 SSI，但大多数人的限制程度似乎较为适度。
