Mathematica Policy Research, Washington, D.C. (Baller, Blyler, Bronnikov); Geisel School of Medicine at Dartmouth, Hanover, New Hampshire (Xie); Westat, Rockville, Maryland (Bond); Social Security Administration, Baltimore (Filion, Hale).
Psychiatr Serv. 2020 Mar 1;71(3):243-249. doi: 10.1176/appi.ps.201800554. Epub 2019 Dec 4.
In this study, the authors assessed the long-term impact of the Mental Health Treatment Study (MHTS), a randomized controlled trial testing the effects of providing 2 years of employment services based on the evidence-based individualized placement and support model to Social Security Disability Insurance (SSDI) recipients with serious mental illness. Treatment recipients also received systematic medication management, supplemental health care supports, and short-term relief from medical continuing disability review by the Social Security Administration (SSA).
MHTS site data for 2,160 participants were linked to SSA administrative data from 2011 to 2015, 1 to 5 years after the original study concluded. Univariate and multivariate models were used to assess the MHTS effects on employment, earnings, and disability benefit suspension-termination up to 7 years after services ended.
The analyses showed that the treatment group was more likely than the control group to work, and average earnings among the treatment group increased more over time than earnings among the control group. Disability benefit suspension/termination did not differ between groups.
Providing the demonstration's package of services and support to SSDI beneficiaries with psychiatric disabilities for up to 2 years may have a long-term impact on employment and earnings. Under the SSDI program as currently structured, however, even after receiving 2 years of evidence-based supported employment and high-quality mental health services, SSDI beneficiaries with psychiatric conditions are unlikely to achieve economic independence within 5 years.
在这项研究中,作者评估了心理健康治疗研究(MHTS)的长期影响,这是一项随机对照试验,旨在测试为社会保障残疾保险(SSDI)受严重精神疾病影响的患者提供基于循证个体化安置和支持模式的就业服务两年的效果。治疗接受者还接受了系统的药物管理、补充医疗保健支持,并通过社会保障管理局(SSA)短期缓解医疗持续残疾审查。
将 MHTS 现场的 2160 名参与者的数据与 2011 年至 2015 年的 SSA 管理数据进行了链接,这是原始研究结束后 1 至 5 年。使用单变量和多变量模型评估 MHTS 对就业、收入和残疾福利暂停/终止的影响,最长可达服务结束后 7 年。
分析表明,治疗组比对照组更有可能工作,而且治疗组的平均收入随着时间的推移增长得更多,而对照组的收入增长得更多。残疾福利暂停/终止在组间没有差异。
向有精神残疾的 SSDI 受益人提供长达两年的示范服务包和支持可能对就业和收入产生长期影响。然而,根据当前的 SSDI 计划结构,即使在接受了两年的循证支持性就业和高质量的心理健康服务后,患有精神疾病的 SSDI 受益人也不太可能在 5 年内实现经济独立。