Estroff S E, Patrick D L, Zimmer C R, Lachicotte W S
Department of Social Medicine, School of Medicine, University of North Carolina, Chapel Hill 27599-7240, USA.
Milbank Q. 1997;75(4):495-532. doi: 10.1111/1468-0009.00067.
Persons with psychiatric disorders comprise the largest diagnostic group of disabled recipients of Supplemental Security Income (SSI) and Social Security Disability Income (SSDI). A 32-month prospective cohort study of pathways to application for and receipt of SSI and SSDI was conducted among 169 people with major psychiatric disorders who were at an early stage of their illness and who had never applied for or received disability income. Of the three pathways that formed the conceptual basis for the investigation—labeling, impairment, and needs/resources—the latter two emerged as significantly associated with receipt. Individuals with more severe symptoms who were African American, and who were psychologically dependent in a primary relationship and financially dependent on their families, were more likely to become recipients. Enabling and disabling aspects of disability income receipt suggest that it may be replacing prolonged hospitalization as the most enduring social role of persons with severe, persistent psychiatric disorders.
患有精神疾病的人是补充保障收入（SSI）和社会保障残疾收入（SSDI）残疾受益人中诊断人数最多的群体。对169名患有严重精神疾病且处于疾病早期、从未申请过或领取过残疾收入的人进行了一项为期32个月的前瞻性队列研究，研究申请和领取SSI和SSDI的途径。在构成调查概念基础的三种途径——标签化、损伤以及需求/资源——中，后两种途径与领取显著相关。症状更严重、非裔美国人、在主要关系中存在心理依赖且在经济上依赖家庭的个体更有可能成为受益人。残疾收入领取的促成和阻碍因素表明，它可能正在取代长期住院，成为患有严重持续性精神疾病者最持久的社会角色。
