168 lines
5.5 KiB
YAML
168 lines
5.5 KiB
YAML
abstract: 'Background: Persons with severe and persistent mental disorders (SPMD)
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have extremely low earnings levels and account for 29.1 percent of all
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U.S. Social Security Disability Income (SSDI) disabled worker
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beneficiaries under age 50. Social insurance and disability policy
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experts pointed to several factors that may contribute to this
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situation, including disincentives and obstacles in the SSDI program, as
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well as lack of access to evidence-based behavioral-health
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interventions. In response, the Social Security Administration (SSA)
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funded the Mental Health Treatment Study (MHTS) demonstration that
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included 2,238 beneficiaries of SSDI whose primary reason for disability
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is SPMD. The demonstration, implemented in 23 different localities,
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consisted of two evidence-based services (individual placement and
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support supported employment (IPS-SE), systematic medication management
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(SMM)), and provision or coverage of additional behavioral-health
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services (OBH).
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Study Aims: This study focused on estimating MHTS intervention effects
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on earnings in the intervention period (two-years). The main outcome
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variable was self-reported average monthly earnings.
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Methods: Subjects were randomly assigned to intervention or control
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groups. Data were drawn from the baseline survey, seven follow-up
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quarterly surveys, a final follow-up survey, and SSA administrative
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data. In all surveys, respondents were asked about earnings prior to the
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interview. Dependent variables were average past-30-days earnings
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reported in all follow-up surveys, similar averages for the first four
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follow-ups and for the last four follow-ups, fraction of surveys with
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prior earnings above SSA''s substantial gainful activity (SGA) threshold,
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and final-follow-up earnings for the past 90 days. Regression analyses
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compared earnings of intervention vs. control group subjects. Covariates
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included baseline values of: (i) beneficiary demographic and social
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characteristics; (ii) beneficiary physical and mental health indicators;
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(iii) beneficiary recipiency history; (iv) beneficiary pre-recruitment
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and baseline earnings; and (v) local labor-market unemployment rates.
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Results: Results show significant positive MITTS earnings impacts.
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Estimated annual increases of earnings range from \$791 (based on the
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2-year average) to \$1,131 (based on the final quarter of Year 2).
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Effects on the fraction of quarters with earnings exceeding SGA are
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positive and significant but very small in magnitude.
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Discussion: The consistent increase in earnings impacts over the study
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period suggests the possibility of even larger impacts with longer-term
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interventions. The moderate size of the intervention impacts may partly
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be explained by a study population that already had an average of 9
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years on SSDI, and whose labor-supply decisions continued to be affected
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by concerns about possible loss of benefits. Limitations are that (i)
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earnings effects of specific intervention components cannot be estimated
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since all treatment subjects received the same package of services, and
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(ii) study results may not generalize to the majority of the beneficiary
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population due to selection effects in beneficiaries'' participation
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decisions.
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Implications: Replication of the MHTS on a broader scale should show
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similar positive earnings impacts for a substantial number of
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beneficiaries with characteristics similar to the study population.
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Future studies should consider reducing policy barriers to labor supply
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of persons with SPMD. Future studies should consider longer-term
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interventions, or at least measuring impacts for follow-up periods
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greater than two years.'
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affiliation: 'Salkever, DS (Corresponding Author), Univ Maryland Baltimore Cty, Dept
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Publ Policy, Rm 418,Public Policy Bldg 1000 Hilltop Circle, Baltimore, MD 21250
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USA.
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Salkever, David S., Univ Maryland Baltimore Cty, Dept Publ Policy, Baltimore, MD
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21250 USA.
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Gibbons, Brent, Univ Maryland Baltimore Cty, MIPAR, Baltimore, MD 21250 USA.
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Drake, Robert E., Dartmouth Coll, Geisel Sch Med, Dept Psychiat, Hanover, NH USA.
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Frey, William D.; Karakus, Mustafa, WESTAT Corp, Rockville, MD 20850 USA.
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Hale, Thomas W., US Social Secur Adm, SSA ORDP ORDES OPR, Woodlawn, MD USA.'
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author: Salkever, David S. and Gibbons, Brent and Drake, Robert E. and Frey, William
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D. and Hale, Thomas W. and Karakus, Mustafa
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author-email: Salkever@umbc.edu
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author_list:
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- family: Salkever
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given: David S.
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- family: Gibbons
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given: Brent
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- family: Drake
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given: Robert E.
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- family: Frey
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given: William D.
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- family: Hale
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given: Thomas W.
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- family: Karakus
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given: Mustafa
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da: '2023-09-28'
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eissn: 1099-176X
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files: []
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issn: 1091-4358
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journal: JOURNAL OF MENTAL HEALTH POLICY AND ECONOMICS
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keywords-plus: 'LABOR-MARKET OUTCOMES; SUPPORTED EMPLOYMENT; SCHIZOPHRENIA; ILLNESS;
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PEOPLE; PREDICTORS; MULTISITE; TRIAL'
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language: English
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month: JUN
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number: '2'
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number-of-cited-references: '32'
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orcid-numbers: Gibbons, Brent/0000-0002-9717-8969
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pages: 75-90
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papis_id: adef609b089d3baeb82493bc9c939344
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ref: Salkever2014increasingearnings
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researcherid-numbers: 'Drake, Robert/AAS-3310-2020
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'
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times-cited: '13'
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title: Increasing Earnings of Social Security Disability Income Beneficiaries with
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Serious Mental Disorder
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type: article
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unique-id: WOS:000337268500005
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usage-count-last-180-days: '0'
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usage-count-since-2013: '18'
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volume: '17'
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web-of-science-categories: Health Policy \& Services; Psychiatry
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year: '2014'
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