Does assigning a representative payee reduce substance abuse?

Abstract:

BACKGROUND:Approximately 700,000 Social Security beneficiaries in the U.S. with psychiatric disabilities have been assigned a representative payee to manage their funds but it is unclear how those judged to need a payee differ from others and whether payee assignment improves clinical outcomes, especially substance abuse. METHODS:Participants in this observational 12-month cohort study (n=1457) received SSI or SSDI and had serious mental illness. They were subsequently enrolled at eighteen community-based sites that provided Assertive Community Treatment. Social Security administrative records were used to determine whether a payee had been assigned. RESULTS:At baseline, participants who were assigned a payee were more likely to have schizophrenia and had more severe clinician-rated drug and alcohol use than those not assigned a payee. In GEE models that adjusted for these and other potentially confounding covariates, participants assigned a payee between 4 and 12 months after program entry subsequently used significantly more psychiatric services than participants not assigned payees but showed no greater reduction in substance use. CONCLUSIONS:Although substance use is associated with being assigned a payee, substance use does not decline substantially following payee assignment. Participants assigned payees made greater subsequent use of psychiatric services, suggesting the potential for benefit from payee assignment.

journal_name

Drug Alcohol Depend

authors

Rosen MI,McMahon TJ,Rosenheck R

doi

10.1016/j.drugalcdep.2006.05.026

subject

Has Abstract

pub_date

2007-01-12 00:00:00

pages

115-22

issue

2-3

eissn

0376-8716

issn

1879-0046

pii

S0376-8716(06)00210-9

journal_volume

86

pub_type

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