Changes in mental health and service use after termination of SSI benefits.
OBJECTIVE
Supplemental Security Income (SSI) benefits for a substance abuse disability were terminated by federal legislation as of January 1, 1997. This study examined the changes in mental health and in the use of mental health services two years after the legislation was implemented among individuals who had been receiving benefits under this classification.


METHODS
From a random sample of 400 SSI beneficiaries in Los Angeles, 253 were interviewed at the time the legislation took effect and again at 12-month, 18-month, and 24-month follow-ups. The study subjects were characterized by income source after the legislation and by probable mental health diagnosis. Their use of mental health services was also measured.


RESULTS
The mental health status of the participants remained unchanged between baseline and 24-month follow-up. The proportion who reported any use of mental health services decreased, primarily among those who continued receiving SSI benefits under a different classification. Among those who lost SSI benefits, emergency department visits and hospitalizations did not increase, and rates of outpatient visits remained the same.


CONCLUSIONS
Contrary to expectations, the mental health status of individuals who had been receiving SSI benefits for a substance abuse disability did not worsen after the benefits were terminated. Local safety nets and reclassification under another disability may have mitigated the effects of the policy change. The results of this study underscore the need for longitudinal data to inform policy decisions.
Watkins
K E
KE
Rand, Santa Monica, CA 90407-2138, USA. kwatkins@rand.org
Podus
D
D
Lombardi
E
E
Burnam
A
A
D000328:Adult; D005500:Follow-Up Studies; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007182:Income; D015141:Los Angeles; D008603:Mental Health; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D012943:Social Security / Q000331:legislation & jurisprudence*; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D014481:United States