title: Veterans who may need a payee to prevent misuse of funds for drugs.
abstract: OBJECTIVE
  This study sought to determine the possible need for a payee among Department of Veterans Affairs (VA) inpatients with substance use disorders who receive public support payments.
  
  
  METHODS
  A total of 290 veterans hospitalized in VA psychiatric units completed a survey designed to identify patients who may be in need of a payee because of excessive expenditures for substances of abuse. Level 1 screening identified patients with a general likelihood of needing a payee because they received public support payments, did not have a payee, and had a substance abuse diagnosis. Level 2 screening identified level 1 patients for whom there was further evidence of need for a payee because, in addition to spending substantial amounts of money on substances of abuse, they reported either difficulty meeting basic material needs or substantial harm from substance use.
  
  
  RESULTS
  Of 290 patients surveyed, 78 (27 percent) met level 1 criteria. Altogether, 35 patients (45 percent of level 1 patients and 13 percent of all surveyed patients) met the more specific level 2 criteria, indicating that they were likely to be in need of a payee. As expected, veterans who met the level 2 criteria were more likely than those meeting only the level 1 criteria to have both self-rated and clinician-rated difficulties managing money. However, clinicians did not rate these veterans as more likely to benefit from a payee.
  
  
  CONCLUSIONS
  A substantial proportion of veterans who have not been assigned a payee may need one. More effective approaches to money management in this population are needed.
authors.affiliation: Psychiatry, Yale University School of Medicine, New Haven, CT, USA. marc.rosen@yale.edu
authors.forename: Marc I
authors.initials: MI
authors.lastname: Rosen
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rosenheck
authors.forename: Andrew
authors.initials: A
authors.lastname: Shaner
authors.forename: Thad
authors.initials: T
authors.lastname: Eckman
authors.forename: Gail
authors.initials: G
authors.lastname: Gamache
authors.forename: Christopher
authors.initials: C
authors.lastname: Krebs
mesh_terms: D002201:Capital Expenditures; D005376:Financial Management / Q000191:economics* / Q000379:methods*; D006301:Health Services Needs and Demand; D006801:Humans; D008605:Mental Health Services / Q000191:economics*; D008875:Middle Aged; D012944:Social Support; D019966:Substance-Related Disorders / Q000191:economics*; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology*