Characteristics of third-party money management for persons with psychiatric disabilities.
OBJECTIVE
The study examined different types of third-party money management arrangements for persons with psychiatric disabilities and consumers' perceptions of their finances in the context of these arrangements.


METHODS
Clinical and demographic data were collected through structured interviews and record reviews for 240 persons with a diagnosis of a psychotic or major affective disorder who had been involuntarily hospitalized and were awaiting discharge on outpatient commitment in North Carolina. All consumers were receiving Supplemental Security Income or Social Security Disability Insurance.


RESULTS
Third-party money management arrangements were reported by 102 (41 percent) of the study participants. A majority (77 percent) of these consumers had their finances managed by a family member. Consumers with third-party money managers were more likely to have a median annual income below 5,000 US dollars, to have a diagnosis of a primary psychotic disorder, and to have substance use problems. Most participants with third-party money managers reported that they received sufficient money to cover basic expenses, although about half also perceived having insufficient money to participate in enjoyable activities.


CONCLUSIONS
Given that treatment for severe mental illness emphasizes social skills training and development of social support networks, financial limitations could undermine therapeutic efforts. It is important that clinicians consider the role of financial concerns when assessing consumers. Additional research should be conducted to better understand the role of financial variables in providing effective mental health services.
Elbogen
Eric B
EB
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA. eric.elbogen@duke.edu
Swanson
Jeffrey W
JW
Swartz
Marvin S
MS
Wagner
H Ryan
HR
D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders; D005190:Family; D005260:Female; D005382:Financing, Personal / Q000379:methods*; D006801:Humans; D018868:Insurance, Disability / Q000191:economics*; D007872:Legal Guardians; D008297:Male; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D009657:North Carolina; D010347:Patient Care Planning / Q000191:economics; D017060:Patient Satisfaction; D011618:Psychotic Disorders / Q000188:drug therapy / Q000191:economics*; D012943:Social Security / Q000191:economics*