title: Psychiatric disorder and unmet service needs among welfare clients in a representative payee program.
abstract: This study assessed psychiatric problems, needs for psychiatric and social services, and service utilization among clients of a public assistance program. Sixty-five clients were assessed using a structured clinical interview to determine the presence of a psychiatric disorder (using the CIDI-A), extent of social service need, and health-related quality of life (RAND SF-36). Seventy-seven percent of the sample met criteria for at least one current or lifetime psychiatric disorder. Health-related quality of life was substantially below published norms. Most clients reported needing financial, housing, and vocational assistance. Many had contact with mental health services, but few were actually receiving psychiatric treatment. Although many clients were assessed as having serious psychiatric, physical, or social needs, very few were receiving appropriate services for these problems. Findings suggest problems or barriers to the provision of services that need to be investigated among this vulnerable community population.
authors.affiliation: Indiana University-Purdue University Indianapolis, Psychology Department, LD 124, 402 North Blackford Street, Indianapolis, IN 46202-3275, USA. jevans2@iupui.edu
authors.forename: Jovier D
authors.initials: JD
authors.lastname: Evans
authors.forename: Dustin E
authors.initials: DE
authors.lastname: Wright
authors.forename: Soren
authors.initials: S
authors.lastname: Svanum
authors.forename: Gary R
authors.initials: GR
authors.lastname: Bond
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015146:Midwestern United States; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011788:Quality of Life / Q000523:psychology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012943:Social Security / Q000706:statistics & numerical data*; D012946:Social Welfare / Q000706:statistics & numerical data*; D012949:Social Work, Psychiatric / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D014600:Utilization Review
chemical_list: D011619:Psychotropic Drugs