title: Early interventions to prevent disability for workers with mental health conditions: impacts from the DMIE.
abstract: BACKGROUND
  As of 2011, over 9 million working-age adults were receiving federal disability benefits and this number is expected to rise steadily. Early intervention programs that seek to maintain employment and forestall the receipt of federal disability benefits offer a promising strategy to reduce the growing number of working-age adults on the disability rolls.
  
  
  OBJECTIVE
  Using random assignment, this study examined whether an early intervention program of personal navigators, enhanced medical care, and employment supports can reduce dependence on federal disability benefits for adult workers with mental health conditions.
  
  
  METHODS
  The study reports multivariate and descriptive findings based on 2279 participants in the Demonstration to Maintain Independence and Employment (DMIE). Logistic regression analysis was used to estimate program impacts in the treatment group relative to the control group. Data were integrated from state participant surveys and the SSA Ticket Research File.
  
  
  RESULTS
  The DMIE intervention significantly reduced the percent of participants who received disability benefits after 12 months of enrollment. Across both states, the difference between the treatment group and control group was 1.1 percentage points (2.5% versus 3.6%, p < 0.01). In Texas, the difference was 1.2 percentage points (3.2% versus 4.4%, p < 0.01).
  
  
  CONCLUSIONS
  Early intervention programs with a personal navigator can reduce dependence on federal disability benefits for adult workers with mental health conditions. Future studies on the cost-effectiveness of such programs are needed.
authors.affiliation: Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA. Electronic address: ggimm@gmu.edu.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Gimm
authors.affiliation: Mathematica Policy Research, Washington, DC, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Hoffman
authors.affiliation: Mathematica Policy Research, Washington, DC, USA.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Ireys
mesh_terms: D000328:Adult; D003695:Delivery of Health Care; D006233:Persons with Disabilities; D004651:Employment; D005260:Female; D006801:Humans; D018868:Insurance, Disability; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders; D009786:Occupational Health Services; D015397:Program Evaluation; D012943:Social Security; D013781:Texas; D014481:United States
keywords: Disability; Early intervention; Employment; Mental health; Random assignment