Supplemental Security Income Benefits for Mental Disorders.
The Supplemental Security Income Program (SSI) provides financial support to low-income households with children and youth with severe disabilities. The program included children when it began in the early 1970s. The numbers of children receiving SSI benefits increased substantially in the early 1990s, in part through an expansion of the listings of mental health conditions with which children could become eligible. Over the past 20 years, larger numbers of children have received SSI benefits for mental disorders, and these increases have led to questions from the press and Congress regarding these numbers. Do they indicate more of an increase in mental disorders among SSI children than in the general population? The National Academy of Medicine (NAM; formerly the Institute of Medicine) convened a study panel to examine what is known about mental disorders among the child SSI population and how that compares with evidence about mental disorders in children in general. The NAM report provides detailed information about how SSI works, about the changing numbers of children receiving SSI for mental disorders, and some comparisons with other evidence about rising rates of mental disorders in the general population and especially among children living in poverty. The report indicates that increasing numbers of children with mental disorders in SSI mirror similar increases in the population in general. This article summarizes key evidence from the NAM report and suggests the implications for pediatricians.
MassGeneral Hospital for Children, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; jperrin@mgh.harvard.edu.
James M
JM
Perrin
Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania;
Amy
A
Houtrow
Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, The Ohio State University, Columbus, Ohio;
Kelly
K
Kelleher
Department of Child Psychiatry, New York University School of Medicine, New York, New York;
Kimberly
K
Hoagwood
Children's Hospital at Montefiore, Bronx, New York; Albert Einstein College of Medicine, Bronx, New York; and.
Ruth E K
RE
Stein
Department of Psychiatry and Biobehavioral Sciences and UCLA-Semel Institute for Neurosciences and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, California.
Bonnie
B
Zima
D002648:Child; D004185:Disability Evaluation; D019988:Children with Disabilities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D001523:Mental Disorders; D011203:Poverty; D012720:Severity of Illness Index; D014481:United States