Policy Brief: Evaluating the long-term effects of helping mental health consumers to receive SSI and Medicaid

Michael G. Dow
Timothy Boaz


People who live in poverty and are unable to work because of serious mental or physical illness are eligible for Supplemental Security Income (SSI). With SSI eligibility, consumers are enrolled in Medicaid and Food Stamp prgrams. Thus, it is crucial that mental health programs help consumers to apply for these benefits. In 1994, Institute faculty published the results of a controlled study in Community Mental Health Journal, which showed that a brief intervention could significantly increase the rates of applications and awards for persons with severe and persistent mental illnesses. Now, ten years later, administrative data from the FMHI Policy and Services Research Data Center (PSRDC) and mortality data from the Social Security Death Index were examined to gain insights into the longitudinal history of these individuals. It is possible for case managers to complete a simple form that predicts SSI allowance over an 8 to 12 year period. Thus, mental health programs who work with severely and persistently impaired individuals should engage in SSI outreach activities and assist this vulnerable population to secure benefits. This study also shows the persistent nature of severe mental illness. Researchers were able to account for over one-half of the people in the original study during the ten-year follow-up period. At the follow-up period, about one-half of the possibly eligible consumers who were not on SSI in 1991 were on SSI 8 to 12 years later. Moreover, the rate of death, Baker Act placement, and/or state hospital placement was quite high. This suggests that the populations served by these three community mental health centers were largely experiencing severe and persistent mental illness that still required treatment many years later. Further, these results suggest that the aging of the “baby boomer” generation will cause a significant increase in the number of people on SSI. Finally, consistent with the results of the original study, it is clear that applied mental health treatment programs should establish structured programs to help disabled individuals to apply for SSI in addition to normal case management activities. The study suggests that formal intervention with trained linkage workers, knowledgeable about this complex program, is beneficial. For more information about this study, contact Michael Dow or Timothy Boaz.