New Study Assesses Risks for Receiving Mental Disability Payments

Having a mental or addictive disorder was the most significant predictor of receiving disability payments, according to a new study by researchers at the Johns Hopkins School of Public Health. The researchers also found that those with less education or lower incomes were more likely to receive mental disability payments. The report appears in the July 2000 issue of Psychiatric Services, a journal of the American Psychiatric Association.

More than 35 million Americans, or one in seven, have disabling conditions that interfere with their life activities. Working rates among the disabled have dropped in recent years, causing an increase in the number of people receiving disability payments. Those suffering from mental or addictive disorders comprise the largest group collecting disability.

The Hopkins study is based on data from the National Institute of Mental Health Epidemiologic Catchment Area (ECA) survey, and includes 11,981 people from Baltimore, Md.; New Haven, Conn.; Durham, N.C.; and Los Angeles, Calif. Researchers initially determined the rates of mental disorders and sociodemographic predictors of the participants by using standardized interview questions to obtain DSM-III diagnosis. A year later, the investigators returned to find that 2.2 percent of the initial group had started to receive new mental disability payments. Those with less than an eighth grade education were almost four times as likely to be receiving payments, while those whose income was less than $5,000 per year were three times as likely.

Those at risk for receiving payments for a disability, however, were still more likely to suffer from mental disorders than any other predictor, pointed out Anthony Kouzis, PhD, assistant professor of Opthamology and Medicine at Johns Hopkins School of Medicine. The most common disorders causing disabling conditions were panic disorder and schizophrenia.

Kouzis said serious mental illness often prevents people from performing their normal activities. "Despite the stereotypes, people receiving mental disability payments have psychiatric disorders that could be treated, possibly allowing them to continue working or functioning independently in the community," he said.

The study refutes the misperception that most people receiving mental disability payments are addicted to alcohol or other drugs. "Unlike what's been often discussed in Washington or the news media, people suffering from alcohol or drug dependencies are not those most likely to receive disability payments," said Kouzis. The researchers found that those suffering from panic disorder, 5.1 percent, were most likely to receive disability payments, while the rate for those suffering from alcohol dependency was only 2.6 percent.

The authors, Drs. Anthony Kouzis and William Eaton, PhD, professor of Mental Health at Johns Hopkins School of Public Health, say that a better understanding of mental illness would help keep people off disability, or facilitate a quicker return to work. "Care and treatment services for conditions like depression aren't as plentiful as they are for physical ailments like heart disease and cancer," said Kouzis. More funding for preventive measures or workplace accommodations, such as counseling on the job and more liberal leave, could ultimately reduce money spent on mental disability pay.

Funding for this study was provided by a grant from the National Institute of Mental Health.