Simulations Test Impact Of Education, Employment, And Income Improvements On Minority Patients With Mental Illness

被引:16
作者
Alegria, Margarita [1 ,2 ,3 ]
Drake, Robert E. [4 ]
Kang, Hyeon-Ah [5 ]
Metcalfe, Justin [6 ]
Liu, Jingchen [5 ]
DiMarzio, Karissa [3 ]
Ali, Naomi [3 ]
机构
[1] Harvard Med Sch, Dept Med, Boston, MA USA
[2] Harvard Med Sch, Dept Psychiat, Boston, MA USA
[3] Massachusetts Gen Hosp, Dept Med, Dispar Res Unit, Boston, MA 02114 USA
[4] Westat Corp, IPS Employment Ctr, Lebanon, NH 03766 USA
[5] Columbia Univ, Dept Stat, New York, NY USA
[6] Dartmouth Inst, Lebanon, NH USA
关键词
PSYCHIATRIC-DISORDERS; SUBSTANCE USE; HEALTH; DISPARITIES; PEOPLE; RACE; EPIDEMIOLOGY; PREVALENCE; MORTALITY; PATTERNS;
D O I
10.1377/hlthaff.2017.0044
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
100404 [儿少卫生与妇幼保健学];
摘要
Social determinants of health, such as poverty and minority background, severely disadvantage many people with mental disorders. A variety of innovative federal, state, and local programs have combined social services with mental health interventions. To explore the potential effects of such supports for addressing poverty and disadvantage on mental health outcomes, we simulated improvements in three social determinants-education, employment, and income. We used two large data sets: one from the National Institute of Mental Health that contained information about people with common mental disorders such as anxiety and depression, and another from the Social Security Administration that contained information about people who were disabled due to severe mental disorders such as schizophrenia and bipolar disorder. Our simulations showed that increasing employment was significantly correlated with improvements in mental health outcomes, while increasing education and income produced weak or nonsignificant correlations. In general, minority groups as well as the majority group of non-Latino whites improved in the desired outcomes. We recommend that health policy leaders, state and federal agencies, and insurers provide evidence-based employment services as a standard treatment for people with mental disorders.
引用
收藏
页码:1024 / 1031
页数:8
相关论文
共 53 条
[31]
A Randomized Clinical Trial of a Telephone Depression Intervention to Reduce Employee Presenteeism and Absenteeism [J].
Lerner, Debra ;
Adler, David A. ;
Rogers, William H. ;
Chang, Hong ;
Greenhill, Annabel ;
Cymerman, Elina ;
Azocar, Francisca .
PSYCHIATRIC SERVICES, 2015, 66 (06) :570-577
[32]
Liebman JB, 2013, PROPOSAL
[33]
Does employment alter the course and outcome of schizophrenia and other severe mental illnesses? A systematic review of longitudinal research [J].
Luciano, Alison ;
Bond, Gary R. ;
Drake, Robert E. .
SCHIZOPHRENIA RESEARCH, 2014, 159 (2-3) :312-321
[34]
Supported Employment: Assessing the Evidence [J].
Marshall, Tina ;
Goldberg, Richard W. ;
Braude, Lisa ;
Dougherty, Richard H. ;
Daniels, Allen S. ;
Ghose, Sushmita Shoma ;
George, Preethy ;
Delphin-Rittmon, Miriam E. .
PSYCHIATRIC SERVICES, 2014, 65 (01) :16-23
[35]
Why Behavioral And Environmental Interventions Are Needed To Improve Health At Lower Cost [J].
Milstein, Bobby ;
Homer, Jack ;
Briss, Peter ;
Burton, Deron ;
Pechacek, Terry .
HEALTH AFFAIRS, 2011, 30 (05) :823-832
[36]
Murdoch M, 2011, ARCH GEN PSYCHIAT, V68, P1072, DOI 10.1001/archgenpsychiatry.2011.105
[37]
Global mental health 1 - No health without mental health [J].
Prince, Martin ;
Patel, Vikram ;
Shekhar Saxena ;
Maj, Mario ;
Maselko, Joanna ;
Phillips, Michael R. ;
Rahman, Atif .
LANCET, 2007, 370 (9590) :859-877
[38]
Rogers E.S., 2010, Systematic review of supported education literature 1989-2009
[39]
Shattuck lecture - We can do better - Improving the health of the American people [J].
Schroeder, Steven A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 357 (12) :1221-1228
[40]
Scott David, 2011, Issues Ment Health Nurs, V32, P589, DOI 10.3109/01612840.2011.569846