Psychiatric emergencies: The check effect revisited

Federal income support to persons with alcohol and drug related disabilitie s was ended in 1997 The argument for ending the programs was that recipient s were using their benefits to purchase drugs and alcohol. This supposedly led to the "check effect," an increase in psychiatric emergencies in Americ an communities in the days following the receipt of disability benefits. We test two hypotheses implied by this argument. The first is that psychiatri c emergencies are elevated in the fourth through eighth day of the month. T he second is that the excess of emergencies in these days was significantly reduced when benefits were ended. The tests are based on 35,500 psychiatri c emergencies in San Francisco, California occurring over 1,551 days. Resul ts support the first hypothesis but not the second. The implications are th at there is a general check effect and that it was not reduced by ending be nefits to persons with drug and alcohol related disabilities.