R. Catalano et al., Does the disbursement of income increase psychiatric emergencies involvingdrugs and alcohol?, HEAL SERV R, 35(4), 2000, pp. 813-823
Citations number
19
Categorie Soggetti
Public Health & Health Care Science","Health Care Sciences & Services
Objective. To determine if the incidence of psychiatric emergencies involvi
ng drugs or alcohol supports the argument that mentally ill persons contrib
ute to elevated mortality during the days following disbursement of private
earnings and public income transfers.
Study Design. interrupted time-series using Box-Jenkins methods.
Data Collection/Extraction Methods. Daily counts of adults admitted to psyc
hiatric emergency services in San Francisco after using drugs or alcohol we
re derived from medical records for the period January 1 through June 30, 1
997.
Principal Findings. Psychiatric emergencies among males who had used drugs
or alcohol were elevated in the early days of the month. Such emergencies a
mong females were not similarly elevated. Emergencies among females who had
not used drugs or alcohol were elevated in the early days of the month.
Conclusion. Elevated mortality in the first week of the month may be attrib
utable, in part, to the "check effect" or use of drugs and alcohol by menta
lly ill males in the days after they receive income. The contribution of wo
men is more complex and may be induced by drug or alcohol abuse among perso
ns in their social networks. The check effect suggests that persons with a
history of substance abuse and mental illness should be offered the opportu
nity to have their income managed by someone who can monitor and influence
how the money is being spent. The fact that drug- or alcohol-related admiss
ions among males exhibit temporal patterns suggests that the provision of p
reventive as well as treatment services may be strategically scheduled.