Changes in mental health and service use after termination of SSI benefits

Objective: Supplemental Security Income (SSI) benefits for a substance abus e disability were terminated by federal legislation as of January 1, 1997. This study examined the changes in mental health and in the use of mental h ealth services two years after the legislation was implemented among indivi duals who had been receiving benefits under this classification. Methods: F rom a random sample of 400 SSI beneficiaries in Los Angeles, 253 were inter viewed at the time the legislation took effect and again at 12-month, 18-mo nth, and 24-month follow-ups. The study subjects were characterized by inco me source after the legislation and by probable mental health diagnosis. Th eir use of mental health services was also measured. Results: The mental he alth status of the participants remained unchanged between baseline and 24- month follow-up. The proportion who reported any use of mental health servi ces decreased, primarily among those who continued receiving SSI benefits u nder a different classification. Among those who lost SSI benefits, emergen cy department visits and hospitalizations did not increase, and rates of ou tpatient visits remained the same. Conclusions: Contrary to expectations, t he mental health status of individuals who had been receiving SSI benefits for a substance abuse disability did not worsen after the benefits were ter minated. Local safety nets and reclassification under another disability ma y have mitigated the effects of the policy change. The results of this stud y underscore the need for longitudinal data to inform policy decisions.