Mentally Disabled Rehabilitation Clients: Financial Benefits Received At Referral, Characteristics, Rehabilitation Services and Outcomes.

Abstract

This study examines the relationship of financial benefits received at referral and client characteristics, rehabilitation services provided, and client outcomes for persons diagnosed as having a mental illness, who were provided rehabilitation services by the state/federal rehabilitation program. Three components of the rehabilitation program, input (client characteristics), process (services provided), and outcome (employed or unemployed) are analyzed to test the general hypothesis that clients receiving financial benefits at referral compared to those receiving no financial benefits would vary significantly among these factors. Data were analyzed on a national sample of 9,731 (population 214,843) mentally disabled clients with diagnosis of psychosis, psychoneurosis, alcoholism, drug addiction, and other character disorders, whose cases were closed in 1979. Using gainful employment as a success criterion, analysis indicated that (1) clients who were receiving financial benefits at referral, regardless of severity of disability, were less successful than clients who were receiving no benefits, (2) severely disabled clients who were receiving financial benefits at referral were less successful than the severely disabled clients who were receiving no financial benefits, (3) clients who entered competitive employment, compared to noncompetitive employment, were less likely to have been receiving financial benefits at referral, (4) clients who were receiving financial benefits at referral earned less at closure than clients receiving no financial benefits, and (5) the most successful outcomes were likely to be achieved by clients who were female, white, married, from a larger family, with a higher family income, and a higher level of education, but women were placed more often in noncompetitive employment which yielded lower weekly earnings. The disincentive formulation appears to be supported since an interpretation of the findings suggests that rehabilitation clients who receive financial benefits at referral are less likely to achieve a successful outcome of gainful employment. Further study is recommended to examine the relationship between severity of disability, the receipt of financial benefits, and rehabilitation outcomes, through public and private rehabilitation programs.