Protecting the entitlements of the mentally disabled: the SSDI/SSI legal battles of the 1980s.
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Consumer Advocacy↗
Biomedical subjects
A A Gattozzi
Publications and source records attributed to A A Gattozzi.
Murder in the cathedral revisited: President Reagan and the mentally disabled.
A key objective of the Reagan administration when it took office in 1981 was to decrease domestic spending. Intending to offer the new administration "a little bit of a present," employees in the General Accounting Office, an arm of Congress, identified ineligible Social Security Disability Insurance (SSDI) beneficiaries as a possible source of billions of dollars of savings annually. Subsequently the administration's Office of Management and Budget instructed the Social Security Administration to begin, on an accelerated schedule, eligibility reviews authorized by the Social Security Amendments of 1980. One-fourth of the 130,500 beneficiaries dropped from the rolls during the first full year of the reviews were mentally impaired, although the mentally impaired constituted only one-ninth of SSDI beneficiaries. The reaction by mental health advocacy groups, Congress, and the courts turned "a little bit of a present" into a major problem for the administration, and the various components of government that had consorted on a misguided policy began to make amends. The experience offers useful insights for future policymaking.
Cost Control↗
Balance of powers: Social Security and the mentally disabled, 1980-1985.
Concern about costs in the early 1980s led both Congress and the newly installed Reagan administration to initiate an intensive review of eligibility for disability benefits under the Social Security system. Within a year it became apparent that a high percentage of mentally disabled were being declared ineligible. Much of the problem derived from the use of outdated criteria to determine mental disability. After a protracted struggle, the executive branch yielded to pressure from various advocacy groups, as well as the judiciary and legislative branches, and began to revise the criteria on the basis of contemporary psychiatric and rehabilitation standards.
Eligibility Determination↗
Defining and counting the chronically mentally ill.
The shifts in the pattern and locus of mental health care arising from the deinstitutionalization movement have resulted in a lack of definitive information on the scope of the problem of chronic mental illness. In addition, there is a lack of consensus on the boundaries that define the chronically mentally ill population, boundaries that can guide national policy-makers in a more scientific assessment of needs. In a national study following up the recommendations of the President's Commission on Mental Health, the authors developed a detailed definition of the chronically mentally ill population based on diagnosis, disability, duration of illness, and the institutional and community settings in which chronic mental patients may be found. They used prevalence data from a number of sources to arrive at a national estimate of between 1.7 million and 2.4 million in the target population, including 900,000 in institutions.
Chronic Disease↗