In Rebuttal / Disserving those on disability: The mentally ill need services; they are not 'gaming the system'
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As a spokesperson for people whose lives are affected by mental illness, I am writing in response to Dr. Marnin E. Fischbach's Aug. 7 op-ed piece "Patients Are Gaming the Disability System -- at High Cost to Themselves and Society."
In my 27 years as a director of community-based mental-health case-management services and now as the director of a mental-health advocacy organization, I have never experienced the Social Security disability process that Dr. Fischbach described. I can honestly say I don't know a single person with mental illness who was awarded disability benefits after one visit to a psychiatrist. A typical application process usually takes from 18 to 24 months. Two out of three initial applications are rejected.
Claiming that many people apply fraudulently for disability benefits, malinger with symptoms and are able to will symptoms away once disability is granted is an unconscionable way of explaining serious mental illness to a public audience.
Severe mental illnesses are biological brain disorders characterized by an array of symptoms and acute episodes. Mental illnesses can be persistent and serious, resistant to treatment and medications and, while treatable, not curable. Both patients referenced by Dr. Fischbach -- the man with depression and the woman with bipolar disorder -- were treated for four and five years, respectively. The question begs to be asked: If the man was symptom-free for over three years and the woman had overcome bipolar disorder five years ago and both were fit and able to work, why were they still being seen by a psychiatrist?
The man with depression referenced in the article, in treatment for four years and supporting himself with disability benefits, will not remain in the system for the rest of his life without any oversight. According to the Social Security Administration, "all people receiving disability benefits must have their medical conditions reviewed from time to time." The reviews are scheduled based on the severity of the medical condition and the likelihood it will improve: within six to 18 months for conditions expected to improve, every three years when improvement is possible, and every five to seven years when improvement is not likely.
This same patient was quoted as saying, "I ... could never make the kind of money I get from disability from a job."
Consider that the maximum Supplemental Security Income disability benefit is currently $698 per month, or $8,376 per year. The 2011 poverty guidelines for a single person is $10,800 per year. Persons with mental illness receiving SSI are not living the high life on Social Security checks, but are in fact surviving on incomes below the poverty line.
There are many people with mental illness who receive SSI and are in recovery. Many individuals with treatment, supports and various community services are able to work part-time. Many others seek employment and return to full-time work, giving up the security of a guaranteed disability income.
In these tough economic times, when mental-health funding is being cut at both the state and federal levels, a negatively inaccurate and grossly generalized portrayal of the Social Security disability process can be very damaging. Casting patients with mental illness as stereotypical schemers and frauds who use the system to live off the "government dole" incites public outrage to cut disability benefits for the people who need them, instead of responsibly encouraging improvements to the system.
First Published August 13, 2012 12:00 am