News Release

Clinton/Gore Administration
Announces Historic 5-year Affective
Disorder Demonstration Project at the
Social Security Administration
to Help People with Mental Illness
Return to Work in Honor of
the White House Conference
on Mental Health

Vice President Al Gore announced today that the Social Security Administration (SSA) will offer up to 1,000 Social Security Disability beneficiaries with affective disorders the opportunity to participate in a 5-year demonstration project to test improved treatments that could result in better functioning and a return to the workforce.

Research suggests that as many as 60 percent of affective disorder cases can be controlled with appropriate treatment, yet a review of approximately 200 Social Security claims showed that some beneficiaries with affective disorders received no treatment and many beneficiaries were not treated by mental health professionals. These results support anecdotal information that many beneficiaries with affective disorders receive less effective care than is available today because of restrictions in health insurance coverage, treating physicians without a psychiatric specialty and a lack of access to improved treatment methods. By providing the best possible treatment to disability beneficiaries with affective disorders, SSA believes that many of these individuals will be able to overcome the disabling effects of their illnesses and successfully transition back to work, ultimately enabling them to leave the disability rolls.

Under the study, SSA will allow participants' treating sources the opportunity to pick from a list of modern treatment regimens including the option to use modern medication or psychosocial therapy, or both. SSA will pay the costs of drugs and therapy for participants who continue to follow the prescribed regimen during the demonstration. Throughout the process, SSA will solicit input and advice of specialists in the medical community and advocates in the disability community.

Of the 4.7 million Social Security Disability Insurance (SSDI) disabled beneficiaries who received disability payments from SSA, approximately one of every nine (about 500,000) has a primary diagnosis of affective disorder. Affective disorders are characterized by a disturbance in mood (depression, mania or both). Many affective disorders are episodic in nature, with onset typically before age 35. Major diagnoses under affective disorders include Major Depressive Disorder and Bipolar Disorder.

Affective Disorders are the fastest growing category of disabilities, consistent with the increasing recognition by the medical profession of affective disorders in society. Over a lifetime, each SSDI beneficiary will receive an average of $90,000 in benefits.

The Administration has been actively involved in efforts to encourage citizens with disabilities to enter the workforce and is supporting legislation sponsored by Senators Jeffords, Kennedy, Roth and Moynihan that would eliminate work disincentives and expand the availability of health care services. In addition, the legislation includes a "ticket" that would enable Social Security Disability Insurance or Supplemental Security Income beneficiaries to obtain employment, rehabilitation, and/or support services that are tailored to their needs from a choice of either a public or private provider of services.

SSA will offer the return-to-work (RTW) resources available to all participants in the study. Outcomes for participants will be recorded at regular intervals for several years afterward. Success will be measured in terms of improvements in functioning and the extent to which study participants demonstrate the ability to sustain work, as well as in terms of increases in earnings and decreases in SSDI program costs.

The study will be conducted under two contracts. The first contract will be for the design of the study and is being currently announced for solicitation of proposals. A contract conducting the study will immediately follow the completion of the study design.

The study will be designed primarily as a return-to-work demonstration. SSA will be testing access to established treatment regimens as facilitators of work efforts for beneficiaries with affective disorders. The demonstration is intended to show that if SSA provides access to the right treatment for disabled beneficiaries, many will be able to return to work.

"It is my belief that this innovative pilot study will provide a gateway for individuals with affective disorders to return to work and lead more productive lives," said Kenneth S. Apfel, Commissioner of Social Security. "Everyone reaps benefits when each individual has an opportunity to make a unique contribution to society."