Social Security Administration (SSA) disability benefits are an important source of income for people with psychoses and confer eligibility for health insurance. The authors examined the impact of coordinated specialty care on receipt of such benefits in first-episode psychosis, along with the correlates and consequences of receiving them.

The Recovery After an Initial Schizophrenia Episode–Early Treatment Program (RAISE-ETP) study, a 34-site cluster-randomized trial, compared NAVIGATE, a coordinated specialty care program, to usual community care over 2 years. Receipt of SSA benefits and clinical outcomes were assessed at program entry and every 6 months for 2 years. Piecewise regression analysis was used to identify relative change in outcome trajectories after receipt of disability benefits.

Among 399 RAISE-ETP participants, 36 (9%) were receiving SSA disability benefits at baseline; of the remainder, 124 (34.1%) obtained benefits during the 2-year study period. The NAVIGATE intervention improved quality of life, symptoms, and employment but did not significantly reduce the likelihood of receiving SSA disability benefits. Obtaining benefits was predicted by more severe psychotic symptoms and greater dysfunction and was followed by increased total income but fewer days of employment, reduced motivation (e.g., sense of purpose, greater anhedonia), and fewer days of intoxication.

A 2-year coordinated specialty care intervention did not reduce receipt of SSA disability benefits. There were some advantages for those who obtained SSA disability benefits over the 2-year treatment period, but there were also some unintended adverse consequences. Providing income supports without impeding recovery remains an important policy challenge.

社会保障署（SSA）的残障补助金对于患有精神病的人来说是重要的收入来源，并使其有资格获得健康保险。作者研究了协调的专科护理对首发精神病患者获得此类福利的影响，以及接受这些福利的相关性和后果。

最初的精神分裂症发作早期治疗计划（RAISE-ETP）研究后的恢复，一项34地点的整群随机试验将协调的专科护理计划NAVIGATE与两年来的常规社区护理进行了比较。在项目进入时以及每两年每6个月评估一次SSA受益和临床结局。在获得残疾补助后，使用分段回归分析来确定结果轨迹的相对变化。

在399名RAISE-ETP参与者中，有36名（9％）在基线时获得了SSA残疾津贴。其余的124名（34.1％）在为期2年的研究期内获得了收益。NAVIGATE干预措施改善了生活质量，症状和就业，但并未显着降低获得SSA残疾补助的可能性。预计获得收益的原因是精神病症状更加严重和功能障碍加剧，其次是总收入增加，但工作时间减少，动机减少（例如，目标感，快感不足）和中毒天数减少。

一项为期2年的协调专业护理干预措施并未减少对SSA残疾津贴的接收。对于那些在2年的治疗期间获得了SSA残疾津贴的人来说，有一些好处，但也有一些意想不到的不利后果。在不阻碍经济复苏的情况下提供收入支持仍然是一项重要的政策挑战。