You’d think the long harsh winters would be reason enough to feel a certain sense of impending doom as fall comes to an end up here. But I’m not talking about seasonal affective disorder here. I’m talking about SSI data.
Furious Seasons poses the question today, why do the New England states have such a higher percentage of people who are on SSI in the “mental disorders” category. The data can’t tell us why (because it never asked the question), but we can make some suppositions based upon findings from other data and connecting the dots. (This is a fairly long, rambling post based upon findings from multiple data sources, so if this kind of thing isn’t of interest to you, you’ve been warned.)
First of all, for the uninitiated, the U.S. has a social services program called SSI. The Supplemental Security Income (SSI) program pays benefits to disabled adults and children who have limited income and resources. SSI is a needs-based program. For those who have never worked, or those whose earnings in recent years have been low enough to result in a small Social Security benefit, or no benefit at all, SSI may be the only program they qualify for. SSI is basically a program for the poorest of the poor.
Now onto the SSI data. Out of the top 10 states, New England states make up 6 of them for “other mental disorders” and 5 of them out of total mental disorders. (New England is a historical term describing the region of 6 northeastern states in the U.S. – Vermont, Maine, New Hampshire, Massachusetts, Connecticut and Rhode Island). Furious Seasons only looks at the “other mental disorders” column, which is all mental disorders not including mental retardation.
The bottom 10 states who pay out SSI for other mental disorders included Louisiana, Georgia, Alabama, Arkansas, South Carolina, Oklahoma, West Virginia, North Carolina, Mississippi, and Nebraska.
A lot of those states are also in the same geographic region in the U.S. — traditionally referred to as just “the South” (not including Oklahoma and Nebraska, two mid-Western states).
SSI determinations are made at regional Social Security offices, not at a central headquarters. One possibility is that different regions set different standards for granting SSI benefits. Particular regional SSI offices in the country, just like certain federal courts, may be more lenient in granting benefits for specific conditions, such as mental disorders.
Under this hypothesis it could be that New England, traditionally considered a bastion of Democrats and liberalism (and the promotion of social programs), grants more SSI claims for mental disorders because they recognize they are real, serious disorders. Southern states, which traditionally are more Republican and socially conservative, are less open to granting SSI benefits to people with these disorders, perhaps carrying some of the old stigma of what a mental disorder reflects (e.g., a substandard character that should just pull themselves up their bootstraps).
I should note that it is unlikely that a different formal policy exists in each regional office to reward SSI claims based upon specific conditions (especially since the criteria for rewarding such claims is set at the federal level). If such a bias existed, it would largely be unrecognized by those making the decisions.
A related hypothesis has to do with socioeconomic status and median income in U.S. states. Five of the highest SSI states also have the highest median income (2006 figures): Hawaii, Connecticut, New Hampshire, Massachusetts, and Minnesota. More tellingly, 8 of the lowest median income states also have the lowest SSI claims for mental disorders: North Carolina, South Carolina , Oklahoma, Alabama, West Virginia, Louisiana, Arkansas, and Mississippi.
Perhaps if the SSI criteria are set nationally, we’re seeing the least payouts in the poorest states (because so many people qualify, the ability or percentage to actually award a distribution is lower, because less money is available). In the higest median income states, fewer people meet SSI criteria, so payouts are granted more often for more disorders.
Digging deeper, if we look at SAMHSA data for serious psychological distress by state, we see four of the same states (out of the top 10) that have the highest prevalence of such distress (2005 data): Arkansas, South Carolina, Oklahoma, and West Virginia. In those states with the lease serious psychological distress, we find only Hawaii and Massachusetts in the bottom 10. If we expand the two criteria to the top 20 and the bottom 20, we get two more states in the top 20, and three more states in the bottom 20. This relationship seems weaker, if present at all.
But taking all of this data together, a picture emerges. Poorer states with greater serious psychological distress as a percentage of the state’s overall population grant less SSI benefits based upon a mental disorder than states with larger median incomes and, perhaps, less of a percentage of psychological stress.
It’s an odd finding, taken as a whole, since conventional wisdom would suggest that the poorest states with the greatest psychological distress really should be giving out the most SSI based upon a mental disorder determination. But clearly that doesn’t appear to be happening here.