Representative payee programs for persons with mental illness in Illinois

Objective: Representative payee programs can improve the community tenure of persons with mental illness by ensuring that their basic needs, such as housing, are met. The authors conducted a survey to assess the extent to which representative payee programs are provided by community mental health centers and the criteria used in enrolling clients in these services. Methods: Community mental health centers under contract to the Illinois Department of Human Services participated in a census survey. Survey questions concerned provision of representative payee programs, service characteristics, and criteria for enrollment in the programs. Results: Representative payee programs were directly provided by 59 percent of the 95 community mental health centers in the sample. More than a third of clients who were receiving intensive services had a representative payee. More than three times as many such clients had a representative payee when agencies provided representative payee programs directly rather than through referrals of family members. Frequently cited criteria for enrollment in a representative payee program included a lack of financial skills (89 percent), a lack of rent money (52 percent), substance abuse (50 percent), homelessness (33 percent), and frequent (37 percent) or long-term (30 percent) hospitalization. The majority of the representative payee programs (76 percent) provided this service to clients who received representative payee services under the mandate of the Social Security Administration. Conclusions: Given the high proportion of clients of agencies that directly provided representative payee services who were assigned to a representative payee, all community mental health centers that provide intensive services should also directly provide representative payee services in order to improve access to representative payee services.