For many people, access to appropriate services is determined by their ability to access the health benefits and other entitlements for which they are eligible. People with mental illness who are found to be disabled by their illness or who have little or no income as a result of their disability are eligible for an array of income and reimbursement benefits. Many mental health and addiction services provided by community agencies are reimbursable through Medicaid and Medicare, which are generally available to people who qualify for Supplemental Security Income (SSI) or Social Security Disability Income (SSDI). Qualification for income support also can lead to eligibility for housing supports. In any case, income support through SSI and SSDI provides funds with which an individual can pay rent and meet other basic needs. Other valuable benefits programs for which persons with mental illness may be eligible include Temporary Assistance for Needy Families (TANF), food stamps, and benefits available to veterans through the Veterans Administration. 

Rules and procedures for accessing disability entitlement programs are difficult for many with mental illness to understand. There is also a shortage of staff at community mental health agencies who are trained to provide assistance to clients who may qualify for either entitlement program. It is more common than not for first-time applications for entitlements to be denied, at a minimum causing a delay in benefits for qualified applicants. Because these entitlements are frequently the only legitimate source of income for many with mental illness, such delays can lead to homelessness and such "survival crimes" as shoplifting and bill evasion.

The issue of accessing government benefits is also examined in the sections of this report that look at the release of people with mental illness from jails and their reentry to the community from prison (see Policy Statement 13: Intake at County / Municipal Detention Facility and Policy Statement 21: Development of Transition Plan). Because many people with mental illness coming out of jail or prison have no other means of support, linkage with appropriate government benefits in a timely manner can make the difference between success and failure in the community. As discussed elsewhere in the report, mental health provider agencies must work with partners in jails and prisons to establish protocols that will result in people with mental illness gaining speedy access to appropriate benefits.

Mental health agencies must train staff to provide assistance with applications for SSI and SSDI and the follow-up that is so often needed to secure these benefits. Further, they must ensure that case managers, employment counselors, rehabilitation therapists, and others who may be working with clients to secure employment are familiar with the each client's benefits profile. An increase in income can mean an end to benefits. When clients are working, especially when they are doing so through "transitional employment" or "supported employment" programs, staff should make sure that their transition does not leave them without health insurance or sufficient funds for housing and food. The rules and regulations applied by the Social Security Administration to these programs can create challenges for staff to provide guidance to clients on entitlement and benefit matters. It can also be time-consuming. Training and prioritization of this service are necessary if clients are to access supports intended to help them at a difficult time in their lives.