Intervening Before Disability

Juan was a delivery driver, but his health problems were putting him at risk of losing his job. His diabetes was poorly controlled and had caused foot ulcers that made it difficult for him to walk. He also had bipolar disorder, which was not being controlled. Working Well is part of the Demonstration to Maintain Independence and Employment, which is funded by the Centers for Medicare and Medicaid Services. Current federal policy provides support - through Social Security Disability Insurance and Supplemental Security Insurance - for people who are no longer able to work. These programs, in turn, act as gateways to health insurance - Medicare in the case of SSDI and Medicaid for those who quality for SSI. This safety net is vital for people who are too disabled to work. Once people qualify for Social Security, however, they rarely move off it, despite strong evidence that many people with mental health problems want to and can work. The DMIE represents a break with existing policy.

Its purpose is to actively support people who are at risk of becoming too disabled to work, so that they can remain in their jobs and do not apply for public disability programs. Two of the demonstration sites, Texas and Minnesota, focus on people with serious mental illnesses and people with chronic physical health problems who also have a mental health condition. Early results are promising. In Minnesota, the DMIE intervention is proving to be effective in improving clients access to healthcare services, health and functional status, job stability, and earnings. It has also reduced the number of applications for SSDI (Linkins & Brya, 2009). Analysis indicates that earlier interventions, such as the DMIE, could make sound financial sense for the federal government as well as for clients. 48 million in providing all the necessary services. One of the challenges of adopting a more comprehensive approach to earlier intervention is the absence of strong evidence as to how to effectively support people before they become Social Security beneficiaries.

DMIE is one federal effort to address this evidence gap; the Recovery After, an Initial Schizophrenia Episode program is another. RAISE is a major new initiative from the National Institute for Mental Health that will be launched this summer. For most people, the first onset of schizophrenia occurs in adolescence or early adulthood. Emerging evidence suggests that intervening at this point can reduce the likelihood that a patient will develop full-blown schizophrenia, but researchers have not reached a consensus as to which early interventions work best. RAISE will test two sets of interventions to assess whether they can effectively prevent the development of the condition and reduce long-term disability as a result of mental illness. Research has indicated other opportunities for earlier intervention to prevent long-term dependence on disability programs. Drake et al. (2009) concluded their analysis of the potential savings from earlier intervention with several policy proposals. First, they suggested that states provide supported employment and mental health services early in the course of mental illness. Initiatives such as the DMIE and RAISE are testing that approach. Second, they suggested that health insurance be delinked from disability status. The two recommendations are intimately connected. For people with any kind of chronic condition, including a mental illness, access to healthcare is vital. The only way some people can access healthcare is to qualify for disability benefits. Fear of losing healthcare then becomes a major barrier to moving off benefits. In this respect, current discussions around extending health insurance to the uninsured are particularly important. Earlier intervention will only take hold if patients have a route to accessing healthcare that does not depend on qualifying for disability benefits.

The vegetarian group also lost more muscle mass than the conventional group, particularly when doing their usual exercise routine. This might be an unwanted outcome and a disadvantage when compared with the usual diet. The study involved a relatively small sample of overweight people with type 2 diabetes. The findings may not be applicable to the general population. Based on the findings of this study, we can't say that a vegetarian diet is more beneficial than a conventional diet for people with type 2 diabetes. What we can say is that the vegetarian diet resulted in greater weight loss, and a reduction in some types of bodily fat, for the people who took part in this small study. The additional loss of muscle mass might mean it's not preferable to the conventional diet currently recommended for people with diabetes. If you have type 2 diabetes and are concerned about your weight, talk to your GP or diabetes care team. Achieving a healthy weight should help you control your symptoms and reduce the risk of complications.

Researchers have discovered that diabetes patients can benefit from blood sugar control level as can be used to foresee occurrence of diabetes in patients. A diabetic can hope to lead a less than stressful life by taking care of his sugar levels. A person who is found to have diabetes should take careful steps to keep the sugar level in check. Diabetes treatments followed by vigilant monitoring of sugar level in the blood are of utmost importance for a diabetic patient. The use of blood sugar chart at home helps to monitor the levels! Keeping a close eye on the sugar levels in the body’s bloodstream is necessary to formulate a diet and exercise plan. This is instrumental to keep the blood sugar levels low and to lead a hassle free lifestyle. Planning helps in preventing unforeseen conditions. Another thing is to get to know the disease inside out. Know the normal levels of sugar in the blood. There is no blood sugar control when the numbers are not known.