Veterans Who May Need a Payee to Prevent Misuse of Funds for Drugs

OBJECTIVE: This study sought to determine the possible need for a payee among Department of Veterans Affairs (VA) inpatients with substance use disorders who receive public support payments. METHODS: A total of 290 veterans hospitalized in VA psychiatric units completed a survey designed to identify patients who may be in need of a payee because of excessive expenditures for substances of abuse. Level 1 screening identified patients with a general likelihood of needing a payee because they received public support payments, did not have a payee, and had a substance abuse diagnosis. Level 2 screening identified level 1 patients for whom there was further evidence of need for a payee because, in addition to spending substantial amounts of money on substances of abuse, they reported either difficulty meeting basic material needs or substantial harm from substance use. RESULTS: Of 290 patients surveyed, 78 (27 percent) met level 1 criteria. Altogether, 35 patients (45 percent of level 1 patients and 13 percent of all surveyed patients) met the more specific level 2 criteria, indicating that they were likely to be in need of a payee. As expected, veterans who met the level 2 criteria were more likely than those meeting only the level 1 criteria to have both self-rated and clinician-rated difficulties managing money. However, clinicians did not rate these veterans as more likely to benefit from a payee. CONCLUSIONS: A substantial proportion of veterans who have not been assigned a payee may need one. More effective approaches to money management in this population are needed.