Mustafa Karakus - Academia.edu (original) (raw)

Papers by Mustafa Karakus

Mathematica Policy Research Reports, 2015

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Journal of Rehabilitation, 2003

The psychiatric rehabilitation literature has documented difficulties that persons with severe an... more The psychiatric rehabilitation literature has documented difficulties that persons with severe and persistent mental disorders such as schizophrenia face in retaining employment in competitive jobs (Blankertz & Keller, 1997; Peckham & Muller 1999; Rutman, 1992; Scheid & Anderson, 1995). Risk of job loss is high for these individuals because of problems maintaining steady work schedules, episodic and unpredictable symptom manifestations, medication side effects, and difficulty in handling workplace stress (Peckham & Muller; Scheid & Anderson). Vocational programs that provide long-term support to promote job retention have been implemented, and a substantial literature evaluating these programs has been produced (Salkever, 2003). A large fraction (probably more than half) of employed persons with schizophrenia, however, are not served by these programs, and are instead working without formal vocational supports. Our own unpublished tabulations show that this is true for two-thirds of...

Mathematica Policy Research Reports, 2015

Psychiatric Services, 2021

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

The journal of mental health policy and economics, 2014

BACKGROUND Persons with severe and persistent mental disorders (SPMD) have extremely low earnings... more BACKGROUND Persons with severe and persistent mental disorders (SPMD) have extremely low earnings levels and account for 29.1 percent of all U.S. Social Security Disability Income (SSDI) disabled worker beneficiaries under age 50. Social insurance and disability policy experts pointed to several factors that may contribute to this situation, including disincentives and obstacles in the SSDI program, as well as lack of access to evidence-based behavioral-health interventions. In response, the Social Security Administration (SSA) funded the Mental Health Treatment Study (MHTS) demonstration that included 2,238 beneficiaries of SSDI whose primary reason for disability is SPMD. The demonstration, implemented in 23 different localities, consisted of two evidence-based services (individual placement and support supported employment (IPS-SE), systematic medication management (SMM)), and provision or coverage of additional behavioral-health services (OBH). STUDY AIMS This study focused on e...

American Journal of Psychiatry, 2013

People with psychiatric impairments (primarily schizophrenia or a mood disorder) are the largest ... more People with psychiatric impairments (primarily schizophrenia or a mood disorder) are the largest and fastest-growing group of Social Security Disability Insurance (SSDI) beneficiaries. The authors investigated whether evidence-based supported employment and mental health treatments can improve vocational and mental health recovery for this population. Using a randomized controlled trial design, the authors tested a multifaceted intervention: team-based supported employment, systematic medication management, and other behavioral health services, along with elimination of barriers by providing complete health insurance coverage (with no out-of-pocket expenses) and suspending disability reviews. The control group received usual services. Paid employment was the primary outcome measure, and overall mental health and quality of life were secondary outcome measures. Overall, 2,059 SSDI beneficiaries with schizophrenia, bipolar disorder, or depression in 23 cities participated in the 2-year intervention. The teams implemented the intervention package with acceptable fidelity. The intervention group experienced more paid employment (60.3% compared with 40.2%) and reported better mental health and quality of life than the control group. Implementation of the complex intervention in routine mental health treatment settings was feasible, and the intervention was effective in assisting individuals disabled by schizophrenia or depression to return to work and improve their mental health and quality of life.

American Journal of Public Health

Administration and policy in mental health, Jan 17, 2017

Previous studies suggest that providing employment services to individuals with serious mental il... more Previous studies suggest that providing employment services to individuals with serious mental illnesses can help them obtain competitive, real-world employment. However, these services are still not easily accessible to this population. This paper provides a brief summary of recent federal initiatives that may influence widespread implementation of employment services. While there is an increasing recognition of the need to remove barriers and provide supported employment services to individuals with mental illnesses, a wide-spread coordination across Federal polices, financing and regulatory changes are necessary to promote measurable and lasting effects on the broad availability of employment services among this population.

Psychiatric services (Washington, D.C.), Jan 15, 2016

This study compared characteristics of visits to emergency rooms (ERs) for mental and substance u... more This study compared characteristics of visits to emergency rooms (ERs) for mental and substance use disorders and for physical health conditions to establish a baseline against which to measure changes after full implementation of the Affordable Care Act (ACA) and parity legislation. The retrospective, cross-sectional analysis fit a logistic regression model to pooled data comprising 193,526 observations from National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2005 to 2011. ER visits for mental or substance use disorders increased from 27.9 per 1,000 ER visits in 2005 to 35.1 in 2011. Homeless persons and nursing home residents had the highest rates of such visits-173.7 and 95.2 per 1,000 ER visits, respectively, in 2011. Understanding differences in profiles of ER visits on the basis of the reason for the visit can inform the design of more cost-effective policies to guide ER intake, after further implementation of the ACA and parity legislation.

Psychiatric services (Washington, D.C.), Jan 15, 2016

The purpose of this Open Forum is to highlight strategies that can be implemented by federal heal... more The purpose of this Open Forum is to highlight strategies that can be implemented by federal health care policy makers to improve the delivery of effective behavioral health care services in the public and private sectors. The recommendations can be accomplished by using existing funds or authorities allocated to federal agencies dealing with the behavioral health system. These recommendations do not require new or additional funding and focus on strategies with a track record for success. The strategies described require relatively small changes but have the potential for big impacts.

The Journal of Rehabilitation, Oct 1, 2003

Psychiatric services (Washington, D.C.), Oct 1, 2016

The Social Security Administration's Mental Health Treatment Study (MHTS) produced positive m... more The Social Security Administration's Mental Health Treatment Study (MHTS) produced positive mental health, employment, and quality of life outcomes for people on Social Security Disability Insurance (SSDI). The investigators discuss major policy implications. First, because integrated, evidence-based mental health and vocational services produced clinical and societal benefits, the authors recommend further service implementation for this population. Second, because provision of these services did not reduce SSDI rolls, the authors recommend future research on prevention (helping people avoid needing SSDI) rather than rehabilitation (helping beneficiaries leave SSDI). Third, because integrating mental health, vocational, and general medical services was extremely difficult, the authors recommend a multifaceted approach that includes streamlined funding and infrastructure for training and service integration. Fourth, because insurance coverage for people with disabilities during ...

J Behav Health Serv Res, 2011

The relationship between depression and development of chronic illness among older adults is not ... more The relationship between depression and development of chronic illness among older adults is not well understood. This study uses data from the Health and Retirement Study to evaluate the relationship between depression at baseline and new onset of chronic illnesses including cancer, heart problems, arthritis, and diabetes. Analysis controlling for demographics (age, gender, race, education), health risk indicators (BMI and smoking), functional limitations (gross motor index, health limitations for work), and income show that working-age older people (ages 50-62) with depression at baseline are at significantly higher risk to develop diabetes, heart problems, and arthritis during the 12-year follow-up. No significant association was found between depression and cancer. Prevention efforts aimed at chronic illnesses among the elderly should recognize the mind-body interaction and focus on preventing or alleviating depression.

Health affairs (Project Hope), Jun 1, 2016

The majority of people with serious mental illnesses want to work. Individual placement and suppo... more The majority of people with serious mental illnesses want to work. Individual placement and support services, an evidence-based supported employment intervention, enables about 60 percent of people with serious mental illnesses who receive the services to gain competitive employment and improve their lives, but the approach does not lead to fewer people on government-funded disability rolls. Yet individual placement and support employment services are still unavailable to a large majority of people with serious mental illnesses in the United States. Disability policies and lack of a simple funding mechanism remain the chief barriers. A recent federal emphasis on early-intervention programs may increase access to employment services for people with early psychosis, but whether these interventions will prevent disability over time is unknown.

Atlantic Economic Journal, 2009

Obesity among U.S. adolescents ages 12-19 rose from 4.6% in 1963-1965 to 17.4% in 2003-2004. This... more Obesity among U.S. adolescents ages 12-19 rose from 4.6% in 1963-1965 to 17.4% in 2003-2004. This paper contributes to the literature on the impact of unhealthy body mass index (BMI) on health (e.g., obesity) and human capital (e.g., schooling) investments of adolescents. We use the propensity score method to study 8,388 individuals who responded to survey Waves I through III of the National Longitudinal Study of Adolescent Health (Add Health), for students in grades 7-12. We estimate an economic model that captures longer-term effects of BMI categories (obesity and overweight separately) on on-time (dichotomous) high school graduation. We control for characteristics at the individual, household, and community levels. Baseline probit regression estimates were improved upon by using matching estimators (propensity scores yield consistent estimate of the average treatment on the treated) based on the nearest neighbor and the more robust kernel density weighting schemes. Results from both full and reduced models suggest no adverse impact of overweight or obesity on timely high school completion for males, but a significant average negative effect on

ABSTRACT INTRODUCTION: Farmers markets (FMs) play a major role in promoting locally grown fruits ... more ABSTRACT INTRODUCTION: Farmers markets (FMs) play a major role in promoting locally grown fruits and vegetables to members of community, including Supplemental Nutrition Assistance Program (SNAP) participants. While the number of FMs and SNAP authorized FMs continue to grow, SNAP redemptions still account for only 0.01 percent of all SNAP redemptions. Because SNAP serves millions of Americans, it is imperative to understand why so few SNAP participants redeem benefits at farmers markets. APPROACH: A two stage sampling process was used to administer a survey to a random sample of SNAP participants. The sample included SNAP participants who shopped at selected FMs between late August and mid-October 2013 and those who did not shop at these FMs. The survey comprised of five topic areas including where participants shopped for groceries including fresh fruits and vegetables; whether they shopped at the reference FM; whether they shopped at any FM; what their reasons were for not shopping at any FM; and socio-demographic characteristics including participation in other nutrition assistance programs. RESULTS: The findings related to fruit and vegetable shopping behaviors of SNAP participants will be presented, including reasons for infrequent shopping or not shopping at FMs. DISCUSSION: Understanding what influences SNAP participants’ shopping decisions at FMs will allow public health practitioners to develop effective strategies for promoting use of FMs among SNAP participants.

Mathematica Policy Research Reports, 2015

This page has been left blank for double-sided copying.

Journal of Rehabilitation, 2003

The psychiatric rehabilitation literature has documented difficulties that persons with severe an... more The psychiatric rehabilitation literature has documented difficulties that persons with severe and persistent mental disorders such as schizophrenia face in retaining employment in competitive jobs (Blankertz & Keller, 1997; Peckham & Muller 1999; Rutman, 1992; Scheid & Anderson, 1995). Risk of job loss is high for these individuals because of problems maintaining steady work schedules, episodic and unpredictable symptom manifestations, medication side effects, and difficulty in handling workplace stress (Peckham & Muller; Scheid & Anderson). Vocational programs that provide long-term support to promote job retention have been implemented, and a substantial literature evaluating these programs has been produced (Salkever, 2003). A large fraction (probably more than half) of employed persons with schizophrenia, however, are not served by these programs, and are instead working without formal vocational supports. Our own unpublished tabulations show that this is true for two-thirds of...

Mathematica Policy Research Reports, 2015

Psychiatric Services, 2021

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

The journal of mental health policy and economics, 2014

BACKGROUND Persons with severe and persistent mental disorders (SPMD) have extremely low earnings... more BACKGROUND Persons with severe and persistent mental disorders (SPMD) have extremely low earnings levels and account for 29.1 percent of all U.S. Social Security Disability Income (SSDI) disabled worker beneficiaries under age 50. Social insurance and disability policy experts pointed to several factors that may contribute to this situation, including disincentives and obstacles in the SSDI program, as well as lack of access to evidence-based behavioral-health interventions. In response, the Social Security Administration (SSA) funded the Mental Health Treatment Study (MHTS) demonstration that included 2,238 beneficiaries of SSDI whose primary reason for disability is SPMD. The demonstration, implemented in 23 different localities, consisted of two evidence-based services (individual placement and support supported employment (IPS-SE), systematic medication management (SMM)), and provision or coverage of additional behavioral-health services (OBH). STUDY AIMS This study focused on e...

American Journal of Psychiatry, 2013

People with psychiatric impairments (primarily schizophrenia or a mood disorder) are the largest ... more People with psychiatric impairments (primarily schizophrenia or a mood disorder) are the largest and fastest-growing group of Social Security Disability Insurance (SSDI) beneficiaries. The authors investigated whether evidence-based supported employment and mental health treatments can improve vocational and mental health recovery for this population. Using a randomized controlled trial design, the authors tested a multifaceted intervention: team-based supported employment, systematic medication management, and other behavioral health services, along with elimination of barriers by providing complete health insurance coverage (with no out-of-pocket expenses) and suspending disability reviews. The control group received usual services. Paid employment was the primary outcome measure, and overall mental health and quality of life were secondary outcome measures. Overall, 2,059 SSDI beneficiaries with schizophrenia, bipolar disorder, or depression in 23 cities participated in the 2-year intervention. The teams implemented the intervention package with acceptable fidelity. The intervention group experienced more paid employment (60.3% compared with 40.2%) and reported better mental health and quality of life than the control group. Implementation of the complex intervention in routine mental health treatment settings was feasible, and the intervention was effective in assisting individuals disabled by schizophrenia or depression to return to work and improve their mental health and quality of life.

American Journal of Public Health

Administration and policy in mental health, Jan 17, 2017

Previous studies suggest that providing employment services to individuals with serious mental il... more Previous studies suggest that providing employment services to individuals with serious mental illnesses can help them obtain competitive, real-world employment. However, these services are still not easily accessible to this population. This paper provides a brief summary of recent federal initiatives that may influence widespread implementation of employment services. While there is an increasing recognition of the need to remove barriers and provide supported employment services to individuals with mental illnesses, a wide-spread coordination across Federal polices, financing and regulatory changes are necessary to promote measurable and lasting effects on the broad availability of employment services among this population.

Psychiatric services (Washington, D.C.), Jan 15, 2016

This study compared characteristics of visits to emergency rooms (ERs) for mental and substance u... more This study compared characteristics of visits to emergency rooms (ERs) for mental and substance use disorders and for physical health conditions to establish a baseline against which to measure changes after full implementation of the Affordable Care Act (ACA) and parity legislation. The retrospective, cross-sectional analysis fit a logistic regression model to pooled data comprising 193,526 observations from National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2005 to 2011. ER visits for mental or substance use disorders increased from 27.9 per 1,000 ER visits in 2005 to 35.1 in 2011. Homeless persons and nursing home residents had the highest rates of such visits-173.7 and 95.2 per 1,000 ER visits, respectively, in 2011. Understanding differences in profiles of ER visits on the basis of the reason for the visit can inform the design of more cost-effective policies to guide ER intake, after further implementation of the ACA and parity legislation.

Psychiatric services (Washington, D.C.), Jan 15, 2016

The purpose of this Open Forum is to highlight strategies that can be implemented by federal heal... more The purpose of this Open Forum is to highlight strategies that can be implemented by federal health care policy makers to improve the delivery of effective behavioral health care services in the public and private sectors. The recommendations can be accomplished by using existing funds or authorities allocated to federal agencies dealing with the behavioral health system. These recommendations do not require new or additional funding and focus on strategies with a track record for success. The strategies described require relatively small changes but have the potential for big impacts.

The Journal of Rehabilitation, Oct 1, 2003

Psychiatric services (Washington, D.C.), Oct 1, 2016

The Social Security Administration's Mental Health Treatment Study (MHTS) produced positive m... more The Social Security Administration's Mental Health Treatment Study (MHTS) produced positive mental health, employment, and quality of life outcomes for people on Social Security Disability Insurance (SSDI). The investigators discuss major policy implications. First, because integrated, evidence-based mental health and vocational services produced clinical and societal benefits, the authors recommend further service implementation for this population. Second, because provision of these services did not reduce SSDI rolls, the authors recommend future research on prevention (helping people avoid needing SSDI) rather than rehabilitation (helping beneficiaries leave SSDI). Third, because integrating mental health, vocational, and general medical services was extremely difficult, the authors recommend a multifaceted approach that includes streamlined funding and infrastructure for training and service integration. Fourth, because insurance coverage for people with disabilities during ...

J Behav Health Serv Res, 2011

The relationship between depression and development of chronic illness among older adults is not ... more The relationship between depression and development of chronic illness among older adults is not well understood. This study uses data from the Health and Retirement Study to evaluate the relationship between depression at baseline and new onset of chronic illnesses including cancer, heart problems, arthritis, and diabetes. Analysis controlling for demographics (age, gender, race, education), health risk indicators (BMI and smoking), functional limitations (gross motor index, health limitations for work), and income show that working-age older people (ages 50-62) with depression at baseline are at significantly higher risk to develop diabetes, heart problems, and arthritis during the 12-year follow-up. No significant association was found between depression and cancer. Prevention efforts aimed at chronic illnesses among the elderly should recognize the mind-body interaction and focus on preventing or alleviating depression.

Health affairs (Project Hope), Jun 1, 2016

The majority of people with serious mental illnesses want to work. Individual placement and suppo... more The majority of people with serious mental illnesses want to work. Individual placement and support services, an evidence-based supported employment intervention, enables about 60 percent of people with serious mental illnesses who receive the services to gain competitive employment and improve their lives, but the approach does not lead to fewer people on government-funded disability rolls. Yet individual placement and support employment services are still unavailable to a large majority of people with serious mental illnesses in the United States. Disability policies and lack of a simple funding mechanism remain the chief barriers. A recent federal emphasis on early-intervention programs may increase access to employment services for people with early psychosis, but whether these interventions will prevent disability over time is unknown.

Atlantic Economic Journal, 2009

Obesity among U.S. adolescents ages 12-19 rose from 4.6% in 1963-1965 to 17.4% in 2003-2004. This... more Obesity among U.S. adolescents ages 12-19 rose from 4.6% in 1963-1965 to 17.4% in 2003-2004. This paper contributes to the literature on the impact of unhealthy body mass index (BMI) on health (e.g., obesity) and human capital (e.g., schooling) investments of adolescents. We use the propensity score method to study 8,388 individuals who responded to survey Waves I through III of the National Longitudinal Study of Adolescent Health (Add Health), for students in grades 7-12. We estimate an economic model that captures longer-term effects of BMI categories (obesity and overweight separately) on on-time (dichotomous) high school graduation. We control for characteristics at the individual, household, and community levels. Baseline probit regression estimates were improved upon by using matching estimators (propensity scores yield consistent estimate of the average treatment on the treated) based on the nearest neighbor and the more robust kernel density weighting schemes. Results from both full and reduced models suggest no adverse impact of overweight or obesity on timely high school completion for males, but a significant average negative effect on

ABSTRACT INTRODUCTION: Farmers markets (FMs) play a major role in promoting locally grown fruits ... more ABSTRACT INTRODUCTION: Farmers markets (FMs) play a major role in promoting locally grown fruits and vegetables to members of community, including Supplemental Nutrition Assistance Program (SNAP) participants. While the number of FMs and SNAP authorized FMs continue to grow, SNAP redemptions still account for only 0.01 percent of all SNAP redemptions. Because SNAP serves millions of Americans, it is imperative to understand why so few SNAP participants redeem benefits at farmers markets. APPROACH: A two stage sampling process was used to administer a survey to a random sample of SNAP participants. The sample included SNAP participants who shopped at selected FMs between late August and mid-October 2013 and those who did not shop at these FMs. The survey comprised of five topic areas including where participants shopped for groceries including fresh fruits and vegetables; whether they shopped at the reference FM; whether they shopped at any FM; what their reasons were for not shopping at any FM; and socio-demographic characteristics including participation in other nutrition assistance programs. RESULTS: The findings related to fruit and vegetable shopping behaviors of SNAP participants will be presented, including reasons for infrequent shopping or not shopping at FMs. DISCUSSION: Understanding what influences SNAP participants’ shopping decisions at FMs will allow public health practitioners to develop effective strategies for promoting use of FMs among SNAP participants.