Report: 4 out of 5 mentally ill people unemployed

More than 80 percent of mentally ill people in the United States are unemployed despite the fact that a majority of them want to find work, according to a study by the National Alliance on Mental Illness (NAMI).

The findings (PDF), published this week, found that the rate of employment among the mentally ill declined from 23 percent in 2003 to 17.8 percent in 2012.

“Employment rates are inexcusably low and getting worse for people living with mental illness,” the report said.

Sita Diehl, the author of the report, told Kaiser Health News the problem was structural in nature, having less to do with the mentally ill themselves but the health of the economy and the sufficiency of mental-health support.

“We knew that mental health services really took it on the chin during the recession,” she said. “Employment rates had already been dismal to begin with, and when the supports were eroded, people with mental illness lost support and lost jobs.”

The study noted significant disparity in the state-by-state unemployment rate of mentally ill people. Maine, with the highest, had an unemployment rate of 92.6 percent, while Wyoming, with the lowest, had 56.1 percent.

Other states with high unemployment rates for the mentally ill include West Virginia, Hawaii, Pennsylvania and California — all above 90 percent.

According to the National Institute of Mental Health, there are 43.7 million U.S. adults with mental illness, nearly 19 percent of the total adult population.

While approximately 60 percent of the 7.1 million people who receive public mental-health services want employment, only 1.7 percent receives public employment-support services, the NAMI report said.

The report found that while quality programs do exist to place mentally ill people in suitable jobs, a number of factors conspire to impede their success.

“Multiple implementation barriers exist, including lack of political will, inadequate funding, misaligned policies, stigma and discrimination against people with mental illness,” the report said.

What’s more, NAMI found that the mentally ill comprise the largest and fastest-growing group enrolled in the Social Security Disability Income (SSDI) and the Supplemental Security Income (SSI) assistance programs.

The implication is that the more investment in the programs the report identities as valuable for employment for the mentally ill — such as rapid employment placement assistance — the more the economy benefits as whole, in addition to the individuals themselves.

According to the report, mentally ill people also face a disincentive to find work.

It said there are both real and perceived problems among many mentally ill persons who receive supplemental assistance from the government that once they find a job, they’ll lose their benefits — especially if gaining employment makes them ineligible for programs like Medicaid but their new employment benefits are inadequate to make up the difference.

Nevertheless, the report noted a few trends it found promising — among them: The Affordable Care Act, also known as “Obamacare,” requires individual and small group health plans to now offer mental-health benefits that are on par with other essential health requirements.

The NAMI report also outlined a number of suggestions for the federal government that could help it improve the unemployment rate for mentally ill people — among them:

• ensure compliance with the Americans with Disabilities Act, which is not only supposed to provide public assistance to mentally ill people, but also help them find jobs;

• introduce placement vocational programs into the Veterans Affairs system so that veterans with mental illnesses are better supported;

• improve data collection for mental illness and employment, including improving access to Department of Labor statistics.

“Now is the time to leverage converging trends to break the cycle of mental illness and poverty that has plagued too many for too long,” the report said.

“It is time for federal and state policymakers to make a serious commitment to implementing effective supported employment programs so that people with mental illness can recover and become contributing members of society.”