Employment and Economic Outcomes of Persons With Mental Illness and Disability: The Impact of the Great Recession in the United States

Objective: To examine variation in employment and economic outcomes before, during, and after the great recession by disability and mental health status. Methods: Using a sample of adults in the 1999 to 2016 National Health Interview Survey (N = 419,336), we examined changes in labor force and economic outcomes by mental health and physical disability status. We employed difference-indifferences analyses to determine whether the changes in these outcomes during and after the recession for each comparison group (those with moderate mental illness, serious psychiatric disability, or physical disability) were significantly different from the changes for persons with neither a mental illness nor a disability. Findings: While the recession impacted all groups, those with mental illnesses or physical disabilities were hardest hit. Persons with disabilities were disadvantaged on all outcomes at each period, but persons with mental illnesses were the most disadvantaged. Unemployment, poverty, and use of food stamps increased for all groups, but the increase was greatest for persons with mental health problems who also saw a more substantial decline in wage income. Conclusions and Implications for Practice: The effects of the recession persist well after the recovery period. Practitioners should be aware that although most persons with mental illnesses want to work, they face significant barriers to employment. Following economic shocks such as those brought on by the current coronavirus pandemic, interventions should focus on people who are the most vulnerable, especially those with mental health problems. Renewed focus on employment for people with mental disorders is important.

Automated summary

The study found that individuals with mental illnesses or physical disabilities were most impacted before, during, and after the recession. People with disabilities were disadvantaged across all outcomes, while those with mental illnesses were the most disadvantaged, experiencing higher unemployment, poverty, and reliance on food stamps. Economic shocks such as the current pandemic highlight the need for interventions to focus on vulnerable populations, particularly those with mental health problems, and emphasize the importance of employment support for individuals with mental disorders.