Policy Issues Regarding Employment for People with Serious Mental Illness

Abstract

This chapter addresses three critical policy questions related to employment for the ten million working-age adults with severe mental illness (SMI): First, do disability policies influence the low rate of employment among people with SMI? Second, could policy changes improve employment of people with SMI? Third, could policy changes enhance access to supported employment? Current disability policies clearly influence employment of people with SMI. Most people in this population want to work and could work, but disincentives in the disability system and lack of access to effective supports limit their success. Given that disability policies limit employment, new policy could potentially improve employment outcomes. No consensus exists yet on what the changes should be. The field needs controlled research, especially involving early interventions. Although disability policy changes are uncertain, evidence-based supported employment is an effective strategy that could help people with SMI acquire and maintain employment. Yet the current funding process obstructs implementation and access. The United States needs a simple funding mechanism for evidence-based supported employment.