How the Affordable Care Act Can Support Employment for People with Mental Illness

Issue Brief
Publisher: Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy
May 30, 2014
Allison Wishon Siegwarth and Crystal Blyler

Mental illness, like any health concern, can disrupt the ability to work. Less than 20 percent of people who receive publicly funded mental health services are employed, although research consistently demonstrates that, with the right supports, 40-60 percent of people with serious mental illness (SMI) can work. Many of those who do so work part-time, intermittently, or at low wages (Blyler 2003; Bond 2004, 2007; SAMHSA 2011). Unemployment or low levels of work may lead to reliance on disability benefit programs, which gives the social safety net an important role in their lives. Working-age people with psychiatric disorders are the largest and most rapidly expanding group of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) beneficiaries. Currently, 36 percent of SSDI and 60 percent of working-age SSI beneficiaries have a mental illness (SSA 2011a, 2011b), and estimates suggest that less than 4 percent of SSDI beneficiaries exit the program due to earnings within the first ten years of enrollment (Stapleton et al. 2010).