Mental illness, work, and income support programs

Am J Psychiatry. 2009 Apr;166(4):398-404. doi: 10.1176/appi.ajp.2008.08020297.


Improved treatment makes it easier for individuals with mental illness to participate in mainstream society, including the labor force. Nevertheless, a diagnosis of a severe and persistent mental illness or a substance use disorder often coincides with reduced work activity and lower earnings. The Social Security Disability Insurance Program and the Supplemental Security Income program provide income support for increasing numbers of individuals with mental illness. A growing share of a third program, Temporary Assistance for Needy Families, which offers cash support to low-income single caregivers, is composed of individuals with mental illness, as new work requirements result in faster exits of those without mental health conditions. These programs have come under increasing scrutiny as the shares of recipients with mental illness increase. Some question whether these programs serve many individuals capable of working and supporting themselves. However, evidence on whether eligibility criteria for these income support programs are too stringent or too lax regarding individuals with mental illness is mixed. Appropriate income support policy for those with mental illness will differ dramatically depending on the source of the recent rise in individuals with mental illness using income support.

Publication types

  • Letter

MeSH terms

  • Adolescent
  • Adult
  • Disability Evaluation
  • Eligibility Determination / trends
  • Female
  • Forecasting
  • Humans
  • Income*
  • Male
  • Mental Disorders / rehabilitation*
  • Middle Aged
  • Morals
  • Motivation
  • Rehabilitation, Vocational*
  • Social Security / trends*
  • Substance-Related Disorders / rehabilitation*
  • Unemployment / trends
  • United States
  • Young Adult