abstract: 'A major public policy problem is the extremely low labor force

  participation of people with severe mental illness coupled with their

  overrepresentation on the public disability rolls. This situation is

  especially troubling given the existence of evidence-based practices

  designed to return them to the labor force. This article reviews

  research from the fields of disability, economics, health care, and

  labor studies to describe the nature of barriers to paid work and

  economic security for people with disabling mental disorders. These

  barriers include low educational attainment, unfavorable labor market

  dynamics, low productivity, lack of appropriate vocational and clinical

  services, labor force discrimination, failure of protective legislation,

  work disincentives caused by state and federal policies, poverty-level

  income, linkage of health care access to disability beneficiary status,

  and ineffective work incentive programs. The article concludes with a

  discussion of current policy initiatives in health care, mental health,

  and disability. Recommendations for a comprehensive system of services

  and supports to address multiple barriers are presented. These include

  access to affordable health care, including mental health treatment and

  prescription drug coverage; integrated clinical and vocational services;

  safe and stable housing that is not threatened by changes in earned

  income; remedial and post-secondary education and vocational training;

  benefits counseling and financial literacy education; economic security

  through asset development; legal aid for dealing with employment

  discrimination; peer support and self-help to enhance vocational

  self-image and encourage labor force attachment; and active involvement

  of U.S. business and employer communities.'
affiliation: 'Cook, JA (Corresponding Author), Univ Illinois, Ctr Mental Hlth Serv
  Res \& Policy, Dept Psychiat, 1601 W Taylor St,4th Floor M-C 913, Chicago, IL 60612
  USA.

  Univ Illinois, Ctr Mental Hlth Serv Res \& Policy, Dept Psychiat, Chicago, IL 60612
  USA.'
author: Cook, Judith A.
author-email: cook@ripco.com
author_list:
- family: Cook
  given: Judith A.
da: '2023-09-28'
doi: 10.1176/appi.ps.57.10.1391
eissn: 1557-9700
files: []
issn: 1075-2730
journal: PSYCHIATRIC SERVICES
keywords-plus: 'SEVERE MENTAL-ILLNESS; VOCATIONAL-REHABILITATION; SUPPORTED EMPLOYMENT;

  HEALTH; WORK; POLICY; SCHIZOPHRENIA; DISORDERS; INSURANCE; OUTCOMES'
language: English
month: OCT
number: '10'
number-of-cited-references: '136'
pages: 1391-1405
papis_id: 56337c9494842cb08c908e082cc923f1
ref: Cook2006employmentbarriers
researcherid-numbers: Cook, Judith/B-9107-2013
tags:
- relevant
- review
times-cited: '170'
title: 'Employment barriers for persons with psychiatric disabilities: Update of a
  report for the president''s commission'
type: article
unique-id: WOS:000241046000006
usage-count-last-180-days: '2'
usage-count-since-2013: '62'
volume: '57'
web-of-science-categories: 'Health Policy \& Services; Public, Environmental \& Occupational
  Health;

  Psychiatry'
year: '2006'