The economic life of seriously mentally ill people in the community.

OBJECTIVE

The study examined economic disincentives and incentives to work among people with serious mental illness.

METHODS

Fifty people with severe and persistent mental illness who were living in the community were interviewed about the amount and sources of their income and expenses. In addition, a randomly selected group of 100 people with schizophrenia or schizoaffective disorder was interviewed about work, income, and wage requirements.

RESULTS

In the first sample, the mean total cash and noncash income of unemployed subjects ($929 a month), which was derived mainly from disability supports and rent subsidies, was only slightly lower than that of subjects with part-time employment ($1,028 a month). The limited difference was largely a consequence of reductions in entitlement income when subjects worked. To overcome these disincentives, most subjects in the second sample felt they needed to earn between $5 and $6 an hour to make working worthwhile. The mean monthly cost of psychiatric treatment for unemployed subjects was $2,083, compared with $910 for those with part-time employment and $292 for those working full time.

CONCLUSIONS

The findings emphasize the importance of developing higher-paying jobs for this population and reforming entitlement programs to incorporate work incentives for the mentally disabled population.