Employment and economic outcomes of persons with mental illness and disability: The impact of the Great Recession in the United States.

Donna D. McAlpine, Sirry M. Alang

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Objective: To examine variation in employment and economic outcomes before, during, and after the great recession by disability and mental health status. Methods: Using a sample of adults in the 1999 to 2016 National Health Interview Survey ( N = 419,336), we examined changes in labor force and economic outcomes by mental health and physical disability status. We employed difference-in-differences analyses to determine whether the changes in these outcomes during and after the recession for each comparison group (those with moderate mental illness, serious psychiatric disability, or physical disability) were significantly different from the changes for persons with neither a mental illness nor a disability. Findings: While the recession impacted all groups, those with mental illnesses or physical disabilities were hardest hit. Persons with disabilities were disadvantaged on all outcomes at each period, but persons with mental illnesses were the most disadvantaged. Unemployment, poverty, and use of food stamps increased for all groups, but the increase was greatest for persons with mental health problems who also saw a more substantial decline in wage income. Conclusions and Implications for Practice: The effects of the recession persist well after the recovery period. Practitioners should be aware that although most persons with mental illnesses want to work, they face significant barriers to employment. Following economic shocks such as those brought on by the current coronavirus pandemic, interventions should focus on people who are the most vulnerable, especially those with mental health problems. Renewed focus on employment for people with mental disorders is important. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Original languageEnglish (US)
Pages (from-to)132-141
Number of pages10
JournalPsychiatric rehabilitation journal
Issue number2
Early online dateOct 8 2020
StatePublished - Jun 2021

Bibliographical note

Publisher Copyright:
© 2020 American Psychological Association


  • disability
  • economic status
  • employment
  • mental illness
  • recession
  • Economic Recession/statistics & numerical data
  • Disabled Persons/rehabilitation
  • Health Status Disparities
  • Mental Disorders/economics
  • Humans
  • Middle Aged
  • Male
  • Vulnerable Populations
  • Mental Health/economics
  • COVID-19/economics
  • Employment/statistics & numerical data
  • SARS-CoV-2
  • United States/epidemiology
  • Adult
  • Female
  • Unemployment/statistics & numerical data
  • Economic Status/statistics & numerical data

PubMed: MeSH publication types

  • Journal Article


Dive into the research topics of 'Employment and economic outcomes of persons with mental illness and disability: The impact of the Great Recession in the United States.'. Together they form a unique fingerprint.

Cite this