Course of Mental Illness and Role of Multiple Health Conditions Among People Under Age 50 in Predicting Change in Public Disability Benefit Status and Labor Force Participation

The purpose of this study is to determine whether deteriorating mental health conditions result in premature labor force exit among workers with psychiatric disabilities under age 50 and, concomitantly, whether worsening mental health increases the likelihood of becoming an SSI/DI beneficiary. We also examine whether co-occurrence of physical health conditions along with disabling mental health disorders increases the risk of premature labor force exit, and leads to enrollment in the SSI and DI programs. Finally, our study explores whether receiving supported employment services interacts with the presence of co-morbid physical health conditions and deteriorating mental illness course to influence labor force participation and SSA disability beneficiary status. We found that deteriorating mental health conditions as measured by exacerbated symptomatology were significantly associated with more frequent and earlier job loss among people with severe mental illness. In addition, we found that mental health deterioration without proper management was significantly associated with premature job loss. For our second study question, we found that mental health deterioration resulted in more frequent and earlier reports of new SSI/DI cash benefits. We found that the presence of comorbid physical health conditions was not associated with job loss or report of new SSI/DI cash benefits. Finally, there was no interaction effect between supported employment and deteriorating mental illness or the presence of physical health co-morbidities. However, supported employment recipients were more likely to receive proper clinical care management, and more likely to secure and maintain employment.