This is the eighth and last in a series (seven blogs, one article) that addresses how persons caught up in the mental health system can be helped to live as effective citizens in the larger community. This particular blog will focus on jobs, the failure of the mental health system to connect its consumers to mainstream jobs, and the political strategy that mental health consumers, past and present, will have to pursue in order to obtain jobs in the mainstream or larger community.
If you ask individuals receiving treatment services from a behavioral health program if they want to work, to a person they'll answer "Yes." Yet, most have never worked and, if they have, will never get another job. They'll be blocked by terrible apprehension at what they might encounter, much of it rooted in unhappy interpersonal experiences in the workplace and in the larger community, both of which serve to engender as well as reinforce their sense of personal inadequacy. Those that are able to return to work in mainstream jobs are often those who have previous work experience and are determined to re-create the lives they once lived.
The few that succeed have good skill sets and a reasonably solid support system at work, at home and in the treatment system. In my own experience, the relatively few case management clients in my programs who worked did so in sub rosa jobs—off the books, low paying, no benefits—mostly in their home neighborhoods. Catalano, et al, refer to these jobs as comprising the "secondary job market." Generally, our clients knew their employers, co-workers and customers. In short, regardless of their apparent exploitation, they chose to work in venues where they were accepted, wouldn't have to explain themselves, and where their entitlements weren't jeopardized. They enjoyed earning extra money, which they used to purchase the small luxuries their SSI benefits wouldn't allow them—a cell phone; cable TV; cigarettes; etc. They could also leave and return to these jobs as they needed to.
This sector of the job market, by definition, does not figure in U.S. Bureau of Labor Statistics tabulations. Accordingly, most of our clients, whether working or not, are never included in the federal government's published monthly unemployment rates. In fact, despite the Americans with Disabilities Act (ADA), passed by the Congress 20 years ago, persons with a range of disabilities, whether physical, developmental, or psychiatric, are grossly underrepresented in the mainstream or "primary" labor market. At any one time, approximately five million persons with disabilities are employed full-time in the primary job market. In a recent speech before the U.S. Chamber of Commerce, Senator Tom Harkin, Chairman of the U.S. Senate Committee on Health, Education, Labor and Pensions and one of the original proponents of the ADA, noted that 400,000 disabled workers lost their jobs during the two-year period (March 2009 to March 2011). This represented a rate of job loss ten times greater than that for workers with no reported disabilities. In short, at this time of unremitting high unemployment, disabled workers' job status is tenuous. The plans of Harkin and his committee to redress this problem is to cajole private industry to add 1.5 million disabled persons to their payrolls by 2015.