The Relationship of Multiple Program Benefits and Employment to SSI/DI Enrollment and Reliance Among Working-Age Adults with Serious Mental Illness

DRC Working Paper Number 2017-03
Publisher: Washington, DC: Center for Studying Disability Policy, Mathematica Policy Research
Oct 30, 2017
Judith A. Cook and Jane K. Burke-Miller

Key Findings:

  • Multiple program participation was common among working-age adults with serious mental illness (SMI). Multiple program participation was more common in means-tested social welfare programs such as SSI and state welfare than in social insurance programs such as SSDI. 
  • States varied considerably in the proportion of working-age adults with SMI who were receiving SSI or State welfare benefits, even adjusting for individual characteristics and not explained by local area unemployment rates.
  • Employment was related to diminished use of SSI cash benefits, but not to SSDI cash benefit use.
This study provides information about how SSA’s programs for people with psychiatric disabilities intersect and interact with other federal, state and local programs that provide cash and other benefits to people with disabilities, and how enrollment in these programs is affected by changes in employment. We used data from the Employment Intervention Demonstration Program, a federally-funded longitudinal study of supported employment programs for people with serious mental illness (SMI) conducted in 8 states. Detailed employment and benefit information was collected on 1,636 working-age adults over 24 months of follow-up. We present descriptive analyses quantifying sources of income among people with SMI, their relative reliance on public and private income sources, and benefit status changes over time relative to employment.  Key limitations of the study include the self-report nature of benefit status, non-population representative nature of the cohort sample, and consequent reliance on descriptive rather than inferential statistics.