Addressing the Poverty and Social Exclusion of People with Serious Mental Illness in the United States

People with serious mental illness across industrialized and developing countries experience economic exclusion with devastating consequences to their emotional wellbeing and social inclusion.  In the United States only one in five is employed, although a majority expresses a desire to work. Up to half of all people with serious mental illness have incomes below to the federal poverty line. Furthermore, a large proportion live in the “poverty trap” of Social Security benefits - without sufficient income and assets to meet their needs, wanting to work and improve their financial situation yet feeling unable to increase earnings or assets due to the means-testing requirements of Social Security programs. Those who also belong to minority groups are likely to live in even greater economic exclusion. This is expected, since most racial, ethnic and sexual minority communities in the U.S. experience higher levels of unemployment, poverty and dependency than non-minority individuals, rendering them vulnerable to the compounded impact of disability and socio-economic disparities.

This presentation describes the results of a mixed-methods study in New York State examining the financial capability of people with serious mental illness and its impact on their emotional wellbeing and social exclusion. It also presents a peer-supported economic empowerment intervention model for people with serious mental illness currently being piloted for feasibility, acceptability and initial efficacy. This model includes strategies to help individuals with serious mental illness overcome systemic, community, programmatic, and individual-level barriers to economic inclusion; and to revert the impact of economic exclusion on emotional and social wellness domains - such as hopelessness, life dissatisfaction, shame, and social isolation.The relevance of these results and intervention model are discussed in the context of welfare and public health policies to address social determinants of health and disability, and socioeconomic inequalities, in the U.S. and other industrialized nations.