Exacerbating Long-Term Unemployment: Big Data and Employment Assessments

A recent Brookings Institution paper states that the “diverse and varied set of characteristics [of the long-term unemployed] implies that a broad array of policies will be needed to substantially lower the long-term unemployment rate and stem labor force withdrawal, as concentrating on any single occupation, industry, demographic group or region is unlikely to have a substantial impact reducing long-term unemployment by itself." Please see On the Margins of the Labor Market.

There is, however, a common employment factor that can be linked to numerous occupations, industries, demographic groups and regions -- online job application processes that require individuals (i) to provide "location-based information" (i.e., distance from job site, commute time, household relocation) and (ii) to complete personality assessments.The screening elements in these processes exclude or penalize persons with lower socioeconomic status - disproportionately Blacks, Hispanics, persons with mental illness, and the less well-educated. The same groups (ex persons with mental illness) that the recent Brookings Institution paper found to comprise a disproportionate percentage of the long-term unemployed.

Jobs that were once filled on the basis of work history and interviews are left to personality tests, data analysis and algorithms. The new hiring tools are part of a broader effort to gather and analyze employee data.  Use of online assessments has grown exponentially over the past 10-15 years, with assessment companies like Kronos now having a database of hundreds of millions of job applicant and employee information. To provide a sense of scale, one major big box retailer processes more than nine million job applications a year.

Personality tests are “growing like wildfire,” said Josh Bersin, president and CEO of Bersin & Associates, an Oakland, Calif., research firm. Bersin estimated that this kind of pre-hire testing has been growing by as much as 20 percent annually in the past few years. Industries that are flooded with resumes such as retail, food service and hospitality are among the ones that use such tests most often, he said.

Employment Redlining: Location-Based Discrimination

Kenexa, an assessment company purchased by IBM in December 2012 for $1.3 billion, will test tens of millions of applicants this year for thousands of clients. Kenexa believes that a lengthy commute raises the risk of attrition in call-center and fast-food jobs. It asks applicants for call-center and fast-food jobs to describe their commute by picking options ranging from "less than 10 minutes" to "more than 45 minutes."The longer the commute, the lower their recommendation score for these jobs, said Jeff Weekley,, who oversees the assessments. Applicants also can be asked how long they have been at their current address and how many times they have moved. People who move more frequently "have a higher likelihood of leaving," Mr. Weekley said.

Painting with the broad brush of distance from job site, commute time and moving frequency results in otherwise well-qualified applicants being excluded, applicants who might have ended up being among the longest tenured of employees. The Kenexa  findings are generalized correlations; the insights say nothing about any particular applicant. Please see From What Distance is Discrimination Acceptable.


Are there any groups of people who might live farther from the work site and may move more frequently than others? Yes, lower-income persons, disproportionately women, black, Hispanic and the mentally ill. They can't afford to live where the jobs are and move more frequently because of an inability to afford housing or the loss of employment.

Spatial  Mismatch and its Institutionalization

An NBER study published in April 2014, "Job Displacement and the Duration of Joblessness: The Role of Spatial Mismatch, finds that better job accessibility significantly decreases the duration of joblessness among lower-paid displaced workers. Blacks, females, and older workers are more sensitive to job accessibility than other subpopulations.

The so-called “spatial mismatch hypothesis,” which originally grew out of research on the effects of segregated housing markets, has been debated among economists and social scientists since the 1960s. But while there’s general agreement that “job accessibility” has some impact on unemployment duration, researchers have disagreed about how important it is and for which groups of workers.

Although the study was limited to the 2000-05 period, its conclusion — that “a worker with locally inferior access to jobs is likely to have worse labor market outcomes” — could help explain the current situation. What we know for sure is that as of March 2014, more than a third (35.7%) of all unemployed Americans had been out of work for more than 26 weeks, according to the BLS. Blacks and Asians are most likely to experience extended joblessness: Last month, 44% of unemployed blacks and about as many unemployed Asians had been out of work longer than 26 weeks, versus a third of unemployed whites and 32% of unemployed Hispanics. Please see Long-Term Unemployment and its Costs.

With the "location-based" scoring "insights" provided by companies like Kenexa, spatial mismatch has been institutionalized over the past 5-10 years. If a job applicant has a long commute - whether due to the lack of effective mass transit where the applicant lives or to the lack of access to personal transportation, that applicant may never be interviewed, let alone offered a job.

Mental Illness and Socioeconomic Status

One of the most consistently replicated findings in the social sciences has been the negative relationship of socioeconomic status (SES) with mental illness: The lower the SES of an individual is, the higher is his or her risk of mental illness.

As an example, for the period from 2005-2010, the Centers for Disease Control found that among adults 20–44 and 45–64 years of age, depression was five times as high for those below poverty, about three times as high for those with family income at 100%–199% of poverty, and 60% higher for those with income at 200%–399% of poverty compared with those at 400% or more of the poverty level.

According to a 2001 study, lower income Americans had a higher prevalence of 1 or more psychiatric disorders (51% vs 28%): mood disorders (33% vs 16%), anxiety disorders (36% vs 11%), and eating disorders (10% vs 7%). Consequently, pre-employment assessments using these location-based "insights" screen out persons with mental illness.

Mental Illness and Disability

The prevalence of mental disorders in the U.S. population remained unchanged between 1990 and 2003.  In that same interval, the rate of treatment of mental illness substantially increased—which in turn should have contributed to improved work-readiness among individuals coping with mental illness. The combination of the prevalence of mental disorders remaining unchanged and substantially increased rates of treatment should have resulted in a decline in the percentage of persons receiving SSDI awards who are diagnosed with mental illness. That has not been the case. Please see Costing Taxpayers Billions of Dollars Each Year.

People with psychiatric impairments constitute the largest and most rapidly growing subgroup of Social Security disability beneficiaries. In 2011, 47.5 percent of persons receiving SSI and 31.0 percent of persons receiving SSDI had a mental disorder. These percentages keep growing, in part because beneficiaries with psychiatric impairments are generally younger than other beneficiaries when they become ill and therefore remain on the Social Security rolls much longer.

Some analysts contend that rising disability awards for mental illness reflect a “broken” system that provides benefits to those who should not receive them; others point out that income support makes it easier for persons with mental illness to live in the community. These conflicting conclusions reflect an ongoing debate over whether increasing awards for mental illness represent a policy success because they reach needy individuals or failure because the increased awards reflect moral hazard.

The income support programs may be working as designed, but those programs did not anticipate the impact of the widespread use of pre-employment assessments and the resulting material increase in the absolute number and percentage of unemployed persons with mental disabilities seeking SSDI and SSI benefits as a consequence of the use of potentially  illegal assessments.

* * * * *

Persistently high long-term unemployment has significant implications for families, government budgets, and the country’s overall economic and social health. The high rate of long-term unemployment has had a direct impact on the federal budget by prompting the extension of normal unemployment benefits, ratcheting up spending on other government safety-net programs (including, indirectly, SSDI, SSI and Medicare) and by reducing taxable wages. Martin Feldstein in a recent article in the Wall Street Journal, draws on the Brookings Institution paper to suggest that those who have been out of work for six months or more do not affect wage inflation and that since the unemployment rate among those out of work for less than six months was only 4.1%, wage inflation may soon begin to rise more rapidly.

The growing and widespread use of employment assessments and applicant data collection processes over the past ten years has likely had an impact on the growth of the long-term unemployed in the U.S. labor market.  Persons with lower socioeconomic status, disproportionately Black, Hispanic, persons with mental illness, and the less well-educated, risk becoming a permanent underclass of the unemployed and underemployed.

Some of the most profound challenges revealed by the recent White House Report "Big Data: Seizing Opportunities, Preserving Values" concern how big data analytics may lead to disparate inequitable treatment, particularly of disadvantaged groups, or create such an opaque decision-making environment that individual autonomy is lost in an impenetrable set of algorithms. Please see White House: Big Data's Role in Employment Discrimination.

Workforce assessment systems, designed in part to mitigate risks for employers, have become sources of material risk, both to job applicants and employers. The systems create the perception of stability through probabilistic reasoning and the experience of accuracy, reliability, and comprehensiveness through automation and presentation. But in so doing, technology systems draw  attention away from uncertainty and partiality. Moreover, they shroud opacity—and the challenges for oversight that opacity presents—in the guise of legitimacy, providing the allure of shortcuts and safe harbors for actors both challenged by resource constraints and desperate for acceptable means to demonstrate compliance with legal mandates and market expectations.

What Are the Issues?

When people apply for a job online these days, they are increasingly being asked to take personality tests even before they exchange an e-mail or have a phone interview with a hiring manager. Such tests are being used by companies as a way to prune the job applications they receive.

The problem is that these assessments may also be used to illegally screen out job seekers with mental disabilities. 

As a result, too many people living with mental disabilities that are willing and able to work remain unemployed or underemployed. Not only does the United States economy experience the indirect loss in productivity and tax revenue arising from the unemployment and underemployment of persons with mental disabilities, there is a direct, rising and material cost to the U.S. Treasury associated with income support payments, like Social Security Disability Insurance and Supplementary Support Income. (Please see the post Costing Taxpayers Billions of Dollars Each Year).

Who are these persons with mental disabilities?

They are our sons and daughters, our mothers and fathers, our friends and colleagues. Mental illness is no respecter of age, race, gender, faith, sexual orientation, occupation, social position, education or wealth. Anyone can develop a mental illness.

They are:

• A soldier returning from Afghanistan looking to enter the civilian workforce, who suffers from PTSD as a result of combat
• A mother of a young child looking to support her family, who is recovering from post-partum depression
• A recent college graduate looking to start his career, who has been diagnosed with bipolar disorder

They are us. An estimated 26.2% of Americans ages 18 and older - about one in four adults - suffer from a diagnosable mental disorder in a given year.

At some point during his or her lifetime, the average American adult has a 28.8% chance of developing an anxiety disorders, a 24.8% chance of developing an impulse-control order, and a 20.8% chance of developing a mood disorder.

How widespread is pre-employment testing?

There are hundreds of companies that offer pre-employment assessments and/or implementation services to employers. One of the larger assessment companies, Kenexa (recently acquired by IBM) assesses more than 20 million persons a year. Other large assessment companies include Kronos (through its acquisition of Unicru), Oracle (through its acquisition of Taleo), SAP (through its acquisition of Success Factors) and SHL.

A mid-sized company in the retail business may have 50,000 assessments per month or 600,000 per year. Large “big box” employers and fast food companies may have 1-2 million assessments per year. 

Personality tests are “growing like wildfire,” said Josh Bersin, president and CEO of Bersin & Associates, an Oakland, Calif., research firm. Bersin estimated that this kind of pre-hire testing has been growing by as much as 20 percent annually in the past few years. Industries that are flooded with resumes such as retail, food service and hospitality are among the ones that use such tests most often, he said.

“A lot of work has been done over the years on how personality tests impact gender, race or age bias, but I don’t know if anyone has done enough research yet on mental disabilities,” says Bersin, “the medical community is starting to redefine what these diagnoses are, and the laws may not have caught up.”

Are pre-employment assessments legal?

The policy of the Equal Employment Opportunity Commission (EEOC) is that pre-employment testing, including personality testing, is acceptable as long as the test is not a "medical examination" as defined by the Americans with Disabilities Act (ADA).

EEOC guidance provides a seven-factor test for analyzing whether a test or procedure qualifies as a “medical examination,” including whether the test is designed to reveal an impairment of physical or mental health such as those listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

According to the guidance, the presence of any one of the seven factors is enough to support a finding that the test is a medical examination. 

How do the assessments screen out persons with mental disabilities?

A key component of the assessment process is a computer-administered personality test based on the five factor model of personality, or FFM, a coordinate system that maps which personality traits go together in people’s descriptions or ratings of one another. the FFM describes personality in terms of five broad factors:

• Openness: inventive and curious vs. consistent and cautious. 
• Conscientiousness: efficient and organized vs. easy-going and careless. 
• Extraversion: outgoing and energetic vs. solitary and reserved.
• Agreeableness: friendly and compassionate vs. cold and unkind
• Neuroticism: sensitive and nervous vs. secure and confident

The majority of personality disorders are characterized by significant positive relations with Neuroticism and significant negative relations with Extraversion, Agreeableness and Conscientiousness. Consequently, applicants who take the Assessment and have low scores on Openness, Conscientiousness, Extraversion and Agreeableness and high scores on Neuroticism are likely not to be offered employment (or even interviewed).

Based on an applicant’s responses to the online test, the assessment categorizes the applicant as red, green or yellow. In many cases, green gets an applicant an automatic follow-up interview. Red is usually an automatic discard.  A red or yellow score on the Assessment does not necessarily mean that an applicant has a mental disability, but a person who has a mental disability is likely to receive a red or yellow score on the assessment and will be denied consideration for employment.

Some have argued that assessments are designed to measure “normal” personalities and/or “stable” personality traits. That argument fails because, as a dimensional model, the FFM determines each applicant’s position along the axis of each of the five traits. Those five traits are the common measuring rod for all persons, including persons with mental disabilities. By its design and structure, an assessment based on the FFM measures all aspects of a personality, including both normal and abnormal personality traits.

For more information, please see the ADA, FFM and DSM post.

Are the tests designed to intentionally screen out persons with mental disabilities?

Perhaps.

One assessment company, Clearfit, lists “27.2 days/yr. lost productivity for depressed workers” as one of the impacts to employers if personality is not taken into account in the hiring process.

In any event, courts have held that the intent is irrelevant. What is relevant is that the use of the FFM as the basis of an assessment means that the assessment was designed to reveal mental impairments by identifying and rejecting those applicants who do not fall within the “green” parameters of the five traits. 

Are there any studies addressing the impact of assessment tests on persons with mental disabilities?

There has been no public disclosure of any studies addressing the impact of FFM-based assessments on persons with mental disabilities. One prominent assessment company, Kronos, has claimed in a court document, that there is “no known method … to ascertain adverse impact against the entire generic category of disabilities.” Kronos goes on to claim ”that “the diverse nature of disabilities (e.g., blindness, paraplegia, deafness, severe mental illness) makes an analysis of a selection device’s adverse impact on “people who have disabilities” impossible.” Such claims are unsupportable.

As stated in a 2004 article published by the the Journal of Rehabilitation Administration, “studies of sub-groups, such as individuals with mental illnesses or cognitive impairments could be conducted to determine the potential, and perhaps likelihood for, pre-employment test results unfairly penalizing these individuals in the employee selection and hiring stages …” 

Such studies are, in fact, mandated. In a 1975 decision, the Supreme Court addressed a case in which an employer implemented a test on the theory that a certain verbal intelligence was called for by the increasing sophistication of the plant’s operations. The Court held that a test should be validated on people as similar as possible to those to whom it will be administered. The Court further stated that differential studies should be conducted on minority groups wherever feasible.

Costing Taxpayers Billions of Dollars Each Year

The material increase in Social Security Disability Insurance (SSDI) and Social Security Insurance (SSI) awards over the past 2+ decades is due in part to a significant increase in the use of pre-employment assessments by employers that screen out persons with mental disabilities from employment consideration:

• SSDI and SSI beneficiary payments by the United States Treasury currently amount to more than $10 billion per month. [1]
• Applications for SSDI and SSI awards have increased from more than 1.2 million in 1999 to more than 2.8 million in 2010. [2]
• The “supply” of persons eligible to apply for SSDI and SSI awards may be defined by reference to the universe of unemployed (or underemployed) persons. [3] 
• Assessments utilize the five factor model (FFM) of personality. FFM is widely accepted as representing the higher-order structure of both normal and abnormal personality traits. FFM-based assessments are used to identify (or “screen in”) persons who are “normal” or “stable” and, as a consequence screen out persons with mental illness. (Please see the ADA, FFM and DSM post.)
• While assessments are based on the characteristics of the employer’s “preferred” employees for the relevant position, the small number of individuals with disabilities in the workforce means that the norming of pre-employment assessments was conducted with a biased sample of non-disabled workers. [4] 

As a consequence of employment assessment test usage, the characteristics of the pool of unemployed (and underemployed) persons do not mirror the characteristics of the broader population:

• In the broader population, approximately 1 in 17 adults in the United States has a serious mental illness. [5]
• Due to FFM-based assessment usage, persons with mental disabilities are “overrepresented” among the universe of unemployed persons – such universe consisting of persons eligible to apply for SSDI and SSI.

SSDI and SSI [6]

Improved treatment of mental illness makes it possible for individuals to participate in society, including the labor force. Nevertheless, diagnosis of a severe and persistent mental illness is often associated with downward economic mobility. For example, the estimated reduction in annual earnings related to mental disorders ranges from 9.5% to 25% for males and from 12% to 29% for females.

The SSDI and SSI programs provide monthly cash payments and medical benefits for individuals who meet the program requirements for mental illness. The chart below shows the number of SSDI and SSI beneficiaries aged 18–64 receiving benefits on the basis of disability as of December 2011. 

SSI is for low-income individuals who are over 65 years of age, blind, or disabled due to a disorder that prevents them from engaging in “substantial” work for at least 12 months or until death. To establish disability, there is a multi-stage screening process, requiring judgment calls about impairment and functioning. A minority of applicants are approved for disability benefits.

SSDI is a traditional social insurance program that replaces a portion of earnings when disability prevents “substantial gainful activity,” defined in 2013 as monthly earnings over $1,040. Only individuals who have contributed sufficiently to this program via payroll taxes can qualify for benefits. Given the early onset and inconsistent work history that accompany serious mental illness, few with mental illness qualify for full benefits. 

Mental Illness and Disability [7]

The prevalence of mental disorders in the U.S. population remained unchanged between 1990 and 2003. [8] In that same interval, the rate of treatment of mental illness substantially increased—which in turn should have contributed to improved work-readiness among individuals coping with mental illness. The combination of the prevalence of mental disorders remaining unchanged and substantially increased rates of treatment should have resulted in a decline in the percentage of persons receiving SSDI awards who are diagnosed with mental illness. [9] That has not been the case.

People with psychiatric impairments constitute the largest and most rapidly growing subgroup of Social Security disability beneficiaries. In 2011, 47.5 percent of persons receiving SSI and 31.0 percent of persons receiving SSDI had a mental disorder. [10] These percentages keep growing, in part because beneficiaries with psychiatric impairments are generally younger than other beneficiaries when they become ill and therefore remain on the Social Security rolls much longer.

Increased SSDI and SSI Awards: Policy Success or Failure?[11]

Income support programs like SSDI and SSI may create a disincentive to work, called moral hazard. Some analysts contend that rising disability awards for mental illness reflect a “broken” system that provides benefits to those who should not receive them; others point out that income support makes it easier for persons with mental illness to live in the community. These conflicting conclusions reflect an ongoing debate over whether increasing awards for mental illness represent a policy success because they reach needy individuals or failure because the increased awards reflect moral hazard.

The income support programs may be working as designed, but those programs did not anticipate the impact of the widespread use of pre-employment assessments and the resulting material increase in the absolute number and percentage of unemployed persons with mental disabilities seeking SSDI and SSI benefits as a consequence of the use of illegal assessments.

Rising Use of Personality Tests [12]

For more and more companies, the hiring boss is an algorithm. The factors they consider are different than what applicants have come to expect. Jobs that were once filled on the basis of work history and interviews are left to personality tests and data analysis, as employers aim for more than just a hunch that a person will do the job well.

Personality tests have a long history in hiring. What’s new is the scale. Powerful computers and more sophisticated software have made it possible to evaluate more candidates, amass more data and peer more deeply into applicants’ personal lives and interests.

The new hiring tools are part of a broader effort to gather and analyze employee data. Globally, spending on so-called talent-management software rose to $3.8 billion in 2011, up 15% from 2010, according to research firm Gartner. Big tech companies are jockeying to serve the growing market. In December 2012, IBM paid $1.3 billion for Kenexa Corp., which uses data analysis to help companies recruit and retain workers. Oracle Corp. acquired job-applicant tracking system company Taleo for $1.9 billion, and Germany’s SAP AG bought SuccessFactors, which specializes in performance tracking, recruiting and compensation, for $3.4 billion.

To date, assessments have been used primarily in the context of recruitment and hiring for entry-level positions. Assessments use is expanding, however, and is expanding to a variety of employment actions, including hiring, promotion, leadership development, training, retention, succession planning, workforce planning, analytics, outplacement, restructuring, and change management. [13] The possible “knock on” impacts of the broadening use of assessments includes the potential that existing employees, many of whom became employees prior to the widespread use of assessments in the hiring process, will find themselves unemployed and potentially looking to the SSDI and SSI programs for support.

Notes

[1] In December 2011, payments to disabled beneficiaries totaled about $10.4 billion according to the Annual Statistical Report on the Social Security Disability Insurance Program, 2011 (2011 Annual Statistical Report).

[2]Id. at Table 59.

[3] The replaces a portion of earnings when disability prevents “substantial gainful activity,” defined in 2013 as monthly earnings over $1,040.

[4] Hartigan, J. A., & Wigdor, A. K. (Eds.). (1989). Fairness in employment testing: Validity generalization, minority issues, and the General Aptitude Test Battery. Washington, D.C.: National Academy Press.

[5] It is also estimated that approximately 1 in 4 adults will have a mental health disorder in any given year (most commonly anxiety or depression); however, many of these disorders will not lead to a lasting disability. Reeves WC, Strine TW, Pratt LA, et al. Mental illness surveillance among adults in the United States. MMWR. 2011; 60(3):1–32. Atlanta, GA: Centers for Disease Control and Prevention. Available from CDC Mental Illness Surveillance Report

[6] This subsection is taken, in part, from Sheldon Danziger, Richard G. Frank, Ellen Meara; Mental Illness, Work, and Income Support Programs, Am J Psychiatry 2009;166:398-404. 10.1176/appi.ajp.2008.08020297 (hereinafter, Mental Illness, Work, and Income Support Programs).

[7] Except for the first paragraph, which is attributable to the publication cited in footnote 4, and the quote associated with footnote 11, this subsection is taken from Robert E. Drake, Jonathan S. Skinner, Gary R. Bond and Howard H. Goldman, Social Security And Mental Illness: Reducing Disability With Supported Employment, Health Affairs, 28, no.3 (2009):761-770. Citations contained in that publication have been omitted from the excerpts above.

[8] RC Kessler, O Demler, RG Frank, M Olfson, HA Pincus, EE Walters, P Wang, ZB Wells and AM Zaslavsky, “Prevalence and Treatment of Mental Disorders, 1990 to 2003,” New England Journal of Medicine 352 (2005): 2515–23.

[9]Id. at 6-7.

[10] These numbers differ from the excerpted article as a consequence of taking updated information from Table 68 in the 2011 Annual Statistical Report. The percentages for SSI and SSDI recipients, as set out above, do not include persons with intellectual disabilities (previously listed under the heading of mental retardation).

[11] The first paragraph of this subsection is taken from Mental Illness, Work, and Income Support Programs.

[12] Other than the final two paragraphs, this subsection is taken from Meet the New Boss: Big Data, Joseph Walker (Wall Street Journal, September 20, 2012).

[13]SHL 2013 Global Assessment Trends, S. Fallaw and T. Kantrowitz

Mental Illness and Issues of Employment

How significant is unemployment and underemployment of persons with mental illness?

According to the National Alliance on Mental Illness (NAMI), the unemployment rate among adults with serious mental illness has been as high as 90%, the highest level of any group of people with disabilities.

According to a 2008 report, 16.5% of the population aged 21 to 64 had a disability and only 45.6% of this group was employed. 

According to the chart below from a 2010 Harris Interactive survey, the employment gap between people with and without disabilities remains significant.

An article published in 2010, shows that during the period between October 2008 and June 2010, the proportion of employed U.S. workers identified as having disabilities declined by 9%, while there was no statistically significant change in the number of labor force participants without disabilities. 

According to a 2006 article, one in three mental health consumers in the United States report being turned down for a job once their psychiatric status became known.

Is there bias against persons with mental illness?

According to that 2006 article:

• Surveys of U.S. employers show that half of them are reluctant to hire someone with past psychiatric history or currently undergoing treatment for depression.
• Approximately 70% are reluctant to hire someone currently taking antipsychotic medication. 
• Half of U.S. employers would rarely employ someone with a psychiatric disability and almost a quarter would dismiss someone who had not disclosed a mental illness.
• People with mental disorders identify employment discrimination as one of their most frequent stigma experiences. Compared with individuals with physical disabilities, twice as many people with mental disabilities (the majority) expect to experience employment-related stigma. 

How prevalent is mental illness?

According to a report by the National Institute of Mental Health, an estimated 26.2% of Americans ages 18 and older suffer from one or more brain or behavior disorders in a given year. 

The Brain and Behavior Research Foundation reports that out of the 10 leading causes of disability identified and tracked in the United States; four are brain and behavior disorders: major depression, bipolar disorder, schizophrenia and obsessive-compulsive disorder.

More information on mental illness may be obtained from the National Alliance on Mental Illness, the National Institute of Mental Health, the Brain and Behavior Research Foundation, and the Depression and Bipolar Support Alliance.

What are the costs of unemployment and underemployment of the mentally ill?

Not only does the United States economy experience the indirect loss in productivity arising from the unemployment and underemployment of persons with mental illness, there is a direct, rising and material cost to the U.S. Treasury associated with Social Security Disability Insurance (SSDI) payments to those persons.

According to a 2011 paper, between 1989 and 2009, the share of adults receiving SSDI benefits doubled, from 2.3 to 4.6 percent of Americans ages 25-64. In the same interval, cash payments to SSDI recipients (adjusted for inflation) tripled to $121 billion.  

One of the most common and rapidly expanding diagnoses for individuals receiving SSDI awards is mental illness, which comprised more than 20 percent of SSDI awards over the past decade.  A 2005 study in the New England Journal of Medicine reports that the prevalence of mental disorders in the U.S. population was unchanged between 1990 and 2003 . In the same interval, the rate of treatment of mental illness substantially increased—which in turn should have contributed to improved work-readiness among individuals coping with mental illness.

Over the past twenty years there has been an exponential rise in the number of pre-employment assessments administered to applicants, driven in large part by the increase in the number of applications per job opening arising as a consequence of online postings of job opportunities. The pre-employment assessments, intentionally or not, discriminate against applicants with mental disabilities in the hiring process. As a result, too many people living with mental illness that are willing and able to work remain unemployed or underemployed.