NAMI Reports Deep Flaws, Money Wasted in System Designed to Help Persons With Severe Mental Illnesses Get Jobs

Posted on February 7, 1997

Arlington, VA, - The federal-state vocational rehabilitation system that supports the employment needs of people with severe mental illnesses is "an abject failure," according to a new report released today by the National Alliance for the Mentally Ill (NAMI). The report identifies pervasive problems in the tax-supported system from outmoded practices and questionable expenditures to deplorable outcomes and resistance to implementing changes.

A Legacy of Failure: The Inability of the Federal-State Vocational Rehabilitation System to Serve People with Serious Mental Illnesses details the results of NAMI's assessment of the overall effectiveness of state programs that spend approximately $490 million annually, 79 percent of which comes from federal funds.

"Our study results confirm what we have long suspected," said Laurie M. Flynn, NAMI's executive director. "This system is not only a waste of tax-payers' dollars, but it fails miserably at helping people with severe mental illnesses get back to work." Major report findings include:

• Administrative costs eat up nearly 50 percent of the system's funding, with the remaining funds supporting direct services. Further, vocational rehabilitation agencies are unable to estimate how many people will be served in a given year and at what cost.
• The system achieves dismal long-term outcomes for those with severe mental illnesses, who are earning less eight years after their cases are "successfully closed" by state agencies than before receiving employment assistance.
• Methods to support this population are grossly outmoded. Services are time limited so that once people obtain employment, the system provides no additional support. This approach is entirely contrary to the realities of severe mental illnesses, which are known to be brain disorders that are episodic in nature and fluctuate in severity and impact over time.
• Incentives reward employment counselors on the easiest placements. Despite successive federal and regulatory attempts to focus the system on people with the most severe disabilities, state vocational rehabilitation agencies have done little to establish incentives for serving individuals with more complicated long-term needs.

More than 85 percent of individuals with serious brain disorders in this country are unemployed. NAMI's report lays out several alternative approaches for helping many of these people obtain and maintain employment. NAMI estimates that between 62,000 and 90,000 persons could be served if the $490 million combined federal and state funds for the vocational rehabilitation system were pulled and redirected into programs that have demonstrated the ability to produce results. "The current system blocks change and is beyond repair," Flynn said. "We're recommending a major overhaul, not a band-aid fix."

The National Alliance for the Mentally Ill (NAMI) is the nation's largest grassroots organization dedicated to improving the lives of persons with severe mental illnesses, including schizophrenia, bipolar disorder (manic-depressive illness), major depression, and anxiety disorders. Based in Arlington, Virginia, NAMI's membership includes more than 140,000 people with brain disorders and their families, and 1,100 state and local affiliates in all 50 states, the District of Columbia, Puerto Rico, and Canada. NAMI's efforts focus on support to persons with serious brain disorders and to their families, advocacy for nondiscriminatory and equitable federal and state policies, research into the causes, symptoms, and treatments for brain disorders, and education to eliminate the pervasive stigma toward severe mental illnesses.