Barriers to Employment for Young Adults with Mental Illness
Statistics about rates of employment can be misleading. A simple google search would probably yield an “unemployment rate” for young adults in the U.S. to be 9 or 10%; this figure is a good bit higher than the rate for all Americans of around 4%. However, it is important to remember that this figure only include those people who are “actively seeking work”. The “economically inactive” rate, measuring the percentage of people not actively seeking work, for Americans was about 30% in 2024. And this rate for Americans with disabilities? Around 75%. Of course, many of those encompassed in this rate are in the geriatric population, but it is estimated that approximately one quarter of this population is under age 35. Another way to look at this issue is that young adults (ages 16-34) with disabilities are almost 5 times more likely than their peers to be economically inactive. So, clearly there are significant disparities, but what factors and considerations are behind these numbers? In this post, we take a deeper dive into the barriers for young adults with disabilities, particularly due to mental illness, to gain and maintain employment.
For those who struggle with mood disorders, like depression and anxiety, which are often cyclical in nature and not necessarily chronic, there are ample barriers to maintaining employment. Some hallmark symptoms of depression, like low level of mood or energy, feeling fairly hopeless, helpless, or worthless, and disruptions to physical health (sleep, diet, physical activity), can make it very difficult to consistently meet expectations at work, as well as limit an optimistic outlook that can help one to persist through challenges. Anxiety symptoms, whether cognitive ones (i.e. racing thoughts, ruminating, intrusive thoughts) or more physiological ones (i.e. heart racing, tightness in body parts, GI distress) also can significantly limit productivity and distort our interpretation of our own performance, often for the worse. In addition, those with mood disorders may spend much of their willpower, bandwidth, and internal resources managing their limitations, leaving less to give to professional life. In the short term, these trends may lead to missing deadlines or producing unsatisfactory results. In the long term, burnout and unemployment are prevalent. The logic of this paragraph has pertained to those already employed; for those not economically active, it is possible that many of these trends underlie the more apparent barriers that would be more evident in one’s lifestyle choices (level of activity and connection, maintaining of physical health, etc.).
For those with more chronic conditions and/or neurodivergent ways of being, like ADHD or OCD, different factors are relevant to difficulty maintaining employment. In addition to difficulty maintaining concentration in ADHD, an important deficit lies in one’s executive functioning skills, which are critical in helping us stay organized, plan, control our emotions/states, and follow-through with tasks. Problems in these areas over time can interfere significantly in sustaining work. Persons with symptoms of OCD experience significant impairment in their functioning, regardless of how apparent their obsessions and compulsions are to others. The energy and time consumed by the irrational distractions characteristic of OCD are also significant impediments to maintaining employment.
Examining this trend from a cognitive-behavioral perspective is helpful to illuminate the cause-and-effect of various components of the difficult experience of staying employed. That is, our thoughts, feelings, and behaviors are connected, in response to events or situations. Something happens at work or in our life, and it affects our cognitive and emotional state, which then again can affect our actions. For example, we may receive some explicit feedback (being told that you are not meeting expectations) or implicit feedback (describing standards that others are meeting to a greater extent than you do). This would be likely to somewhat negatively impact our sense of competence; and for those who struggle with anxiety, depression, or other mental illness, we are more likely to distort the objective reality of one piece of feedback to hold greater significance, thinking that, for example, “I am a total failure”. This sort of irrational conclusion may lead to uncomfortable emotions, like sadness, worry, or shame, which could then be a further detriment to our likelihood to put forth a solid effort. In other words, because individuals with mental illness symptoms are more likely to struggle with rational thinking and may tend to distort reality, the deleterious effects of an unfortunate event can be amplified. And when this trend becomes a pattern and happens more regularly, it can exacerbate symptoms and result in an untenable employment status.
To paint a more concrete picture of how the conglomeration of these factors can make maintaining work profoundly difficult, I will share a few of my challenges/barriers. Initially, I have a variety of symptoms of mental illness, including of depression, anxiety, and OCD. And depending on one’s level of stress, these symptoms can be exacerbated. In the recent past, my son experienced a medical problem, which resulted in a significant sleep deficit, exacerbating my already vulnerable system due to treatment in the past for a brain tumor. Another change occurred around this time, in my medications prescribed by my psychiatrist, which contributed to the storm of worsened symptoms. Outside of my mental health, for a variety of reasons, both external and internal, my employment at this time was becoming less of a source of fulfillment and contribution and more of a labor and stressor. MY performance was suffering, negatively impacting my confidence and self-esteem, as well as struggles with cognition for medical reasons, which likely all negatively impacted my work with clients. This cycle seemed to be a downward spiral, until I was no longer employed. You can see how a combination of biological, psychological, and social/environmental factors contributed to my decline. Millions of other young adults with mental illness struggle to enter or maintain employment due to a combination of predispositions/symptoms and stressors, like or unlike mine.
So, given these considerations, where can you individually and we as a society, go from here? In my next post, I will explore strategies and solutions to address these barriers. It is also worth acknowledging that not all readers will share the same goal related to employment; for some, now might not be a realistic time to seek employment. But regardless of your situation, I believe it is worth more fully considering factors making it difficult to maintain employment, and then depending on your personal goals, exploring relevant strategies to help you reach your goals.
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