After leaving her job at an adult club this July, the 28-year-old Woods has floated from motel rooms to storage units, living on Social Security disability insurance derived through her diagnoses of major depression and post-traumatic stress disorder. She wants a regular job and plans to someday attend beauty school.
“I have no confidence that I can do anything, so school would be a start,” Woods says. “According to the government, I’m forever disabled.”
Woods is among the hundreds of thousands of people in America receiving Social Security income to offset mental illness, a number that social workers and college administrators say is growing to include the functional-but-troubled young adults who peopled stores and restaurants as cashiers and servers before the recession made even entry-level jobs scarce.
“It’s primarily economic desperation,” says Social Security Commissioner Michael Astrue. “People on the margins, they take a shot at disability.”
Before the start of the recession in 2007, more young adults with mental illnesses found basic jobs like Woo did, according to the Oregon Office of Vocational Rehabilitation.
“I didn’t want to hang out for a few years and wait for SSI,” Woo says. “I like to work and get paid.”
The Social Security Administration’s annual statistical reports track an increasing number of people younger than 65 who receive SSI for mental disorders ranging from autism to schizophrenia. Between 2004 and 2007, the number grew in Oregon by 10.9 percent – from 26,542 to 29,432. During the next three years of the recession, the tally rose by 18.8 percent to a total of 34,956.
Michael Webb, Social Security spokesman, says the increases are inconclusive.
“While there is a general consensus that a poor economy increases disability applications, there is not statistical data available that would substantiate a claim that young able-bodied individuals are applying for disability regardless of the stated impairment,” he says. “In order to be considered disabled, you still have to meet our criteria.”
A job – any job.
In the midst of a poor economy, George Knox, coordinator of Portland Community College’s Office of Student Employment and Cooperative Education, sees many students looking for a job – any job.
“We have a lot of angry people,” Knox says. “We have students coming in desperate, trying to pay rent, maybe even trying to get a meal. In a normal year, you might see one or two of those people. I’m seeing one or two of them a week.”
Knox says that today’s competitive job market means employers are more selective. Young people visibly struggling with mental illness are often overlooked, he says.
“Everything’s heightened, harder,” Knox says. “Even during the job search. Everyone’s frustrated who’s looking for work right now, and it’s going to show up during the job search. If you’re also dealing with mental issues, it’s even harder to maintain a level of professionalism.”
According to some in the mental health field, economic difficulties faced by young adults with mental illnesses are compounded by treatment needs that can’t be met by private health insurance. Many young adults turn to SSI not only because jobs are hard to find, but also because the private health care system fails them.
Tamara Sale, coordinator of Early Assessment and Support Team in Portland, a community program, points to insufficient health care as a problem driving many young people to apply for SSI.
“We’ve developed a system where kids are forced on disability when they don’t want to go there,” she says. “The problem is that private insurance doesn’t cover counseling and a psychiatrist and occupational therapy and vocational support and family support.”
She believes that the state’s occupational rehabilitation office could be strengthened to provide troubled young adults with incentives.
Woo found his job in 2008 through occupational rehabilitation. Six months earlier, he tried to kill himself by cutting his mouth in the front yard of his parents’ Northeast Portland home and was hospitalized.
“I was hearing things for a long time. People saying negative things about me,” he remembers. “It was getting really bad and I couldn’t live with it anymore.”
He’d cashiered at Plaid Pantry before his hospitalization and quit. By the spring of 2008, he was taking four new medications, and he was confident that he could work, despite severe side effects – twitchings in his leg and body shakes, weight gain and a lack of energy.
“I think things have gotten better,” he says. “I have more mind focus, working.”
He lives in a group home with other mentally ill adults, paying $318 a month for rent. Cascadia Behavioral Health’s Shelter Plus Care program matches the remainder of his basic bills.
“I’m, like, the only person in this building who has a job,” he says.
According to Robert Drake, professor of psychiatry at Dartmouth College and a national leader in the research of severe mental illnesses and vocational rehabilitation, Woo and other young adults with mental illness require jobs to live happily. The process of qualifying for disability payments and the assurance of federal funds only entrenches young people in their diagnoses, he says.
“You have to claim the totally disabled role in order to get support,” he says. “Most young people with mental illness want to return to work or school, but the mental health system and disability system are not lined up to help them.”
The model of a disability system that cripples recipients is present on a local level, some Portland-area workers say. David Kohler, program manager at Cascadia Behavioral Health’s urgent walk-in clinic, oversees Multnomah County’s worst mental cases, clients in crisis with nowhere else to go.
“Ideally, there would be the hope of recovery – having a life worth living, relationships, working, doing quote normal things,” Kohler says. “There are some folks that are so beaten down, and then they get their SSI and think, ‘Good, now I have this income, I can afford my studio apartment and I’m done trying. I’m not going to fight anymore.’ ”
Kohler believes SSI could be more effective as a step to recovery if the application process were faster and simpler, lending itself to early intervention. Applicants typically try three times before obtaining benefits, an effort that can take years of phone calls, letters and interviews.
Ask Julie Briggs, a veteran social worker at Legacy Good Samaritan Hospital in Northwest Portland.
“So many people would have benefited if they’d gotten help sooner and their illness hadn’t progressed so far,” she says. “Most people on SSI are pretty disabled. They’re on SSI for a reason. There are not many people cheating the system.”
A program running through Central City Concern called BEST – Benefits and Entitlements Specialists Team – exists to help those struggling with chronic mental disorders get SSI before lives of long-term homelessness and illness drags them under.
“We do see a lot of people who to apply because they can’t find work,” says Kascadare Causeya, BEST program manager. “We ask our agencies to screen them out. So many of our clients really need SSI. They’re not able to follow through with jobs.”
‘Made me lazy’
Amber Lapp, a 32-year-old living in East Portland with a diagnosis of bipolar disorder, tried for six years to get SSI benefits before she was granted disability status in 2008, qualifying for an income of about $670 a month – that’s about the maximum stipend collected by adults with mental illnesses in Oregon, with $515.77 as the average.
Lapp worked limited hours as a teacher’s aide at a Montessori school in Southeast Portland in 2007, but she says on-the-job challenges were devastating and aggravated her condition.
SSI’s criteria that recipients demonstrate an inability to work truly describes her, she believes.
“I don’t fit in very well,” she says. “If I’m in a situation where I’m expected to be consistent, I can’t do it. I’m also supersensitive. I can’t mend things with my co-workers. I can’t function when I’m misunderstood.”
Her mother, Carol Lapp, helped her through her first SSI application in 2002 and two re-applications. According to Carol, Amber is better off receiving income through SSI instead of getting rent money from the family.
“SSI makes her more confident,” Lapp says. “She was too comfortable with me giving her money.”
Lindsay Woods feels she doesn’t know how to make money. She was a cashier at Michael’s craft store in Northeast Portland for a year and half between 2001 and 2002. After she lost her job, she turned to SSI.
“I want to get undiagnosed,” Woods says. “But the economy being what it is right now and me having no education, I can’t get a good job. My mental illness – for the most part, it’s nothing I can’t really handle. The SSI money just made me lazy.”
By Alison Barnwell
The Portland Tribune