Persons diagnosed with a serious mental illness experience significantly high rates of unemployment compared with the general population. The explanations for this situation have included a focus on the symptoms associated with these disorders, a focus on the lack of effective vocational rehabilitation programs for this population, and, most recently, a focus on employer discrimination and the financial disincentives to employment in various public policies. The authors of this manuscript review the evolution in thought pertaining to the labor market experiences of persons with a serious mental illness and propose as an additional set of factors that should be considered, those labor market liabilities that this population shares with others without disabilities who experience similar employment histories. The authors conclude that the inclusion of these factors in our understanding of issues that persons with serious mental illness face in the competitive labor market will likely lead to a further evolution in program and policy development.

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