The impact of mental and substance-use disorders on employment transitions

Marjorie Baldwin, Steven C. Marcus

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


The cyclic nature of serious mental illness (SMI) and substance-use disorders (SUD) suggests that persons with these conditions may experience high rates of transitions among employment states (full-time, part-time, and no employment). This study uses longitudinal data from two waves of the National Epidemiologic Survey of Alcoholism and Related Conditions to examine employment transitions for persons with SMI/SUD relative to a no-disorder control group. Conditional on employment status in Wave I, we estimate conditional odds ratios and marginal effects of each diagnosis on the probabilities of part-time or full-time employment in Wave II, holding constant other characteristics that influence employment decisions. The results show transitions across employment states are common for all groups but more frequent for persons with SMI/SUD than the controls. Persons with SMI are less likely, and persons with SUDs more likely, to transition out of no employment than the controls. Part-time employment is a relatively transitory state, particularly for persons with SMI/SUD, but full-time employment brings a measure of job stability to all groups. After controlling for differences in observable characteristics, the marginal effects of SMI and alcohol disorders on employment transitions are largely significant, but the effects of drug disorders are not.

Original languageEnglish (US)
Pages (from-to)332-344
Number of pages13
JournalHealth Economics (United Kingdom)
Issue number3
StatePublished - Mar 2014


  • employment transitions
  • job loss
  • job stability
  • mental illness
  • substance-use disorder

ASJC Scopus subject areas

  • Health Policy


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