- As mentioned, many people desire to get better but often this does not happen 
- About 60% of people on disability status express the desire to return to work, only about 2% of individuals receive support to do so with many reporting they get no mental health treatment at all
- Individuals grow accustomed to living with their disability and below the poverty line and research shows this is true across many of the countries studied

Disability Benefits Culture

- People who require aid usually apply to government programs following the leaving of a job, but the application process is lengthy and difficult to navigate 
- Because of the many years it takes to begin receiving aid, many do not want to jeopardize the money they are receiving (despite many saying they would like to return to work, many do not)
- As a result, the main reasons people leave disability status are aging and death - hence the name “disability trap” 

University of Virginia, Charlottesville

About ⅓ of people living on disability status are doing so as a result of a mental health disability. Living on disability is costly as well as encourages those with mental illness to become passive about their health and discourages hope of feeling better. Evidence - based treatments, while effective, are rarely discussed or researched. Policy is so important, but many do not view mental health and disability as areas that need policy improvement. Policy and treatment working in tandem can make or break the experience of having a disability. 

Mental Health Disability: An International Perspective 

Disability insurance can create a moral hazard problem by altering the incentives of insured individuals. Once covered, a person may have a reduced incentive to return to work after an injury or illness, as their income is partially protected. Furthermore, the insurance may inadvertently encourage individuals to report minor, difficult-to-verify ailments as disabling, because the financial consequences of being unable to work are diminished. This is a hidden action problem, as the insurer cannot perfectly monitor a claimant's true health status or their efforts to recover and rejoin the workforce.

Moral Hazard in Disability Insurance

Drake, R. E., Bond, G. R., Thornicroft, G., Knapp, M., &amp; Goldman, H. H. (2011). Mental Health Disability: An International Perspective. Journal of Disability Policy Studies, 23(2), 110–120. https://doi.org/10.1177/1044207311427403 

Mental Health Disability: An International Perspective Reference 

- Strains relationships with family and friends
- Symptoms can appear early and be frightening depending on the severity and type of mental health problem
- The struggles are made worse because of systemic barriers to treatment and care, stigma, and social exclusion

Personal Impact of Mental Health Disability

- Many adults experience mental health disorder yearly, but many go untreated
- Often, these mental health struggles do not interfere greatly with daily life so they do not qualify for disability status 
- Disability as a status is determined through environmental, social, and personal factors
- Generally, once something interferes with a person’s ability to live and function on a daily basis, it becomes classified as a disability 
- Mental health, and other “invisible” disabilities, are more complex because the conditions are often unseen, tend to change over time, and are extremely stigmatized

When Mental Health Becomes a Disability

- Individually, having a mental health disability affects a person’s ability to work, earn an income, and causes great physical and emotional strain (especially if the mental disorder is a secondary disability) 
- Socially, the cost of having entire groups of people be marginalized and oppressed economically and socially is high - especially in regards to reliance on long - term care and treatment
- Research shows that resources pooled towards encouraging employment and decreasing absenteeism might be more effective than other avenues of aid (decreases competition between providers and performance assessments) 

Social vs. Individual Cost

Disability Trap 

- Avoiding short - term treatment plans with placing a focus on prevention  
- More control to people on what resources and services they choose for care 
- Allow those receiving aid to continue receiving aid even while searching for employment
- Increase services that help individuals with severe mental illnesses find full - time employment during all stages of disability status
- Change reduction in payments to allow people to adjust to regular employment as they move out of disability status

Policy Recommendations

Various policy mechanisms are designed to counteract the moral hazard associated with disability insurance. These strategies aim to better align the incentives of recipients with the goal of returning to work when possible. Common approaches include stricter eligibility criteria, periodic medical reviews to reassess disability status, and offering rehabilitation services or financial incentives for re-entering the workforce.

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