Self-Employment for People with Psychiatric
Disabilities: Advantages and Strategies
Laysha Ostrow, PhD, MPP
Patricia B. Nemec, PsyD
Carina Smith, BS
Self-employment is an alternative to wage employment and an opportunity to increase labor
force participation by people with psychiatric disabilities. Self-employment refers to individuals
who work for themselves, either as an unincorporated sole proprietor or through ownership of a
business. Advantages of self-employment for people with psychiatric disabilities, who may have
disrupted educational and employment histories, include opportunities for self-care, additional
earning, and career choice. Self-employment ﬁts within a recovery paradigm because of the value
placed on individual preferences, and the role of resilience and perseverance in business
ownership. Self-employment creates many new US jobs, but remains only a small percentage of
employment closures for people with psychiatric disabilities, despite vocational rehabilitation and
Social Security disability policies that encourage it. This commentary elucidates the positive
aspects of self-employment in the context of employment challenges experienced by individuals
with psychiatric disabilities and provides recommendations based on larger trends in entrepre-
Introduction: the Option of Self-Employment
Individuals with psychiatric disabilities are one of the largest disability-based Social Security
Disability Insurance (SSDI) and Supplemental Security Income (SSI) beneﬁciary groups. A
psychiatric disability is deﬁned as having received mental health services, disability beneﬁts, and/
or workplace accommodations for a psychiatric diagnosis or mental/emotional distress that has
substantially limited one or more major life activities. Mental health services remain largely
isolated from other support systems for individuals with disabilities, including employment
In spite of over 40 years of investment in and emphasis in public mental health systems
Address correspondence to Laysha Ostrow, PhD, MPP, Live & Learn, Inc., Morro Bay, CA, USA. .
Carina Smith, BS, Live & Learn, Inc., Morro Bay, CA, USA.
Patricia B. Nemec, PsyD, Nemec Consulting, Warner, NH, USA.
The work for this publication was completed at Live & Learn, Inc., 785 Quintana Road, Suite 219, Morro Bay CA 93442,
under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).
Journal of Behavioral Health Services & Research, 2018. 1–10. c
2018 National Council for Behavioral Health. DOI
Self-Employment OSTROw ET AL.