I've had a hard time putting the current unemployment data into context based on my own experiences – at OPEN MINDS, we've been on a hiring frenzy…and having trouble getting responses to our ads. Then, one Sunday morning a couple months ago I was watching Laura Tyson in an interview on ABC's This Week with Christiane Amanpour, and I had a flash of revelation. Ms. Tyson, former Chair of the President's Council of Economic Advisers during the Clinton Administration, said that "unemployment for those with college educations is now 4.5 percent." She went on to cite Bureau of Labor Statistics data that for those with less than a high school diploma, the seasonally adjusted unemployment rate was 13.8 percent during July. For those with a high school diploma but no college, the rate was 10.1 percent.

After thinking about that data, I have a new take on the unemployment situation. We have a structural unemployment problem, which is how labor economists refer to a mismatch between the skills of the people who of are out of work and the skills needed for the jobs that are available. And what this really boils down to is an education problem. A fundamental part of the long-term solution to our high unemployment rates is to improve our education system at every level – not only improving the graduation rates from high school and college, but also increasing the academic rigor of those programs. While it is certainly a valid point that "not everyone should go to college," given this employment situation, we also need to think of improvements to non-college technical/vocational training programs. Those training programs need to be relevant in the current context of a global economy and focused on areas with growth-potential that can provide a continuous living wage.

Diving deeper into the nationwide unemployment statistics and the prominence of the education attainment-aspect of the numbers led me to wonder what the implications of this situation would be for individuals with cognitive and mental disabilities. While assistive technologies are increasingly available to facilitate completion of advanced degrees by individuals with physical disabilities, disabilities that interfere with the thought processes are more punitive. In an economic environment where advanced degrees and related skill sets directly correlate to economic well being, the challenge of independently maintaining economic viability is becoming more and more insurmountable for these individuals.

I thought the best summary of the situation was in an article by Steven Pearlstein, The Bleak Truth About Unemployment. Mr. Pearlstein notes: "Somewhere between the rantings of the Republican right, which is peddling the nonsense that excessive government spending is to blame for high unemployment, and the Democratic left, which clings to the false hope that another helping of fiscal stimulus is all that is needed to get millions of Americans permanently back to work, is this stubborn reality: The loss of 8 million jobs reflects problems that are largely structural, not cyclical, which means they won't be brought back by fiddling with a magic dial in Washington that controls how much the government spends."

As Americans are pushed to develop a better-trained and more highly-educated workforce, the employment space for individuals with cognitive and mental disabilities will get smaller and smaller – leaving a population that will struggle to find a viable place in the fast-paced global market economy that we are heading towards.

Wired Magazine never fails to make me think. The October 2009 issue featured “The Smart List: 12 Shocking Ideas That Could Change the World.” There were six ideas that have specific relevance to our field:

1. Recruit Autistics. "A preternatural capacity for concentration and near-total recall" makes autistic folks ideal software engineers according to Thorkil Sonne, who founded Specialisterne in Denmark, an IT consultancy that hire mostly people with autism-spectrum disorders.
2. Embrace Human Cloning. Human clones walk among us—identical twins—so why not take in vitro fertilization to its logical conclusion?
3. Make Health Risk Management Meaningful. According to Ralph Keeney, 55% of deaths for people aged15 to 64 are now due to their own decisions—compared to 5% a century ago. Provide people with better calculations of risk (for not using seatbelts, not exercising, bad diets, etc.) and then adjust health premiums accordingly.
4. Release All Nonviolent Offenders in Prison. Incarcerating nonviolent criminals costs us $22,000 per year—and has no social gain. Make nonviolent offenders go to counseling, get an education, do public serivce, and repay their victims.
5. Legalize Assisted Suicide. Ludwig Minelli, founder of Dignitas, a right-to-die organization, believes that prohibiting suicide doesn't keep desperate people from trying. Instead, provide dignified options—and counseling for people considering suicide.
6. Forget Medical Privacy. Guest commentator Jamie Heywood of PatientsLikeMe believes "privacy has been used as an excuse by those who have a vested interest in hoarding" health care information. He wants us to share our personal data on-line in social communities.

You may or may not agree with them—but, if implemented, they certainly will change our world.

Advocates and provider organization management teams are all tracking state budget problems and what they mean for mental health. A few of my colleagues are breathing a sigh of relief because their state budgets left them 'relatively' unscathed. But, for behavioral health and social services, I think the worst budget cuts are yet to come. In 2010, we will have to deal with the effect of the planned state budgets—and probably some mid-year revisions. But, in many jurisdictions, provider organizations will see county and city budgets for these services unravel. On Saturday, ABC news in El Paso, Texas reported that of the El Paso City Council members, four voted to cut ties with the El Paso Mental Health and Mental Retardation agency. Their rationale is that, by law, those services are the responsibility of the county—not the city. ABC-7 reporter Daniel Marin wrote:

"El Paso City Representative Beto O'Rourke says, by law, MHMR is the responsibility of the county. So he along with special city council committee
members… voted to cut ties with the agency…O'Rourke says MHMR's highly publicized funding issues are the result of the old cliché: too many chefs in the mental health care kitchen…"

"MHMR spokesman Rene Hurtado says while every little bit of funding helps, this is all about more than losing the city's $100,000 yearly contribution. "The mental health care system is very complex," said Hurtado. "The more people we have at the table, the better it is for everyone."

"El Paso County Commissioner Anna Perez says, in her opinion, the city has a direct role in helping the city's mentally ill; adding there's too much at stake for city officials to hide behind a law. "[The law] doesn't mean they don't have a place at the table," she said.

The unfortunate reality? Our current systems for mental health treatment, for addiction treatment, for child welfare, and for other social services are strung together with a hodgepodge of federal, state, county, local, grant, donation, and payer dollars. From my perspective, parity and universal coverage can't come too soon. I'll look forward to a time when Americans with behavioral disorders and disabilities are not begging for safety net funding and charitable donations.