Employment rates are seeing slow increases nationwide, but the effects of the recession are still being felt by hard-hit groups such as adults with serious mental illnesses.

Less than 20 percent of those receiving public mental health services were employed in 2012, dropping more than 5 percent from 2003, according to a report from the National Alliance on Mental Illness (NAMI).

Director of state policy at NAMI, Sita Diehl, told the Washington Post the problem was that support for those with mental illnesses eroded during the recession, with unemployment for them as high as 92.6 percent in Maine.

"During recessions we see a spike in disability," said David Wittenburg, a senior researcher at Mathematica Policy Research. It's a trend that has been made worse by a shift in the labor market. "There's an increasing demand for high-skilled labor, and sometimes people with disabilities get left behind."

While a few organizations that focus on finding jobs for those with mental illnesses exist, the vast majority of these adults are dependent on, and make up a majority of the group using, expensive public programs like Supplemental Security Income and Social Security Disability Income.

With the exception of retirement or death, most who become part of these income programs rarely leave.

But since the Affordable Care Act rolled out, Diehl said there is hope, because people with mental illness cannot be denied coverage for a preexisting condition, and mental health coverage is mandated on plans purchased by individuals or small groups.

"If we were able to bring those programs to scale, then people with mental illnesses would be able to live independently and contribute to their local economies," Diehl told the Washington Post. "The health care cliff is going away."

NAMI is asking state legislatures to take advantage of these changes in mental health coverage and translate it into job assistance and employment for adults with mental illnesses.