Raquel Toledo darts cheerfully from aisle to aisle at a Dollar Tree store in Mission Viejo, re-shelving misplaced merchandise and picking up items that careless customers have knocked to the floor.

The work is tedious, but it gives Toledo a sense of security and self-esteem she never knew before. By her own unabashed admission, the 27-year-old daughter of Mexican immigrants was a “troublemaker” in her teens and early adult years – completely “messed up.”

She became homeless at 19, when her family got a restraining order against her. After spending a month in jail for assault and battery, Toledo fell in with a boyfriend who introduced her to methamphetamine. She hit bottom before finding salvation through a network of private and public programs: treatment from a county mental health clinic, which referred her to Employment Works, a program run by Goodwill of Orange County. That led to Dollar Tree.

She has been there 20 months and calls the job “a miracle in my life.”

Toledo’s success story is all too rare among people who suffer from mental illness. The vast majority of Americans with psychiatric disabilities are unemployed, even though most would rather work for a living than rely on government programs, and nearly two-thirds are capable of doing so, according to a study published earlier this year by the National Alliance on Mental Illness, or NAMI.

The social stigma of mental illness can have a chilling effect on hiring, and many otherwise able people are so discouraged by their diminished prospects that they won’t even look for a job.

The Americans with Disabilities Act generally prohibits employers from asking a job candidate if he or she has a disability, but they can make an offer contingent on passing a medical exam and require medical records to support a new hire’s request for special accommodation.

In many cases people accept jobs that do not offer health benefits only to find they are no longer eligible for the public programs that provide the psychiatric care they need. They often quit those jobs, even if they like them, so they won’t lose access to treatment.

For all of those reasons, joblessness among people with diagnosed mental illnesses is sky-high.

In California, 90 percent of them are unemployed, either because they can’t find jobs or because they are too discouraged to try, according to the NAMI report, which used data from the federal Substance Abuse and Mental Health Administration. In numerous other states, the magnitude of the problem is of a similar order.

The social and economic cost of their rampant unemployment is “exorbitant” in terms of “wasted talent, derailed lives, broken families, lost productivity and increased public spending on disability income and health care,” the NAMI report says. “People living with mental illness are the largest and fastest-growing group of public disability income beneficiaries.”

Agencies such as Goodwill’s Employment Works and the Mental Health Association of Orange County are trying to make a dent in the problem. Employment Works takes patients who are referred by county-run clinics and helps prepare them for jobs by determining what their interests are, helping polish their communications skills and resumes and then taking them to meet potential employers.

The program’s $1 million annual budget is funded entirely by the county with money from the 2004 Mental Health Services Act, also known as Proposition 63, which levies a tax on wealthy individuals that is earmarked for the expansion of mental health services in California.

The people who come into the program suffer from all the most common psychiatric illnesses, including bipolar disorder, schizophrenia, schizo-effective disorder and substance abuse. They are placed in jobs ranging from customer service, clerical positions and field work, to food service, security and property management.

Some of them have been out of work for years or even decades, and finally getting a job “gives them a sense of community and hope,” says Michael Marks, the program manager at Employment Works. “In America, people define themselves by what they do.”

The Mental Health Association, another nonprofit organization, runs a program that is similar to Employment Works, though it accepts virtually anyone with a psychiatric diagnosis – not just those referred by the county – and tends to place its clients mostly in construction and warehouse jobs.

The biggest obstacles to their reinsertion in the workplace are inadequate medication and homelessness, says Kelley Escamilla, the association’s employment specialist. “Many of them don’t have a place to go rest. They’re staying on the streets, and some of them have criminal records, so it’s hard for them to find work.”

One job that people with mental illness may be uniquely suited for is working with others who suffer from similar conditions. If they are stable enough, their own experience can make them effective as counselors and mentors to those who are not as far along in their recovery.

Organizations that provide psychiatric services are increasingly hiring people with diagnosed mental illnesses to serve as peer mentors. That’s the case, for example, at the county-sponsored Wellness Center in Orange, which offers support groups, classes and other outpatient services.

“It’s great because what was once stigmatized is now an asset or even a requirement for some people working in the mental health field,” says Kristen Pankratz, educational programs coordinator at the NAMI office in Santa Ana, who has lived with bipolar disorder for many years.

Nick Johnson, a 32-year-old resident of Costa Mesa, was referred to Employment Works after being hospitalized for severe depression and then living in his car for a year. He got a job as a peer counselor with another Goodwill program, Volunteer to Work, which prepares psychiatrically disabled people for paying jobs by placing them first in volunteer positions.

The county, which funds the $542,000 annual budget for Volunteer to Work with money from Prop. 63, had decided to pull the plug on it for the next fiscal year. But now it may extend the program for at least another year, according to its program director, Ryan Yowell.

It would make no sense to shut the program down, Johnson says, because “for a few dollars you can get people off of public assistance and get them generating tax dollars to invest back into the system.”

Volunteer to Work gets the most severe cases – “the people who are specifically not ready to get jobs,” Johnson notes. He says that having a mental illness is not a requirement of his job, “but it can help” since knowing a lot about psychiatric disorders gives him more patience with the people he assists.

Hufsa Ahmed, 26, also works in mental health after being diagnosed with schizo-effective disorder when she was a freshmen engineering student at Harvey Mudd College. She dropped out for a year, then finished her degree but sank into a prolonged period of dark depression after graduation.

She eventually discovered NAMI and began working with others suffering from mental illness. She is now gainfully employed as a personal service coordinator for Telecare Corp., a provider of comprehensive outpatient psychiatric services. She works in a program that helps people with mental health and substance abuse disorders transition from jail to more stable lives on the outside.

Ahmed says her own symptoms “began to fade away” after she began helping others. “I do believe that work and meaning and structure have all contributed to my mental health,” she says. “Just as much as medication and therapy.”

Whether in the mental health field or in more routine private sector jobs, gainful employment can be a powerful tonic for recovery from psychiatric disability, mental health experts and patients agree.

Raquel Toledo is convinced her darker days are behind her, thanks in no small measure to her stable employment at Dollar Tree. She has even published a book of poetry in Spanish, “Poemas de la Vida,” which addresses in a raw and forthright manner the realities of life on the streets, low self-esteem and the disapproval of others – but also contains wistful odes to love, romance and music.

She is “just awesome,” says Suzette Tipton, Toledo’s supervisor at work. “She always smiles. She has a great attitude. If she sees a customer who needs help, she drops everything and helps.”

For the first time, Toledo knows what it is to have self-confidence, friends and a little money in her pocket. She no longer feels embarrassed when people ask her if she has a job, and she can go out to a movie or a restaurant, which wasn’t possible in her previous life.

“I was depressed, paranoid, I didn’t like going outside,” she recalls. “I would hide from people in the bushes. I looked terrible. I didn’t know how to dress. I didn’t even look like a human.

“Now I actually feel like a person, and I look like one. I actually have a life now.”

Contact the writer: 714-796-2440 or bwolfson@ocregister.com