This study investigated career patterns among persons with serious psychiatric disabilities who had completed higher education. As part of a vocational program follow-up, 48 middle-aged, mostly white men and women consumers were interviewed about educational and employment histories. A computer program based on age of onset, job skill level, job and educational codes, and dates of employment was developed. Five different, mutually exclusive, career development patterns were identified: (a) career constant with postformal education disability onset, (b) career constant with preformal education completion disability onset, (c) career change with post-formal educational disability onset, (d) career change with pre-formal educational completion disability onset, and (e) early onset with no career. Results were related to current career development theories and the needs of counselors serving this population.