The University Record, November 8, 1999

Those with substance abuse and mental health problems may need extended welfare benefits, research shows

By Amy Reyes
News and Information Services

Researchers at the University will present a new study this week about a population whose needs have been overlooked by welfare reform: those with mental health problems and those who suffer from drug dependence.

The Federal Welfare Reform Act of 1996 imposes a lifetime five-year limit for federally funded cash aid, but the law also requires most welfare recipients to find work or participate in job training programs or other work-related activities within two years of receiving aid. But obtaining and maintaining work will be difficult for those who need drug intervention programs or medical treatment, say U-M researchers.

“Substance abuse and dependence, and mental health problems are important barriers to economic self-sufficiency and the successful fulfillment of family roles,” says Harold Pollack, assistant professor of health management and policy. “With treatment, recipients are more likely to become self-sufficient. Effective services are needed to address great and preventable anguish in an important part of the welfare population.”

Pollack will present the results of the study Nov. 9 at the annual meeting of the American Public Health Association in Chicago. The study is co-authored by Sheldon Danziger, professor of social work and public policy and director of the Center for Poverty, Risk and Mental Health; Rukmalie Jayakody, assistant professor of human development and family studies at Pennsylvania State University; and Diane Steffick, a U-M doctoral student in economics.

The study is based on data from the 1994–95 National Household Survey of Drug Abuse (NHSDA), an annual survey conducted by the National Institute on Drug Abuse, U.S. Department of Health and Human Services; and the 1979–96 National Longitudinal Survey of Youth (NLSY), conducted by the Bureau of Labor Statistics, U.S. Department of Labor. The authors focused on a sample of 2,728 single mothers at least 18 years old with at least one child who, under welfare reform, are required to work. The authors found that:

  • Substance use and dependence are significant but exaggerated problems among recipients of public aid.

    NHSDA data indicate that 21 percent of welfare recipients have used at least one illegal drug during the prior year. Although 16 percent of recipients report some marijuana use during the year, only about 10 percent report use of any other illegal drugs. Researchers found that academic skill deficits were a greater barrier to self-sufficiency than substance use.

    “Substance abuse is a marker for unobserved problems, such as depression or family stress. Harsh policies that move substance users from welfare are insufficient because substance use is only part of the underlying problem. Drug treatment should be one part of a set of services provided by welfare-to-work programs,” Pollack says.

  • Many welfare recipients suffer from depression and other mental health problems. Data indicate that 19 percent of welfare recipients met diagnostic criteria for either major depression, general anxiety disorders, agoraphobia or panic attack. The NLSY survey found that 40 percent of long-term recipients were at risk of depression.

  • Many welfare recipients are expected to exceed mandated time limits for federally funded cash aid. Currently, states may exempt up to 20 percent of recipients from the five-year limit. In contrast, 38 percent of young NLSY mothers who received welfare exceeded the five-year limit.

    “The recent decline in welfare caseloads, though encouraging, does not imply that we will have similar success in helping long-term recipients who face greater obstacles to self-sufficiency,” Pollack said.

    These results suggest that policy makers should proceed with caution in imposing sanctions against welfare recipients who may be casual users of illicit substances, he said.

    This study is funded by the Robert Wood Johnson Foundation and the National Institute of Mental Health.