Behavioral Health Problems as Barriers to Work: Results from a 6-year Panel Study of Welfare Recipients

Over the course of welfare reform, behavioral health problems have emerged as significant issues. Welfare time limits have added urgency to recipients’ efforts to obtain economic self-sufficiency and have raised new concerns about mental health and substance abuse problems as barriers to work. However, there is limited research on how behavioral health problems operate to impede the employability of welfare recipients. This analysis draws on data from a 6-year panel study of welfare recipients (n = 341) to examine how a broad spectrum of mental health and substance abuse problems impact efforts to obtain work while on aid and subsequent transitions from welfare to work. Recipients who reported symptoms of depression at baseline were less likely to actively search for work while on aid compared to others. However, they were no less likely to leave welfare for work within a 2-year time frame. In contrast, other problems – including hostility, interpersonal sensitivity, psychoticism, and heavy drug use – had significant effects on work exits from welfare but little association with job search activities. Overall, these results suggest that behavioral health problems do not operate in the same manner to inhibit transitions from welfare to work. Welfare-to-work programs should direct interventions towards the unique constellations of problems that recipients face. This study was made possible by grants from the U.S. National Institutes on Health, National Institute on Alcohol Abuse and Alcoholism to the Alcohol Research Group, Public Health Institute, including: Center Grant (AA-05595), R01 Project Grant (AA-10015), and R21 Grant for Secondary Analysis of Existing Health Services Data (AA-12159). A previous version of this paper was presented at the National Institutes of Health, “Complexities of Co-Occurring Conditions,” Washington DC, June 23–25, 2004.