Urban single mothers nearing the end of their welfare eligibility appear more likely to have substance use and psychiatric disorders than women in the general population, and often do not receive treatment, according to a report in the March issue of Archives of General Psychiatry.
In 1996, U.S. welfare reform legislation created the Temporary Assistance for Needy Families (TANF) program, according to background information in the article. Unlike previous programs, TANF imposed a five-year limit on financial support for families with children younger than age 18. The new regulations also involved stricter requirements for employment and work-related activities. "These changes were intended to enhance self-sufficiency and reduce long-term reliance on public income support," the authors write.
Concerns about the new legislation have emerged from findings regarding the mental health vulnerabilities of low-income families headed by women. Judith A. Cook, Ph.D., of the University of Illinois at Chicago, and colleagues surveyed 333 urban single mothers in the final 24 months of their eligibility for TANF, part of a random sample of 1,000 women selected by the Illinois Department of Human Services. Participants were all "work eligible," meaning they had not been exempted from employment requirements by factors such as pregnancy, substance use treatment or disability. Between 2003 and 2004, in-person interviews were conducted to detect psychiatric and substance use disorders and assess whether women with these conditions received treatment.
A total of 61 percent of the women had a psychiatric or substance use disorder during their lifetime and 46.8 percent had at least one disorder in the 12 months preceding the interview. Psychiatric disorders—the most common being anxiety and mood disorders—affected 53.2 percent of the women over their lifetime and 44.1 within the previous 12-months. A total of 29.1 percent had lifetime substance use disorders and 9 percent had substance use disorders within the previous 12 months.