The “hard-to-employ” include people facing multiple barriers
to work, such as physical and mental health issues, domestic violence,
substance abuse, a history of incarceration, transportation obstacles,
and low education or little job experience or training. As welfare caseloads
have seen the most work-ready leave for employment, the focus has shifted
to the population that faces barriers to employment. Although a significant body of research finds those who remain on welfare
are often more disadvantaged than those who have left, Robert Moffitt
and Andrew Cherlin, in their conference paper “Disadvantage among
families remaining on welfare,” find that a sizable number of welfare
“leavers” are not employed and have high poverty rates, suggesting
that some of the more disadvantaged portions of the caseload have indeed
left welfare. A sizable portion of this group may have experienced a sanction.
The research presented at the conference varied widely by topic, yet
an emerging message was one of employment with barriers rather than barriers
to employment. The question is quickly becoming “How do we help those
with barriers to work?” not “Who cannot work because of barriers?”
In other words, policy and programs should assist those individuals facing
barriers to work with supports and individualized attention, rather than
automatically assuming they cannot work. Inclusionary Practices. IPR fellow Dan
Lewis, Bong Joo Lee, research associate at the Chapin Hall Center
for Children, and JCPR graduate fellow Lisa Altenbernd stressed this emerging
message in their paper “Serious mental illness and welfare reform:
From barriers to inclusion.” Framing their work within the American with Disabilities Act, which strives
for the inclusion in American society of people with disabilities, the
authors examine how depression and work are related among current and
recent welfare recipients and what factors exclude those with depression
from real involvement in a civil society based on work. The authors used both survey data and individual-level administrative
data on use of Medicaid-paid mental health services from their Illinois
Families Study (see p. 1). They drew on a subgroup of 239 families suffering
from depressive symptoms, as indicated by an abbreviated Centers for Epidemiologic
Studies Depression Scale. They focused on the independent effects of depression
on work by controlling for other confounding factors. They find that roughly 23% of the larger sample suffered from depression,
most of it moderate or severe. Only 8%, however, were receiving mental
health services (as indicated by Medicaid-paid claims). Those suffering
depression were less likely to be employed, but many who were suffering
from depression were nevertheless working. Those who were working were
those with more job experience and job skills, fewer physical health issues,
and more personal resources. Those with few job skills, for example, were
66% less likely to be working than those with some job skills. Respondents
with little work experience were 63% less likely to be working than those
with some work experience. The key to achieving the goals of inclusion,
the authors suggest, is to help foster the human capital skills that make
work more likely among this group of women. Women’s Mental Health Issues. States vary in their approaches
to assisting women with mental illness. Michelle Derr and her colleagues
at Mathematica reported on several approaches in their paper, “Providing
mental health services to TANF recipients,” which examined services
in four states. In Florida, for example, TANF funds have been used to purchase mental
health treatment and outreach staff who link to various services. Tennessee
provides short-term, solution-focused mental health treatment for TANF
recipients. It also co-locates services in the welfare offices. Utah’s
social workers conduct clinical assessments and some short-term therapy,
as well as link clients to Medicaid-funded treatments. The service providers
also determine whether mental health needs should be addressed separately
or in combination with other personal and family challenges. As research
at the conference underscored, TANF recipients rarely face only one barrier
to work. The most effective strategy for fostering integration between employment
and mental health services appears to be co-locating the programs. When
this is not possible, it is imperative to build trusting relationships
between mental health and employment services. Conclusion. If efforts are to move in the direction of inclusion,
rather than exclusion based on barriers, the identification of mental
illness and its support is critical. As some of the panelists suggested,
casework on the frontline should offer women with mental health and other
barriers a wide open gate by not prejudging who can and cannot work. On
the other hand, not everyone can proceed through the same gate. Those
with barriers require individualized support to help them get and keep
a job. Toby Herr of Project Match, for example, suggested an approach
that stresses participant-defined services, rather than network-defined
services, in which the agency defines the services and the recipient is
assigned to them. Others suggested the need to offer a suite of benefits
and let families choose which benefits they can use most. Greg Duncan, JCPR director
and IPR faculty fellow, and Susan Mayer, JCPR deputy director and dean
of the Harris School at the University of Chicago organized the conference. |
