This chapter presents a brief discussion of the policy implications of the study’s major findings. In particular, we examine the implications of the findings for the design and delivery of employmentrelated services to TANF recipients by state and local welfare agencies. In addition, key questions emanating from this research and issues that may warrant further study are presented.
POLICY IMPLICATIONS OF THE FINDINGS
The results of the study have a number of implications for designing and targeting more effective services to help TANF recipients with the most serious barriers to self-sufficiency.
NEED TO RECOGNIZE THE RELATIVE IMPORTANCE OF DIFFERENT BARRIERS
The findings indicate that the most important barriers to long-term employability are physical and mental health problems, educational deficits, learning disabilities, and having to care for a sick or disabled family member. Other barriers seem to have less of an impact on employment, such as child care, transportation, housing stability, and neighborhood characteristics, although support services should continue to be provided by TANF agencies, to the extent possible.
In terms of policy implications, the findings suggest that state and local policy makers may need to focus special attention on welfare recipients with physical and mental health problems and possible learning disabilities. Basic employment services such as job search, child care, and transportation assistance are likely to be insufficient to address the needs of recipients with more serious barriers to long-term, stable employment.
NEED FOR IN-DEPTH ASSESSMENT PROCEDURES
In the course of an assessment interview, an intake worker or case manager may not recognize some of the most serious potential barriers to employment – especially mental health problems and learning disabilities. Recipients themselves may not recognize or acknowledge that they have a barrier. In the current study, for example, nearly half of the respondents who had recently experienced symptoms of depression had not seen a doctor about the problem. Not only may depressed respondents not show obvious signs of depression, but also depression may be incorrectly interpreted as “attitude” or lack of motivation by case managers and job placement counselors, as well as by employers.
Correct assessment of learning disabilities and/or other educational deficits may be difficult for case managers. Again, the problems that these recipients may experience in finding or keeping a job may be misdiagnosed as more general employability problems (such as attitude or motivation), while the underlying barrier is not recognized or addressed.
NEED FOR ADEQUATE PROGRAMS AND RESOURCES
We have found that the most serious barriers to employment are health-related problems, learning problems, and lack of education. In the area of physical health barriers, case workers should first ensure that the client has received appropriate and thorough medical attention and diagnostic procedures, and that the client is engaged and able to access prescribed treatments, including medications. When employment is possible, job responsibilities must be reasonable in terms of the client’s physical health limitations. Closer coordination with state departments of vocational rehabilitation may be advantageous.
Regarding mental health problems, adequate programs and referrals are needed to diagnose, treat, and monitor recipients with depression, anxiety, and related problems. This will typically require the development of close linkages with the local mental health community, as well as training for case managers in recognizing the symptoms of mental illness.
The findings suggest that many high school dropouts have learning problems causing, or in conjunction with, difficulties with math, reading, and overall functional literacy. Referring high school dropouts to GED programs or basic skills programs on the assumption that their major employment barrier is the lack of a high school diploma may not be a useful exercise. State policy and local programs should ensure that adequate testing procedures are in place to accurately assess high school dropouts for learning barriers. In addition, more intensive attention and follow-up may be necessary to help recipients with learning problems find and retain appropriate employment.
NEED TO ADDRESS BARRIERS AMONG SUB-GROUPS OF WELFARE RECIPIENTS
Physical and mental health problems were found to be more prevalent among older recipients, divorced or separated recipients, and white recipients. In contrast, younger and never-married black respondents showed less evidence of physical and mental health problems. Similarly, indications of learning disabilities were found to be more prevalent among high school dropouts but relatively infrequent among more educated respondents. State and local program managers need to pay special attention to the possibility of mental health problems and physical health limitations among older welfare recipients and among divorced or separated recipients. One option would be to reassess older recipients to ensure that physical and mental health issues have been properly identified and diagnosed, based on the finding that older recipients are an “at risk” population for these problems.
The surveys also show that TANF recipients who had not completed high school fared significantly worse than other recipients on a variety of employment indicators. To some extent, employment barriers faced by high school dropouts may reflect job requirements for a diploma or GED. However, as indicated above, many high school dropouts appear to have learning problems, as well as more general problems functioning in a learning environment.
IMPORTANCE OF OCCUPATION IN JOB PLACEMENT AND JOB DEVELOPMENT STRATEGIES
The surveys show that most of the TANF recipients were either working or had worked in the recent past, but that job stability and retention may be problematic. A major factor in this situation may be the types of occupations in which many TANF recipients find work. For example, the study found that only one in seven employed respondents was working in an office job.
High school dropouts were particularly lacking in office-related skills and most of the respondents who had worked in the last year lacked computer experience. Learning problems, educational deficits, functional literacy issues and lack of “soft skills” make it difficult to place some TANF recipients in office environments. The surveys confirmed that recipients who work in office jobs usually had better pay, benefits, and prospects for advancement than recipients working in retail/sales jobs, restaurant jobs, or housekeeping jobs. Such job characteristics are important for allowing families to achieve self-sufficiency and to stay off TANF over the long-term. While office jobs are not typically available to TANF clients in rural areas, jobs in health care and in construction may afford similar benefits (although work schedules in these fields tend to be variable). In terms of policy and program design, these findings suggest that job training, placement and development strategies should be focused on placin g TANF recipients in occupations with better potential for job stability and higher wages.
FRAGILE FAMILY ISSUES
Recent research on “fragile families” has examined the long-term stability of relationships between low-income unmarried mothers and fathers. This research has shown that many low-income, nevermarried parents face considerable barriers to forming stable relationships over time and that, in many cases, the father does not stay involved in the child’s life.
The current study showed that about half of the never-married mothers had some type of romantic relationship with the father of their youngest child when the child was born. At the time of the surveys, however, four out of five of these romantic relationships had ended. The findings suggest that it may be possible to build upon the relationships that exist between mothers and fathers at the birth of their child, either to promote family formation or to help strengthen the father’s involvement in the life of the child.
- Findings Consistent with Other Recent State Studies.
The findings in this area are supported by other recent research studies. A recently completed study of long-term TANF recipients in New Mexico employed the same set of questions as the current study to examine physical and mental health problems among the recipients.45 Appendix E Figure VIIIa shows that the prevalence of physical and mental health problems among the long-term recipients increased substantially with age.46
Similar results were found in a study of 1,750 TANF recipients in North Carolina.47 As indicated in Appendix E Figure VIII-b, the percentage of TANF recipients who had experienced two or more weeks of depression in the past year increased steadily with age. The correlation between age and depression was even greater when the study looked at the percentage of TANF recipients who were being treated for depression. Similar results were found in a study of TANF recipients in San Bernardino County, California.48
The studies in New Mexico and North Carolina also found a correlation between mental and physical health problems and marital status, consistent with the results of the current study. For example, in the study of long-term TANF recipients in New Mexico, 50% of divorced or separated respondents had a mental health problem, compared to 30% of never-married respondents. In the same study, 52% of divorced or separated respondents rated their overall health as fair or poor compared to 32% of never-married respondents.
In the North Carolina study, 21% of the divorced or separated respondents were being treated for depression, compared to 6% of never-married respondents. In San Bernardino County, 15% of divorced or separated respondents were under treatment for depression, compared to 7% of nevermarried respondents. In both North Carolina and San Bernardino County, divorced or separated respondents were also more likely than never-married respondents to have physical health problems.
Finally, the three studies were consistent with the current study in showing a much higher prevalence of physical and mental health problems among white recipients. For example, in the study of long-term TANF recipients in New Mexico, 54% of white recipients had a mental health problem, compared to 36% of Hispanic s. In the North Carolina study, 22% of white respondents were being treated for depression, compared to 7% of black respondents. In both states, white respondents were also more likely than non-whites to have physical health barriers.
FUTURE RESEARCH NEEDS
Additional research on the dynamics of multiple barriers as they affect employment and selfsufficiency would be useful. These barriers include the specific types of physical and mental health impairments faced by TANF recipients, especially by older recipients, and other life circumstances such as histories of abuse and/or neglect and stress from impoverished and/or dangerous living conditions.
The nature and extent of learning disabilities among high school dropouts and low functionality in the TANF caseload are important research issues. The current study showed that learning disabilities were a major barrier to employment for some TANF recipients, in that almost 20% of the high school dropouts showed evidence of a possible learning disability. Additional research would be helpful in determining how such individuals may best be assisted in ameliorating their disabilities and in gaining
steady employment. Learning more about how case managers can best recognize physical and mental health problems among TANF recipients would be helpful as would research on improving the employability of clients with health problems. In combination, this research would be valuable for developing more specific intervention strategies to help TANF recipients with the most serious employment barriers.
45 New Mexico TANF Longitudinal Study: Barriers and Safety Net Study. MAXIMUS, March 2003.
46 The survey respondents consisted of 709 persons who had been on TANF for 30 or more months.
47 Characteristics and Barriers of TANF Recipients in North Carolina, MAXIMUS, January 2001
48 Depression and Other Mental Health Barriers Among Welfare Recipients – Results from Three States,