Several researchers have found that a substantial proportion of welfare recipients have multiple barriers to employment and that the presence of multiple barriers decreases the probability of finding and keeping a job (Danziger et al. 1999, Zedlewski 1999, Olson and Pavetti 1996). Thus, an important decision in designing a system to address the mental health needs of welfare recipients is whether to address mental health issues separately or in combination with other personal and family challenges. The advantage of the latter approach is that it could address other issues that may be preventing clients from finding employment. However, it is likely to be difficult to find staff who are expert in assessment and treatment in multiple areas.
Decisions about how broadly to address service needs influence the kind of staff hired, how clients are identified for services, and the types of services provided. Among the study states, there are three different models, or approaches, to defining the range of needs to be addressed: (1) primary focus on mental health conditions, (2) primary focus on mental health and substance abuse issues, and (3) broad focus on a variety of personal and family challenges. This section describes each model and its associated strengths and weaknesses.