Providing Mental Health Services to TANF Recipients: Program Design Choices and Implementation Challenges in Four States. Screening and Assessment


All of the programs use some variation of screening and assessment to identify clients and link them to mental health services. In general, this process occurs in two stages. In the first stage, TANF clients are screened to detect individuals more likely to face mental health conditions. This may be a broad screening during TANF orientation or an individual screening by employment or mental health staff. In the second stage, clients are assessed through a more in-depth examination of the nature and extent of the mental health condition. Assessments may also include a recommendation about the number of hours and types of activities to include in the client's employment plan. The box on the next page more fully describes the screening and assessment tools and the techniques used to identify TANF recipients in need of mental health services.

The study states approach screening and assessment in several ways. Florida is the only state that has hired outreach staff to identify and screen welfare recipients and other low-income families to determine those who may need mental health services.(6) These outreach staff are not licensed mental health professionals; they use a standardized screening instrument and are expected to make referrals to treatment providers in the community based on the results of the screen. Further assessment and treatment planning is provided by licensed mental health professionals after the referral is made. Oregon, Tennessee, and Utah have hired primarily licensed mental health staff, who are highly skilled in conducting mental health assessments, to carry out a screening and assessment before a treatment referral is made. The screening and assessment process in these three states is designed to identify persons in need of mental health treatment, determine the most appropriate treatment provider, assess the client's ability to participate in work activities, and develop a plan for addressing the client's mental health and employment needs. In Utah, staff also use standardized assessment inventories to diagnose specific mental health disorders.

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