Providing Mental Health Services to TANF Recipients: Program Design Choices and Implementation Challenges in Four States. Strong Relationship between Mental Health and Employment


Overall, there is a strong relationship between mental health and employment. Those with mental health conditions are more likely to have poor and sporadic work histories, to be unemployed, and to be receiving cash assistance. Nationally, between 70 and 90 percent of working-age adults with serious mental illnesses are unemployed (Baron et al. 1996, National Institute on Disability and Rehabilitation Research 1993). Other studies focusing more broadly on mental disorders have also found that the presence of a mental disorder is associated with a decreased likelihood of working. Mintz et al. (1992), who looked at the relationship between depression and the general capacity to work, found that about half (52 percent) of depressed patients said that they had some level of functional work impairment. Lennon et al. (2001) concluded that depression may interfere with an individual's capacity to retain employment. In a review of research, Johnson and Meckstroth (1998) reported that mental health conditions not only result in lower rates of labor force participation but also in reduced work hours and lower earnings among those who are working.

Examining the link between mental health conditions and employment in welfare recipients, Danziger et al. (1999) found that major depression significantly decreased the likelihood that a woman on welfare would work, although other conditions such as generalized anxiety disorder and PTSD had no noticeable effect on employment. Focusing on the relationship between mental health conditions and welfare receipt, Jayakody et al. (1999) found that the presence of one or more of four psychiatric disorders increased the likelihood of receiving cash assistance by 32 percent.(3) In a related study, researchers reported that those who were diagnosed with major depression were 40 percent more likely to receive cash assistance than those not so diagnosed (Leon and Weissman 1993). Finally, Olson and Pavetti (1996) found that welfare recipients without a mental health condition were almost twice as likely to be employed throughout the year compared to those with a mental health condition.

Mental health conditions may affect employment in various ways, creating, for example, an inability to concentrate, fatigue, poor interpersonal skills, and difficulty sustaining a job. The stigma associated with mental health conditions may prevent a person from requesting workplace accommodations such as a flexible work schedule to manage a mental disorder.

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