Utah is the only study state in which mental health services for TANF recipients are provided primarily in-house through the TANF administrative agency. For over 10 years, licensed clinical social workers hired as welfare staff have been providing mental health treatment to welfare recipients in the welfare office. In 1996, Utah consolidated the six agencies that handled employment, job training, and welfare functions into the Department of Workforce Services (DWS). In 1998, a social work unit was formed within DWS to provide mental health services, and a uniform statewide set of policies, procedures, and reporting forms was developed. All mental health staff that serve welfare clients are DWS state employees. A state program manager administers and monitors the mental health services and acts as a liaison with welfare administrators to coordinate mental health services. Although most mental health services are provided by DWS staff, the state contracts with other mental health professionals to provide more extensive services when a Medicaid provider is not available to provide them in a timely manner.
The benefit of an in-house service delivery system is that program staff can be easily integrated into the agency's employment program, which may improve the communication between employment case managers and mental health staff and increase the number of referrals to mental health services. One of the drawbacks is that social workers can become professionally isolated within the local offices, making it difficult for them to obtain professional consultation from other mental health counselors. In Utah, the mental health program administrator in Salt Lake City provides supervision for all of the mental health workers. Social workers in rural areas communicate by E-mail and telephone when they need clinical consultation and support.