Screening and Assessment in TANF\Welfare-to-Work: Ten Important Questions TANF Agencies and Their Partners Should Consider. What tools are used to identify mental health problems?


Several states screen welfare clients for mental health problems as part of a multi-barrier screening tool. Among the states reviewed, we found only two states or localities using separate, targeted tools to screen for mental health problems. Mental health experts we interviewed identified several standard tools that are used by trained, clinical professionals to assess people for mental health problems.However, none of the mental health experts we interviewed believed these tools should be used by laypersons in a TANF agency. In fact, experts said that standard tools should only be used by clinically trained professionals. Examples of these may include, but are not limited to the Beck's Depression Inventory-II (BDI-II), the Posttraumatic Stress Diagnostic Scale, and the Zung Depression Scale.

Some mental health tools must be administered by trained professionals.

The BDI-II has 21 scaled questions, must be administered by someone with a Master's degree, and be scored and interpreted by someone with a Ph.D./Ed.D. The Zung Depression Scale is 20 scaled questions and also requires a clinical professional or licensed social worker to administer. The Posttraumatic Stress Diagnostic Scale, on the other hand, is 49 'yes' or 'no' and scaled questions and requires only that it be administered by someone with a Bachelor's degree in psychology or education or a closely related field.

In New Jersey the Divisions of Family Development and Mental Health Services within the Department of Human Services, have initiated a pilot program funded with TANF dollars to identify TANF recipients in one county who have mental illnesses and need related services to help them enter the workforce. The pilot program involves the county welfare agency and two mental health providers who work as a team to identify TANF recipients who have mental illnesses, assess their clinical needs, and to link them to mental health services and a supported employment program to facilitate entry into the workforce. A twelve-item instrument was developed for use by county welfare case managers to assist them in identifying customers who could benefit from the pilot program.

In Portland, Oregon all new TANF applicants screened for mental health and substance abuse problems through participation in an "Addiction Awareness Class." During this class, TANF clients are asked to complete the Zung Depression Scale. The results of the Zung are scored by an onsite alcohol and drug clinical assessment specialist. The specialist informs both the client and the client's caseworker in writing about the test results and the next steps to take.68

68  National Center on Addiction and Substance Abuse 1999.

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