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Evaluation of Mental Health & Rehabilitation Needs of Recipients of Temporary Aid to Needy Families (TANF) in Illinois

PROJECT PURPOSES:

This project, also called “The Reaching for Success Project,” is examining the social, psychological, and economic barriers to work experienced by recipients of the Temporary Aid to Needy Families program (TANF) under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 (Public Law 104-193) in the State of Illinois. Given evidence that a significant proportion of TANF recipients have untreated co-occurring mental health and substance abuse difficulties, there is reason to believe that they experience extremely low levels of self-determination and require innovative service approaches and supports. Information from this study will aid these women and their families by providing a better understanding of their needs and their resources, while providing them with referrals to self-help, professional mental health and substance abuse services, job training and education, and other needed supports.

As a result of consultation with two epidemiologists from the UIC School of Public Health and the National Institute of Mental Health, Epidemiology of Mood Disorders Branch, the decision was made to mount this study using a two-phase process. The first phase consists of a pilot test with 40 women to test the study recruitment procedures and research protocol.  The second phase consists of the larger study of 800 women, with the recruitment procedures and study protocol revised on the basis of knowledge gained from the pilot.

WHAT’S NEW, WHAT’S USEFUL:

Draft Protocol for the Evaluation of Mental Health & Rehabilitation Needs of Recipients for Temporary Assistance for Needy Families (TANF) in Illinois.  This protocol is comprised of 16 sections, assessing issues such as well-being, self-concept, psychiatric disability, child care arrangements, economic hardship, social service utilization, and work history and employment barriers for women receiving TANF.  The protocol also allows for the collection of data regarding the respondents' experiences with Illinois' Welfare-to-Work program, and asks for feedback regarding protocol administration. 

Bibliography on Welfare Reform, Temporary Assistance for Needy Families, and the Personal Responsibility and Work Opportunity Reconciliation Act. This comprehensive literature review highlights the various needs of people on TANF; work outcomes of those terminated from the system; types of services offered to people who receive TANF and service outcomes; and problems experienced by those on welfare before and after termination of benefits.

ACTIVITIES OF THE REACHING FOR SUCCESS PROJECT:

Convening National Workgroup and Obtaining IDHS Approval

During this first project year, UIC NRTC staff convened the project’s multidisciplinary Workgroup, comprising six national experts on welfare-to-work initiatives; 67% of whom are people with psychiatric disabilities and/or family members.  Time also was spent with senior officials of the Illinois Department of Human Services or IDHS (which oversees the TANF program in Illinois) gaining approval for the study, as well as advice on study logistics. 

Project Inclusion and Exclusion Criteria

One of the first project tasks was to finalize the study inclusion and exclusion criteria based upon information obtained from the most recent (June 2001) IDHS statistics, as well as best methods used in similar prevalence studies. Individuals eligible to participate in this study include all single mothers, ages 18 to 59 years, with dependent children (under age 18 years), who are receiving TANF entitlements and case assistance, are classified by the state as “available to work,” are U.S. citizens, speaking English or Spanish, and are within the final 24 months of their lifetime TANF eligibility. Exclusion criteria include men (who comprise less than 5% of “available to work” cases), non-U.S. citizens (to whom different laws and policies apply), those receiving medical coverage only, those in their first two years of TANF eligibility, and those residing outside of Cook County (who comprise only 10% of all “available to work” cases in Illinois). While aware of the trade-offs involved in establishing these sampling criteria, it seemed important to mirror the sample and designs used in prior rigorous research studies, and to focus on those women who are likely to be most vulnerable to sanctions and limitations on self-determination.

Reaching for Success Research Protocol and Procedures

During numerous conference calls with the Workgroup and IDHS staff, the study’s research protocol was designed, focusing on a concise and sensitive series of questions that are relevant to the study’s target population. The protocol has 16 sections, which assess well-being, self-concept, academic skills, psychiatric disability, informal and family supports, relationships, child care arrangements, economic hardship, social service utilization, work history and employment barriers, learning disabilities, and utilization of computers and the Internet (which is the Short Survey developed by the Self-Determination and Technology Workgroup and Center staff ).  Many sections include existing published instruments that have been tested for scientific validity and reliability. The protocol also allows for the collection of data regarding the respondents' experiences with Illinois' Welfare-to-Work program, and asks for feedback regarding protocol administration.

During a series of teleconferences and meetings, the Workgroup and IDHS staff also helped to design the study’s consent form, reviewed and revised the research plan for the pilot study, and approved the research plan and hypotheses.  The incentive for study participants also was decided upon, which will cover the woman’s time, childcare, and transportation costs.  Recruitment procedures will allow for a woman to be contacted on several occasions by mail and/or phone; however, once a woman declines to participate in the study, no further contact will be made. All study materials were translated for Spanish speaking research participants.

CURRENT ACTIVITIES OF THE REACHING FOR SUCCESS PROJECT:

In the summer of 2002, the University’s Institutional Review Board (IRB) approved the pilot study.  Project staff subsequently began recruitment for the pilot study and the response rate has been adequate.  As a result, scheduling of pilot interviews has begun, and follow-up recruitment procedures have been activated. 

NEXT STEPS IN REACHING FOR SUCCESS PROJECT:

In subsequent months, project staff will complete the pilot study, refine study procedures based on the results of the pilot test, and submit an application to the UIC IRB to conduct the full study with 800 women recipients of TANF.

PROJECT STAFF:

Principal Investigator:  Judith A. Cook, Ph.D.

Co-Investigators:  Lynne Mock, Ph.D., Jessica A. Jonikas, MA, Amanda Taylor, BA

NATIONAL WORKGROUP MEMBERS:

Suzanne Andriukaitis, Gayle Bluebird, Jacki McKinney, Jane Moore, Virginia Mulkern, and Dory Rand

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