Pathways through TANF: The impact of unidentified depression, anxiety and PTSD symptoms on employability and successful exits from welfare

Principal Investigator: Mary Beth Shinn, Ph.D. Co-investigators: Mary Jane Alexander, Ph.D.,  Frank Lipton, M.D.

PROJECT GOALS 

Project aims are to: 

• Estimate the rates at which high levels of depressive, anxiety and PTSD symptoms and exposure to traumatic events are found among TANF recipients, 
• Examine the relationship between symptoms and patterns of welfare utilization and work,
• Extend outcomes to include data on attainment of employment and returns to welfare, and the effect of immigrant status on outcomes. 
  

RESEARCH ACTIVITIES AND METHODS 

Methods: Planning meetings to implement this study have been held with the Human Resources Administration (HRA) to understand how HRA job centers work, explore ways interviews and referral processes for this project can be included as part of HRA's ongoing procedures for new applicants and long-term recipients of public assistance, and develop a method for data collection utilizing data from the New York city and state systems. IRB approvals were obtained from NKI and NYU, and the Legal Office of HEA. 

Screening instruments include:

1. Modules from the MINI International Neuropsychiatric Interview (Version 5.0) to assess major depressive episode, dysthymia, manic and hypomanic episode, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder, post traumatic stress disorder and generalized anxiety disorder. 
2. CES-D will be used for a dimensional assessment of depressive symptoms. 
3. Traumatic History Questionnaire supplemented by the Survey of Exposure to Community Violence, to assess exposure to traumatic events, as well as an item eliciting whether the respondent ever needed to file an order of protection. 

Results: During the previous reporting period, data collection was completed using computerized interviews to assess mental health problems and exposure to violence among new applicants and long-term recipients of TANF benefits in four Job (welfare) Centers (568 women over 18, a 76% response rate). A written report and verbal briefing were presented to the Human Resources Administration (HRA). Preliminary results show high levels of mental health problems in the sample, with 43% of women receiving one of nine diagnoses on the MINI International Neuropsychiatric Interview or scoring above 23 on the Center for Epidemiological Studies Depression Inventory. Exposure to both domestic and community violence is related to both types of mental health problems. We are continuing to track respondents in HRA records to determine whether mental health problems are associated with difficulties with the system. We have a minimum of one year of prospective record data on all participants, and have met with HRA staff to determine the best way to create variables from these records.

SIGNIFICANCE OF FINDINGS/ POLICY IMPLICATIONS

HRA is considering whether to adopt the MINI or a more general screening instrument for mental health problems among welfare recipients.

PLANS  

Collection of data from welfare records will continue for a 24-36 month period to track outcomes for respondents. Plans are to examine

the relationship of mental health and exposure to violence to outcomes and determine whether mental health status mediates relationships

between violence and outcomes, or whether violence has an independent association with outcomes.

• Graduate researcher Claudia Rincom will continue to examine the prevalence of difficulties for immigrants, in contrasted to native born persons re: barriers, difficulties with the welfare system, and attainment of employment. Work will specifically examine: 

1. potential differential effects of exposure to violence and mental health problems on immigrants compared with native-born Americans in the population of welfare recipients, 

2. relationships among the various barriers to employment (language proficiency, education, work history, child care demands, domestic violence, community violence, mental health) and difficulties with the welfare system and employment. 
   

Presentations:

Rincon C, Toohey S, Shinn M, Alexander MJ, Lipton F (2001).    Pathways through TANF. Paper presented at the 8th Biennial Conference of the Society for Community Research and Action. June 7-10, 2001. Atlanta, GA.

Shinn, M (2000). Mental health and welfare dynamic study, a conference on what we are learning about the well-being of children in families moving from welfare to work. . Forum on Children and Families, New York University, Child and Family Policy Center,  March 23, 2000

Toohey S, Rincon  C, Bertollo D,  Aybar J,  Shinn, M, Alexander MJ, Lipton F (2001).Computer administered interviewing of women receiving welfare,  presented at the 8th Biennial Conference of the Society for Community Research and Action. June 7-10, 2001, Atlanta, GA.

Rincón, C. P., Toohey, S., Abina-Sotomayor K., Shinn, M., Thaden, E., Alexander, M.J., Lipton, F. (2003). Navigating the welfare system: Challenges to employment among immigrant women. Poster to be presented at the 9th Biennial Conference on Community Research and Action, Las Vegas, NM, June 4-7.

Abina-Sotomayor K., Rincón, C. P., Shinn, M., Toohey, S., Thaden, E., Alexander, M.J., Lipton, F. (2003). Latina’s reports of symptoms of distress: Influences of culture and language use. Poster to be presented at the 9th Biennial Conference on Community Research and Action, Las Vegas, NM, June 4-7.

Toohey, S., Shinn, M., Rincón, C. P., Abina-Sotomayor, K., Thaden, E., Alexander, M.J., Lipton, F. (2003). Assessing mental health, violence, and welfare outcomes for TANF recipients. Paper to be presented as part of a Symposium on Influencing Policy: An exploration of nontraditional research methodologies at the 9th Biennial Conference on Community Research and Action, Las Vegas, NM, June 4-7.

Rincón, C. P., Abina-Sotomayor, K., Sánchez, N., Shinn, M., Thaden, E., Toohey, S., (2002). Immigrant women on welfare: challenges to employment. Poster presented at the Latino Psychology Conference, Kingstown, Rhode Island, October 18-20.

Rincón, C. P., Toohey, S., Thaden, E., Shinn, M., Sánchez, N., Abina-Sotomayor K., Alexander, M.J., Lipton, F. (2002). Barriers to Employment among Immigrant and Native-born Welfare Recipients. Poster presented at the 4th Biennial SPPSI Convention, Toronto, Canada, June 28-30.

Abina-Sotomayor, K., Sánchez, N., Rincón, C.P., Shinn, M., Thaden, E., Toohey, S., Alexander, M.J., Lipton, F. (2002) Exposure to violence and mental health among welfare recipients. Poster presented at the 4th Biennial SPPSI Convention, Toronto, Canada, June 28-30.

Thaden, E., Abina-Sotomayor, K., Rincón, C.P., Sánchez, N., Shinn, M., Toohey, S., Alexander, M.J., Lipton, F. (2002). Association of domestic and community violence with mental health in women receiving or applying for welfare. Poster presented at the Annual Meeting of the Association of Women in Psychology, Vancouver, Canada, June, 2002.

Shinn, M., Alexander, M.J., Lipton, F., Toohey, S., Rincón, C. P. (2001). Screening for mental health problems and exposure to violence as impediments to women's negotiations of the welfare system and movement to work. Trapped by Poverty/Trapped by Abuse Conference, University of Michigan, Ann Arbor, MI, October 26-28.

Rincón, C. P., Toohey, S., Shinn, M., Alexander, M.J., Lipton, F. (2001). Pathways through TANF. Paper presented as part of a Symposium on Special Populations and Welfare at the 8th Biennial Conference on Community Research and Action, Atlanta, GA., June 7-10.

Toohey, S., Rincón, C. P., Shinn, M., Alexander, M.J., Lipton, F. (2001). Computer administered interviewing of women receiving welfare. Paper presented as part of a Symposium on Special Populations and Welfare at the 8th Biennial Conference on Community Research and Action, Atlanta, GA., June 7-10.

Inclusion of Gender and Minority Groups

Entered: July 10, 2000 

Updated: 7/8/03

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