 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
|
| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Laurie Jacobs, MA1, Laura Schmidt, PhD1, and James Wiley, PhD2. (1) Public Health Institute, Alcohol Research Group, 2000 Hearst Ave., Suite 300, Berkeley, CA 94079, 510.642.5208, ljacobs@arg.org, (2) San Francisco State University, 1600 Hollaway Avenue, San Francisco, CA 94132-4025
Historically, welfare systems throughout the U.S. did little to directly address alcohol, drug and mental health problems in their caseloads. With welfare reform, most social service providers have tried to remedy this situation through routine screening and compulsory treatment programs. Even after reform, many raise questions about the effectiveness of welfare interventions. New screening programs frequently rely on welfare eligibility workers to conduct assessments. Yet workers often lack adequate training in clinical assessment, and clients may fail to disclose problems for fear of economic sanctioning or referral to child protective services. Our data consist of a representative survey of 1510 adults seeking welfare services throughout a large California county. Participants were evaluated for substance abuse and mental health problems at the time of application and were followed for one year. Our results indicate that clients with substance abuse and mental health problems receive aid at similar rates to clients without such problems. Once accepted onto aid, however, most clients with addictions and mental health problems are referred to work and employment programs without addressing their underlying substance abuse and mental health impairments. These results raise important questions about where the problems lie in the management of addiction and mental illness by welfare programs. While it could be that welfare eligibility workers are not very effective at screening for clinical conditions, clients may also fail to disclose problems to their caseworkers. Problems could, moreover, be occurring farther downstream, at the point where providers try to engage welfare recipients in treatment.
Learning Objectives:
Keywords: Substance Abuse, Welfare
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.