Temporary Assistance to Needy Families as a Conduit to Substance Abuse Treatment

Background and purpose: Until 1996, Aid to Families with Dependent Children (AFDC) was the traditional vehicle to identify, refer, and finance services to low-income mothers who experience substance use disorders. With the replacement of AFDC by TANF (Temporary Assistance to Needy Families), most low-income mothers are not current recipients of cash aid. Those who do receive TANF aid now face differing program requirements that sometimes enable and sometimes hinder access to appropriate services. These changes raise the possibility that many low-income women with substance use disorders are out of contact with the traditional systems that facilitate assessment, referral, and financing of substance abuse treatment.

Methods: This presentation uses nationally-representative data from the 2007 National Survey of Drug Use and Health (NSDUH) and detailed 2001-2003 data on psychiatric disorders from the Collaborative Psychiatric Epidemiology Studies (CPES) to explore these concerns. In particular, we examine whether TANF receipt is associated with increased probability of treatment receipt among low-income women with substance use disorders.

Results: Welfare recipients evidence lower rates of substance use disorders than expected but higher rates of mental health disorders. Mechanisms promoting access to substance abuse or mental health treatment are limited.

Conclusions and implications: The prevalence of substance use disorders and co-occurring psychiatric disorders among low-income women with dependent children require examination. Associations between substance use disorders and other psychiatric disorders in predicting “disconnected” status—that is low-income mothers who are neither working, nor receiving TANF aid, nor married or cohabitating with an economically stable partner have implications for the design and development of treatment services for women welfare recipients.