Prevalence of psychiatric and substance use disorders among single mothers nearing lifetime welfare eligibility limits.
BACKGROUND
In the 1990s, US welfare reform legislation imposed a 5-year lifetime limit on financial support for low-income families with young children (younger than 18 years). With increasing numbers of single mothers and their children reaching the end of their welfare eligibility, there is concern about potentially high rates of untreated psychiatric and substance use disorders in this population.


OBJECTIVE
To determine the prevalence, correlates, and likelihood of treatment for mental and substance use disorders in a population of urban single mothers receiving Temporary Assistance for Needy Families (TANF).


METHODS
In-person diagnostic assessments were conducted from November 1, 2003, to October 31, 2004.


METHODS
Cook County, Illinois.


METHODS
Female TANF recipients and residents of Cook County (N = 333) who were randomly sampled during the final 24 months of their eligibility for TANF.


METHODS
Prevalence rates of DSM-IV mental and substance use disorders using the World Health Organization's Composite International Diagnostic Interview.


RESULTS
Lifetime prevalence of Composite International Diagnostic Interview disorders was 61.0% (95% confidence interval [CI], 55.7%-66.3%); 12-month prevalence was 46.8% (41.5%-52.2%). Lifetime prevalence of mental disorders was 53.2% (95% CI, 47.8%-58.5%); 12-month prevalence was 44.1% (38.8%-49.5%). Lifetime prevalence of substance use disorders was 29.1% (95% CI, 23.9%-33.8%); 12-month prevalence was 9.0% (6.8%-12.0%). Lifetime prevalence of comorbid mental/substance use disorders was 21.3% (95% CI, 16.9%-25.7%); 12-month prevalence was 6.3% (3.7%-8.9%). Only 21.7% (95% CI, 14.8%-28.5%) of participants with 12-month mental disorders received treatment for mental disorders; 41.4% (22.3%-60.4%) of participants with 12-month substance abuse disorders received treatment for substance use disorders.


CONCLUSIONS
Despite the high prevalence of psychiatric and substance use disorders in this population, many remain untreated. The consequences of terminating welfare assistance are worthy of further investigation, given the potential for adverse effects on both mothers and their young children.
Cook
Judith A
JA
Department of Psychiatry, University of Illinois at Chicago, 1601 W Taylor Street, Chicago, IL 60612, USA. cook@ripco.com
Mock
Lynne O
LO
Jonikas
Jessica A
JA
Burke-Miller
Jane K
JK
Carter
Tina M
TM
Taylor
Amanda
A
Petersen
Carol A
CA
Grey
Dennis D
DD
Gruenenfelder
David
D
D000328:Adult; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D039721:Diagnostic and Statistical Manual of Mental Disorders; D004608:Eligibility Determination / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D009035:Mothers / Q000706:statistics & numerical data*; D015995:Prevalence; D016079:Refusal to Treat / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D015406:Single Parent / Q000706:statistics & numerical data*; D012946:Social Welfare / Q000191:economics* / Q000331:legislation & jurisprudence*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult