Welfare recipients will not seek help if it is too far away, study says

November 19, 2003

PROVIDENCE, R.I. -- Welfare recipients with easy access to mental health and substance abuse providers were 30 percent more likely to use services than individuals who resided farther away from the service providers, according to a new study led by a Brown University political scientist.

The finding, published in the current Journal of Policy Analysis and Management, adds to an increasing body of evidence that significant numbers of welfare recipients experience barriers to employment. Mental health problems and substance use or abuse are obstacles to work activity. The paper is online: http://www3.interscience.wiley.com/cgi-bin/jhome/34787

"Policy-makers and program managers must seek strategies to provide a range of support services that can help those on welfare overcome common barriers to employment," said Scott W. Allard, assistant professor of political science and public policy at Brown University, the study's lead author. "Mitigating the effects of distance may require transportation assistance or on-site childcare programs."

Researchers studied 668 women by combining information about service use among welfare recipients in the Detroit metropolitan area in 1999 with information about access to mental health and substance abuse service providers. Forty percent of the women met diagnostic criteria for at least one mental health disorder, and 7 percent indicated substance or alcohol abuse in the 12 months prior to the survey.

The study defined access to service providers as the number of outpatient mental health or substance abuse treatment facilities within a 1.5-mile radius and a 3-mile radius of a woman's residence. The distances were selected based on information from social service administrators regarding expected commuting distances for welfare recipients.

Overall, the researchers found greater proximity to service providers increased the likelihood that welfare recipients received services. That may be due to a number of factors, including the idea that longer distances imply more difficult commutes, particularly for welfare recipients who have less access to automobile transportation than the general population. In this study, nearly 40 percent of the women did not have regular use of or access to an automobile.

In addition - holding access to service providers constant - African Americans were less likely than whites to use support services, according to the study. African Americans with poor mental health status were nearly half as likely to use mental health services as whites with poor mental health status, researchers said.

Allard collaborated with Richard M. Tolman, associate professor in the School of Social Work at the University of Michigan, and Daniel Rosen, assistant professor in the School of Social Work at the University of Pittsburgh.

"As a significant percentage of social welfare expenditures continues to be targeted at governmental and non-governmental delivery of social services, understanding which factors shape service utilization among low-income populations becomes increasingly important," researchers wrote. "Service utilization can be increased through better marketing, outreach and information systems that allow different service providers to track client referrals."
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Funding for the study was provided by the U.S. Department of Health and Human Services, and by the National Institute of Mental Health.

Brown University

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