How Mental Health and Welfare to Work Interact: The Role of Hope, Sanctions, Engagement, and Support

Abstract

This article describes some of the lessons learned in the implementation of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) as it relates to people with psychiatric disabilities. It attempts to articulate some of the inherent difficulties faced in serving these individuals within the welfare system as well as how the established strengths of each system can inform the other's efforts. The philosophy concerning work for clients of the welfare and mental health systems differ. Each system has developed separately, and they do not easily integrate their differing philosophies and goals. At the client level, this lack of consistency presents obvious coordination barriers. At the system level, examination of practice and the underlying philosophy of each provides incentives for cross-training and policy changes. Two case studies describe the identification of issues, opportunities, and challenges to providing Temporary Assistance for Needy Families (TANF) services to individuals with mental illness. These lessons can provide guidance to mental health systems as they strive to implement evidence-based employment practices and provide welfare entities with policy direction as a result of a widening knowledge base. Specific policy and program innovations in a county and in a state are highlighted to demonstrate these issues. Finally, the authors raise areas for further inquiry and reflection.

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