Depression and Alcohol Dependence among Poor Women: Before and after Welfare Reform

Many studies examine the effect of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) on employment trends, financial security, and family structure, but few consider its implications for mental health issues. Yet mental health is central to a key objective of welfare reform: increasing work effort and self-sufficiency. This study uses data from the 1995 and 2006 waves of the National Survey of Drug Use and Health to relate trends in welfare recipients’ mental health to welfare reform. Results suggest that, before PRWORA, welfare recipients did not differ from other poor women in depressive or alcohol dependence symptoms. Ten years after reform, welfare recipients experience more depressive symptoms than other poor women. This suggests that welfare reform left unusually symptomatic women on the rolls. The findings also suggest that mental health services are critical if welfare recipients are to succeed in making the transition from welfare to work.