Single mothers of young children receiving welfare are more likely to suffer from depressive symptoms that may indicate clinical depression, yet few receive mental health treatment, according to research conducted at the Bloomberg School of Public Health. The study looks at the factors in these women's lives that contribute to depressive symptoms and examines whether these symptoms may prevent the women from gaining employment and becoming independent from welfare. The results appear in a special edition of Women and Health devoted to welfare issues.

"One challenge facing state welfare agencies is to identify barriers to employment. One such barrier--depression--is high among low-income single mothers," says Mary Jo Coiro, an assistant scientist in the Department of Health Policy and Management at the Bloomberg School of Public Health. "Results of this study indicate that while women with higher levels of depression were at an increased risk for welfare dependency, their depression was not associated with the likelihood of their working or attending school or training programs."

Data for the study were extracted from a national evaluation of welfare-to-work strategies. All the welfare recipients enrolled in the national evaluation were assigned either to programs designed to promote employment or to a control group. Because Coiro's paper was not designed to compare the programs, only those participants in the control group were included in the sample. These women remained eligible for financial aid and could seek out education, training or employment on their own but were not required to participate in any welfare-to-work activities. All women were African-American single mothers with at least one child aged 3 to 4 at enrollment time.

Sociodemographic information about each woman was obtained from a questionnaire at the beginning of the evaluation. Details included mother's age, race, education, employment status and history, history of welfare receipt and number and ages of children. Participants were interviewed three months later to assess social support and life stress and again two years later to gauge the success of moving from welfare to employment.

Forty percent of the women reported symptom levels that would likely indicate a diagnosis of clinical depression, yet very few had received any mental health services. Significantly higher levels of depressive symptoms were found in women who grew up in households receiving financial aid, who were on welfare for more than five years, who perceived less social support to be available to them and who reported more stress in their lives.

The study then addressed whether the depressive symptoms influenced participation in educational and training activities, employment, and success in leaving welfare within the two-year period. While symptoms of depression did not affect the likelihood of attending educational or training activities, women with more depressive symptoms were less likely to leave welfare over the two-year period. "Therefore, to get the most out of educational or training activities, and gain successful employment enabling the transition off welfare, it may be more effective to treat those with depressive symptoms prior to beginning a program," Coiro suggests.

Surprisingly, mothers reporting higher levels of stress were more likely to become employed and to go off welfare. According to Coiro, this could be because the desperation of their situation necessitated finding employment, or perhaps at the beginning of the evaluation the mothers were already actively seeking employment, which could heighten their levels of stress.

"These findings support the need for further research and point to the importance of identifying and treating symptoms of depression in low-income mothers for the benefit of the women and their children, and in working toward the larger goal of achieving successful employment and independency from welfare," Coiro concludes.

Funding for this study was provided by the National Institute of Child Health and Human Development Family and Child Well-Being Research Network, with support to the author from the Society for a Science of Clinical Psychology Dissertation Research Award.