This paper proposes that a comprehensive, long-term program with a cas
e-management focus will produce better outcomes and be more cost-effec
tive than the current approach to managing the illnesses of women on T
emporary Assistance for Needy Families (or TANF formerly known as AFDC
) who are afflicted with both drug dependency and mental illness, i.e.
a dual diagnosis. It is proposed that this comprehensive approach wou
ld diminish the generational cycle of substance abuse, dysfunction (in
cluding violence), and dependence on public support, which is too ofte
n the pattern in single-parent homes where the mother has been dually
diagnosed. For our purposes, dual diagnosis is defined as any mental h
ealth diagnosis using the DSM-IV criteria coexisting with a diagnosis
of substance abuse, whether licit or illicit. Current drug policy, par
ticularly as it applies to those with a dual diagnosis, has an emphasi
s on criminal justice system solutions. It is extremely expensive (inc
arceration alone is variously estimated as costing $25,000 to $45,000
per year per person), and does little to treat, prevent, or consequent
ly, reduce the problem. The model design discussed in this article pro
vides for comprehensive treatment and support services to women with a
dual diagnosis receiving TANF Its goal is to help break the family cy
cle of system dependency. The article hypothesizes that if a well-desi
gned program evaluation is implemented, it will demonstrate savings in
reduced health care, criminal justice, and social service costs.