BREAKING THE CYCLE OF DEPENDENCY - DUAL DIAGNOSIS AND AFDC FAMILIES

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.