The Cost Effectiveness of Evidence-Based Prevention and How it Impacts You
Does saving the life of one child matter to you personally? What if it’s your own child versus someone else's? You can look at this from a humanitarian or economic perspective, but they may not be as different as you’d think.
An altruistic person gives their time, talent and material goods without looking for reward. In developing a mental health intervention that utilizes volunteers as mentors to serve children from low-resource families (Great Life Mentoring), I’ve been a witness to this for over twenty years. I have met the cream of the crop of our society, and I am impressed.
In the beginning, volunteers talk about “giving back,” or “helping others,” and later they find that their own life has benefitted in the process. There is a deep emotional benefit to giving. (Click here to see unscripted videos from some of our mentors sharing their stories.)
Helping people, from a humanitarian standpoint, is not too difficult to understand. Biologists see humans as having a natural willingness to help, even from our infancy. Consequently, they have also found that we must, to some extent, be selfish to survive.
So for the sake of looking at this from both motivations, let’s talk about economics.
Nearly 30 million American children live in low-income households, which makes them two to three times more likely to develop mental health disorders (1). These are the children Great Life Mentoring is designed to help, and formal research says we’re effective at it.
Mental health disorders can lead to serious, life-long impairment of adaptive functioning, educational and social development and overall health. That’s 40% of all American children most at risk for crime and delinquency, drugs and substance abuse, educational failure and other forms of psychological dysfunction. The costs are enormous.
The economic costs of mental health disorders (mostly anxiety, mood and substance abuse disorders as cited in this NIH report) account for more economic costs than chronic somatic diseases, such as cancer or diabetes. Based on data from 2010, they report the global economic burden of mental disorders was estimated at $8.5 trillion in 2010. Both direct and indirect costs are expected to double by 2030. (2)
To take this one step further, spending on behavioral health correlates with higher overall healthcare Spending. According to a study by the LBL Group in 2020, people with behavioral health conditions tend to have higher healthcare costs than those who don’t. Researchers used data from employers and other commercial payers, looking at insurance claims for 21 million people in 2017.
They reported that people with conditions such as anxiety, depression or substance abuse disorders had healthcare costs 3.5 times higher than those who didn’t. Those with behavioral health conditions spent $12,272 annually, or $33.62 per day.
Further, their spending on behavioral healthcare accounted for only 4.4% of total healthcare costs for the 21 million people. The vast majority of spending was on patient’s physical health needs. (3)
Substance abuse costs in America are over $600 billion annually (NIH 2018), and 77% of this is financed by public sources (NIH 2003). And, how about the average cost of incarceration in America? $65.75 per day. Don’t even get me started! American taxpayers are covering the cost.
The National Institute on Drug Abuse (NIDA) reports, “every dollar invested in addiction treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to healthcare are included, total savings can exceed costs by a ratio of 12 to 1. Major savings to the individual and to society also stem from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths.” (4) That’s good news and an important investment.
Great Life Mentoring could help reduce these costs even lower in the future. It’s all about prevention.
NIDA’s plentiful research over the past few decades has shown “positively altering a child’s life trajectory by reducing various risk factors, strengthening protective factors, and increasing access to resources can reduce or delay later drug use, as well as minimize other adverse outcomes, like criminality or other mental illness.” (5)
In the NIDA blog, Dr. Nora Volkow points out that “high-quality intervention programs are costly, and communities may be reluctant to invest the needed resources when the payoff may be years or more in the future. However, studies have strikingly shown that many programs more than pay for themselves.” This is just what we’re hoping to illustrate here.
The economic benefit to society, of an evidence-based prevention model, is like other important investments we make (think retirement). The careful approach pays off.
In the behavioral health realm, evidence of impact is essential, and Great Life Mentoring has spent the last two decades yielding evidence in Clark County, WA. Given the overwhelming success of children showing a significant improvement in mental health disorders, the organization is ready to expand this mental health intervention to as many children as possible, starting with a new location in Portland, Oregon.
If we break it down, it costs an average of $5 per child per day (over four years, our average match length) to provide this essential service to our kids. This might sound like a lot, but compare it to the cost of the alternatives listed above, and it becomes the most cost-effective societal impact you can make.
With a three-phase plan, aiming for a total of five sites over five years, along with a rigorous research project evaluating outcomes, we’ll have a field-tested model that can benefit children in communities throughout America.
We're ready to expand and we invite you to join us. Do it because you’re smart, or do it because you’re kind. But please do it.
The life you change may be your own.