Time to tot up the costs of late intervention

Alison Todd

“What does late intervention cost you?”

In advance of the local government elections, that’s the question Children 1st is posing to both voters and council candidates.

We’ve long focused on the desirable benefits of early intervention. Surely it’s common sense to support children to express and address their anxieties and build their resilience when they show the first signs of poor emotional health, rather than waiting until they meet the high threshold of an oversubscribed, more expensive Child and Adolescent Mental Health Service (CAMHS). Likewise it seems ludicrous to wait until families fall into a poverty trap, from which their children may never escape, before helping them with money information and advice.

But while the benefits of providing early support to children and families are well-documented and fully embedded within the Scottish policy landscape, this hasn’t been matched by the commitment and spend required to make a decisive shift towards services focused on early support across Scotland.

Our experience, shared by the other members of the Coalition of Care Providers Scotland (CCPS) #plan4children campaign, is that services focused on early support have already borne the brunt of funding cuts. During a decade of declining local authority budgets, early support has been viewed as a luxury, not an imperative. With the Fraser of Allander Institute predicting a continuing decline until at least 2021, the need to reduce the demand for acute, more expensive interventions by putting early support at the crux of public service provision has become even more urgent.

That’s why it’s time local authorities, together with their community planning partners, start considering the cost of late intervention.

The impact of childhood trauma

It’s time they compared the expense of trying, often ineffectively, to deal with the deeply-rooted impacts of unresolved childhood trauma against the costs of focusing on early support. Unresolved trauma arising from experiences such as child neglect and abuse, domestic abuse or, growing up surrounded by drug and alcohol misuse can result in children and young people experiencing poorer mental and physical health, lower educational attainment and fewer job prospects - impacts which can last a lifetime.

The Early Intervention Foundation estimates that late intervention costs England and Wales almost £17bn a year, or £287 per person. Local authorities shoulder most of the bill. While the study includes the costs of, for example, taking a child into care it does not capture the costs of dealing with lasting negative effects, such as the impact that being in care can have across a child’s lifetime.

We don’t have an estimate of the total cost of late intervention on Scotland’s public purse. What we do know -without a shadow of a doubt – is that the cost of losing both your childhood and your future life chances is incalculable.

At Children 1st we hear the stories of hundreds of vulnerable children whose grandparents, aunts, uncles or siblings are caring for them, because their parents are no longer able to do so, through our kinship care support line and local hubs.

It’s not unusual to hear of social workers arriving at a family member’s door at 9pm on a Friday night with children dressed in just pyjamas with no alternative. Relatives are often given a hard choice between caring for the children themselves or having them taken into local authority care.  Sometimes the children arrive with nothing other than the trauma of their recent experiences and their loss of connection to their home and parents. Many kinship carers take on the role without a moment’s notice. But once the children have a roof over their heads, kinship carers can be left to do the best they can in difficult circumstances.

Kinship care placements cost on average £5,000 a year, while foster care or residential care costs range from £30,000 to £1,000,000. Further investment in preparation, including family group conferencing, and full assessment of the needs of children in kinship care and their carers can ensure more children receive the love and help they need to support their recovery and make the most of their lives, while saving on public funds.

Effective early support

Kinship care is not appropriate for every child at risk of being looked after. Some late intervention is inevitable. But there are many children in Scotland with experience of local authority care, or on CAMHS waiting lists who could have enjoyed a different, more positive story if they and their family had received effective support at an earlier stage.

Totting up the costs of late intervention to Scotland’s local authorities will help inform tough decisions about the future shape and costs of our public services. In the long run early support will free up resources. Most importantly it will help today’s and future generations of Scotland’s children to thrive.

A version of this article first appeared in The Herald.