Resumen
Background: Specialized mental health services for the treatment of Child Sexual Abuse (CSA) are generally expensive and labour intensive. They require a trauma-informed approach that may involve multiple services and therapeutic modalities, provided over the course of several months. That said, given the broad-ranging, long term negative sequelae of CSA, an evaluation of the cost-benefit analysis of treatment is clearly justified. Methods: We performed a Social Return on Investment (SROI) analysis of data gathered as part of the treatment program at the Be Brave Ranch in Edmonton, Canada to determine the value-for-money of the services provided. We endeavoured to take a conservative, medium-term (5 year) perspective; this is in contrast to short term (1–2 year) effects, which may rapidly dissipate, or long term (15–20 year) effects, which are likely diffuse and difficult to measure. As such, our analysis was based on an average annual intake of 100 children/adolescents (60:40 split) and their families, followed over a five-year timeframe. Financial proxies were assigned to benefits not easily monetized, and six potential domains of cost savings were identified. Results: Our analyses suggest that each dollar spent in treatment results in an average cost savings of $11.60 (sensitivity analysis suggests range of 9.20–12.80). The largest value-for-money was identified as the domain of crisis prevention, via the avoidance of rare but costly events associated with the long term impacts of CSA. Somewhat surprisingly, savings related to the area of criminal justice were minimal, compared to other social domains analysed. Implications are discussed. Conclusions: Our results support the cost effectiveness of the investment associated with specialized, evidence-based early interventions for CSA. These approaches alleviate severe, negative outcomes associated with CSA, resulting in both economic savings and social benefits. These findings rest upon a number of assumptions, and generalizability of these results is therefore limited to similar programs located in comparable areas. However, the SROI ratio achieved in this analysis, in excess of $11:1, supports the idea that, while costly, these services more than pay for themselves over time.
Idioma original | English |
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Número de artículo | 892 |
Publicación | BMC Health Services Research |
Volumen | 22 |
N.º | 1 |
DOI | |
Estado | Published - dic. 2022 |
Nota bibliográfica
Funding Information:One evidence-based program for treatment of CSA is the Little Warriors Be Brave Ranch (BBR) in Alberta, Canada. Operating since fall 2014, the BBR provides a secure, remote facility where children and adolescents receive 200h hours of targeted, multi-modal, episodic treatment in a welcoming, camp-like setting (community-based therapies, by contrast, are generally limited to 1–2 hours per week). The program is unique in that it is funded entirely via donations and receives no provincial healthcare funding. This approach makes understanding value-for-money particularly critical for the success of this program.
Publisher Copyright:
© 2022, The Author(s).
ASJC Scopus Subject Areas
- Health Policy
PubMed: MeSH publication types
- Journal Article