Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada.
Be Brave Ranch, Centre for Treatment of Child Sexual Abuse, Edmonton, Canada.
BMC Health Serv Res. 2022 Jul 9;22(1):892. doi: 10.1186/s12913-022-08267-w.
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.
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.
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.
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.
专门的心理健康服务，用于治疗儿童性虐待（CSA），通常费用昂贵且劳动强度大。它们需要一种创伤知情的方法，可能涉及多种服务和治疗方式，需要在几个月的时间内提供。也就是说，鉴于 CSA 带来的广泛而长期的负面影响，对治疗的成本效益分析进行评估是合理的。
我们对加拿大埃德蒙顿勇敢牧场（Be Brave Ranch）治疗项目中收集的数据进行了社会投资回报率（SROI）分析，以确定所提供服务的物有所值。我们试图采取保守的、中期（5 年）视角；这与短期（1-2 年）效果形成对比，短期效果可能会迅速消散，或者长期（15-20 年）效果可能会扩散且难以衡量。因此，我们的分析基于每年平均有 100 名儿童/青少年（60:40 比例）及其家庭的摄入量，并在五年的时间内进行跟踪。对不易货币化的收益分配了财务代理，并确定了六个潜在的成本节约领域。
我们的分析表明，治疗每花费 1 美元，平均可节省 11.60 美元（敏感性分析表明范围在 9.20-12.80 美元之间）。最具成本效益的是危机预防领域，通过避免与 CSA 长期影响相关的罕见但昂贵的事件。令人惊讶的是，与分析的其他社会领域相比，与刑事司法相关的节省微不足道。讨论了影响。
我们的结果支持与 CSA 的专门的、基于证据的早期干预相关的投资的成本效益。这些方法缓解了 CSA 带来的严重负面影响，从而带来了经济和社会效益。这些发现基于许多假设，因此这些结果的普遍性仅限于类似的位于类似地区的项目。然而，本分析中实现的 SROI 比率超过 11:1，支持这样的观点，即尽管费用高昂，但这些服务随着时间的推移会得到回报。
