Early intervention is firmly back on the political agenda.
In recent months, the government has announced a £10m contract for an organisation to run the new Early Intervention Foundation, while the Shadow Children’s Minister, Sharon Hodgson has attacked the coalition’s record on the subject.
The economic and social benefit of providing support, advice and help for those families struggling the most has long been recognised. For instance a 10% success rate with young offenders has potential savings of more than £100 million-a-year.
A 2009 report by the Audit Commission identified how a young person with behavioural issues, who enters the criminal justice system at a young age, will cost the public purse over £200,000 by the age of 16.
An excellent analysis of the role and outcomes of prevention was published in November 2011 by Community Links, Early Action Taskforce.
“The Triple Dividend” (read the report here), recognised the distinction between very early “enabling services”, “prompt interventions”, “acute services” and “containment”. Each of these levels requires a different type of intervention.
Frequently the default approach is to focus on the intensive, face-to-face interventions, on the grounds they are ‘evidence-based’, which leaves the potential of digital, mobile and telephony on the periphery of intervention strategies.
However shifting to a multichannel approach offers multiple benefits. On one level there is a direct cost comparison. An online consultation with a community health service ranges from a few pence for basic information to £10 for a session comparable to the visit of a health visitor, which offline costs around £60. Telephone engagement with NHS Direct costs over £12 per interaction, compared with £0.12 online.
And then there are the wider economic and social benefits. We know up to 75% of parents say they regularly look for support but for a variety of reasons the majority are unable to find or unwilling to use the services they need.
For many, the barrier to entry is too high. Stigma of perceived failure or the fear of being judged, along with a lack of confidence are commonly reported as key factors. A further barrier is that face-to-face sessions may not be available at times convenient to work or child demands.
A multichannel offer removes many of these barriers. We saw this in the Family Information Direct programme Transform developed for the Department for Education.
In three years the programme’s digital and telephone services received more than ten million contacts, covering the most serious parenting issues and engaged large numbers who had not previously used support services.
The Government Digital Service has set out ten Design Principles to govern the development of digital services. Several could apply to the development of any service, including: do the hard work to make it simple; build for inclusion; understand context; and be consistent, not uniform. However the first is especially prescient – start with user needs.
An overwhelming majority of people discover services via friends, family and community recommendations. Where community once meant the local physical environment, it is now also defined in terms of online social channels and groups coalescing around common issues. Internet penetration among households with at least one dependent child is now 91% of the population.
So it is increasingly likely that services will be found through Facebook groups, Twitter streams or community forums. By only providing face-to-face services the net result is likely to be families accessing them later on, at a far higher cost, than could otherwise have been achieved.
Providing other channels, particularly for complex issues such as post-natal depression, domestic violence or those involved with the care system, better enables those seeking support to do so anonymously. Netmums already do this with significant results in supporting mothers experiencing PND.
Evidence from existing services is that many users will ‘lurk’ in the background until they feel confident enough to engage. However during this time they are receiving important passive support through other people’s experiences and the advice they receive.
Placing a digital strategy at the heart of the intervention agenda would create a vital group of ‘enabling services’ highlighted in the Triple Dividend. Equally they can also deliver ‘prompt intervention’ services by providing a triage and link between health, social and other state services and their users.
Achieving successful early action and intervention requires a step-change in early intervention thinking built around embracing innovation.