Thursday, 31 January 2013

Counting the Cost...

A couple of reports caught my eye last week. One from CLG, The Cost of Troubled Families shows the high cost to public services of those who need repeated interventions from social services, education, NHS, police and other agencies. The report is more about costing methods than solutions, but the inference is clear: joined-up thinking and early intervention is far better than many agencies tackling problems later. In simple terms, prevention is better than cure.

The second was sombre data from the Office for National Statistics (ONS): their bulletin Suicides in the United Kingdom, 2011 reports a significant increase. We're only now getting 2011 figures because of the need to wait for coroners’ decisions. But if this trend is shown to continue in 2012 and beyond, it’s a very worrying one.

ONS don’t speculate on the reasons for this increase, but many others have. Organisations working in mental health report increased referrals from people in crisis, and identify unemployment and the economic downturn as amongst the contributory factors. Certainly the group most at risk – men aged 30-44 – are those for whom losing their job, perhaps compounded by debt, isolation and other kinds of deprivation, might precipitate a crisis. And we know that a high proportion of suicides have no previous contact with mental health services, so the scenario is certainly plausible.

Even if this cause-effect link is unproven, should we not be trying to understand it? The cost of “troubled family” is estimated between £45,000 and £100,000. Meanwhile the government’s own estimate of the cost of suicide (from No Health Without Mental Health, Dept of Health 2011) is £1.7m per instance.

So where is the joined-up thinking and early intervention on suicide? The government's 2012 paper Preventing Suicide in England is a set of palliative measures for different situations, not a joined up strategy linked to root causes. The fact that different methods of calculating these costs are used in different situations merely strengthens the argument. It gives the impression that the figures are being produced to make a political point rather than develop real solutions. (Perish the thought!)

So let’s have some real joined up thinking please. Thinking that counts the costs and benefits of policies in social and economic terms, not just through the mantra of GDP. It might even lead to a society with fewer troubled families and fewer suicides in the first place.

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