Cost-Benefit Analysis of a Preventive Intervention for Divorced Families: Reduction in Mental Health and Justice System Service Use Costs 15 Years Later

Abstract

This cost-benefit analysis compared the costs of implementing the New Beginnings Program (NBP), a preventive intervention for divorced families to monetary benefits saved in mental healthcare service use and criminal justice system costs. NBP was delivered when the offspring were 9– 12 years old. Benefits were assessed 15 years later when the offspring were young adults (ages 24–27). This study estimated the costs of delivering two versions of NBP, a single-component parenting-after-divorce program (Mother Program, MP) and a two-component parenting-after-divorce and child-coping program (Mother-Plus-Child Program, MPCP), to costs of a literature control (LC). Long-term monetary benefits were determined from actual expenditures from past-year mental healthcare service use for mothers and their young adult (YA) offspring and criminal justice system involvement for YAs. Data were gathered from 202 YAs and 194 mothers (75.4 % of families randomly assigned to condition). The benefits, as assessed in the 15th year after program completion, were $1630/family (discounted benefits $1077/family). These 1-year benefits, based on conservative assumptions, more than paid for the cost of MP and covered the majority of the cost of MPCP. Because the effects of MP versus MPCP on mental health and substance use problems have not been significantly different at short-term or long-term follow-up assessments, program managers would likely choose the lower-cost option. Given that this evaluation only calculated economic benefit at year 15 and not the previous 14 (nor future years), these findings suggest that, from a societal perspective, NBP more than pays for itself in future benefits.

Self-harm risk between adolescence and midlife in people who experienced separation from one or both parents during childhood

“…This national cohort study adds weight to existing published evidence indicating that a troubled upbringing, as indicated by separation from one or both parents, may be linked with harmful long-term mental health problems through late adolescence, young adulthood and on to early middle age. The U.S. National Institutes of Health-funded ‘New Beginnings Program’ ( https://asupreventionresearch.com/ ) has been shown to be effective in ameliorating the potentially harmful impact of child-parent separation and divorce across multiple outcome domains ( Wolchik et al, 2009 , Wolchik et al, 2013 ; Sigal et al, 2012 ; Herman et al, 2015 ). The novel findings generated from our cohort study suggest that future interventions could be tailored toward subgroups of exposed individuals who are psychologically distressed into adulthood, including those separated from both of their parents and particularly during early adolescence, those with little experience of familial cohesion throughout their upbringing, and those with the most complex trajectories who lived through many transitions of child-parent separation.…”

Long‐Term Effects of Parenting‐Focused Preventive Interventions to Promote Resilience of Children and Adolescents

“…For males, it also reduced the number of substance use disorders from adolescence to emerging adulthood ( d = .40), polydrug use ( d = .55), and other drug use ( d = .61) in the past year, and substance use problems ( d = .50) in the past 6 months. Also, emerging adults in the NBP spent less time in jail and used fewer services for psychological problems than those in the control condition . The NBP also affected biological measures of stress regulation for older participants .…”

Randomized Effectiveness Trial of the New Beginnings Program for Divorced Families with Children and Adolescents

“…At the 6-month follow-up, the parenting program reduced children's externalizing problems as reported by parents, children, and teachers. Follow-up evaluations at 6 years and 15 years found a broad range of benefits, including reductions in mental health problems and disorders, substance use and abuse, and high-risk sexual behavior (Wolchik et al, 2013;Wolchik, Sandler, Weiss, & Winslow, 2007); less involvement in the criminal justice system; and use of mental health services (Herman et al, 2015), as well as improvements in indicators of positive functioning such as self-esteem and grade point average (Wolchik et al, 2007). Consistent with the program theory, many of these effects were mediated through improvements in quality of parenting (Tein, Sandler, MacKinnon, & Wolchik, 2004;Zhou, Sandler, Millsap, Wolchik, & Dawson-McClure, 2008).…”