We all know intuitively that prevention is better than cure. Yet this does not translate easily into the way public services are prioritised or resourced, nor how we arrive at the best response to take when things go badly wrong. This has always been the case; when public spending is squeezed, questions about how to strike a better balance between investment in the future and present crises becomes even more pressing and, arguably, more difficult.
There is both broad consensus and strong evidence to show that prevention is critical in the area of preventing crime among young people. There are close links between young people's alienation from school, involvement in crime and anti-social behaviour, and poor career prospects. Almost 40% of young offenders are regular truants; and some 60% of the 18- to 20-year-olds who enter custody were unemployed the month before.
Such unresolved problems carry high costs. The average lifetime charge to public finances of just one young person not gaining and sustaining a job is more than £56,000; the price of custody for an adult lies in the order of £39,000 per year; while an estimated 11% of the children of women in prison are either taken into local authority care, fostered or adopted. Yet even in times of relative plenty, prevention has often come second to short-term needs. In 2009/10, for example, the Youth Justice Board spent five times as much on custody as on prevention, while police efforts often focus on addressing ‘symptoms' rather than seeking ‘cures'.
Alternatives to the standard approach
But there are preventative models, targeting young people at different stages of life, that we know to work and which could, we estimate, yield extensive savings. The Through the Gates project operated by the St Giles Trust includes a mentoring scheme conducted both before and after an offender leaves prison. This costs around £870 per annum per person, but it is believed that savings to the public purse are 10 times that figure.
Several police forces have championed the use of Youth Restorative Disposal orders (YRDs), where young people must face up to the impact of their offence, offer an apology, and examine why the transgression took place. Where appropriate, a plan is made for the young person to make good the wrong that was done. The intervention is light touch and costs are low - in the order of £42-worth of police time in each case. The Young Foundation estimates that 45,000 YRDs could be given each year, reducing re-offending among that cohort by as much as 9% as compared to the alternative approach of arrest, prosecution and criminalisation.
We could also look to the US for inspiration, where Multisystemic Therapy (MST) was developed at the Medical University of South Carolina. MST works with those at risk of re-offending, and is an intensive family- and community-based treatment programme that encompasses the whole lives of chronic and violent young offenders: their homes and families, schools and teachers, neighbourhoods and friends. MST costs roughly £5,000 per participant, and can reduce future offending by up to 25% compared to standard alternatives. Our assessment is that a national programme in the UK could reach a number of around 7,000 participants.
There are many further good examples. Our assessment is that their wide-scale adoption is feasible, and that the rewards would be great. An investment programme of £145 million in preventative action over two years could assist almost 100,000 people to turn their lives around, returning savings of more than £200 million to councils, police and prisons in the medium term, while averting a further £100 million-worth of harm to victims through injury, emotional trauma and inability to work. Initial investment would come from pooling existing budgets. Over time, the savings built up and shared across the public sector could be re-invested in further preventative activity.
So if the evidence is there, what is the problem? Unfortunately, there are a number of barriers to preventative action, including siloed budgeting and a lack of effective service-user and community engagement.
Building on existing models of early intervention
A strategy that genuinely takes prevention and risk management seriously would be one that recognises short-term pressures but balances those against long-term objectives, drawing on all the ideas, partnerships, skills and analysis needed to make this happen. Such a strategy would build on five key steps: mainstreaming a focus on soft skills development, which not only helps young people secure work but also understand and tackle their own behaviour better; encouraging greater partnership working and smarter budgeting arrangements; expanding investment for prevention in targeted programmes; encouraging analysis for prevention and learning from past experiences with payment by results; and encouraging experimentation.
Welcome experiments already exist, such as Total Place community pilots and the government's Troubled Families programme. But an effective prevention strategy will require local services to empower their staff and communities, central government to allow real innovation and flexibility, and both to ensure that they bring the public along with them.