Funding to Family and Community Support Services (FCSS)

Investment in prevention services will be a significant step in creating sustainable systems for Children and Youth Services, Health, Justice, and Education.

In the human service delivery system there are three levels of service-sometimes called by different names.   Each level is described below.

“Prevention” “Primary Prevention” “Universal Services”
Purpose
– Promote wellness
– Promote positive behaviour

Target
– Everyone

Strategy
– Change environments
– Build skills
– Promote awareness
– Provide supports

“Secondary Prevention” “Early Intervention” “Targeted Services”

Purpose
-To intervene at early signs of problems
-To reduce crises
-To change troubling behaviours

Target
-People in early crisis
-“High-risk” groups

Strategy
-Recommend solutions to problems
-Respond to crises
-Diffuse short term crises
-Provide skills to change responses
-Change situations

“Tertiary Services” “Crisis Intervention” “Clinical Services” “Treatment”

Purpose
-To rehabilitate
-To reconstruct
-To treat

Target
-People in crisis
-Clients

Strategy
-Treat symptoms:
–  detoxification
–  therapy
–  residential
-Provide skills to rehabilitate

The Perry Preschool Program was implemented in 1962.  A sample of 123 young African American children were randomly assigned to a program group that received a high-quality preschool program at ages 3 and 4 or to a control group.  The children in both groups were assessed on 14 occasions between the ages of 3 and 40.  Children in the program group exceeded the control group in:

– Tested ability and performance throughout childhood
– Higher adult earnings
– Rates of employment
– Rates of home ownership
– Half as many lifetime arrests for violent, property and drug crimes
– Fewer convictions

The economic return to society was $17.07 for every dollar invested.
(Victims & Offenders, Volume 2, Issue 2 April 2007, pages 141-160)

In November, 2009, Wilder Research published the Cost Savings Analysis of School Readiness in Michigan report. It concluded the cost savings and revenues realized in 2009 in the state of Michigan due to the investments in school readiness over the past 25 years is an estimated $1.15 billion. The study also concluded the ongoing cost burden of not investing in school readiness for all disadvantaged children is an estimated $598 million per year.  (www.wilderresearch.org)

Luciano L’Abate outlines criteria that differentiate approaches to service delivery in his book Building Family Competence.

CRITERIA – PRIMARY
Risk – Low to minimal
Reversibility – High: 100% to 66%
Probability of Breakdown – Low but potential
Population – Non-clinical: labelled but not diagnosable
Ability to Learn – High
Goals – Increase competence and resistance to breakdown
Type of Involvement – Voluntary: many choices
Recommendations – “Could benefit by it” / “It would be nice”
Cost – Low
Effectiveness – High
Personnel – Lay volunteers and pre- and paraprofessionals
Types of Intervention – General, learning, strengthening, enrichment
Degree of Structure – High
Degree of Specificity – General and topical

CRITERIA – SECONDARY
Risk – High: in need but not critical
Reversibility – Medium: 66% to 33%
Probability of Breakdown – Medium but probably
Population – Preclinical and diagnosable
Ability to Learn – Medium
Goals – Decrease stress and chance of crisis
Type of Involvement – Obligatory: decrease in choices
Recommendations – ““You need it before it’s too late”/“Recommend strongly that you do it
Cost – Medium
Effectiveness – Questionable yet to be found
Personnel – Middle-level professionals
Types of Intervention – More specific to behaviour, that is, programmed materials
Degree of Structure – Medium
Degree of Specificity – Individualized

CRITERIA – TERTIARY
Risk – Very high: critical
Reversibility – Low to very low: 33% to 0%
Probability of Breakdown – High and real (actual)
Population – Clinical: critical and diagnosed
Ability to Learn – Low
Goals – Restore to minimum functioning
Type of Involvement – Mandatory: no other choices available
Recommendations – “It is necessary”/ “Nothing else will work”/“Other choices would be more expensive” (i.e. hospitalization, incarceration)
Cost – High
Effectiveness – Relatively low
Personnel – Professionals
Types of Intervention – Specialized therapy
Degree of Structure – Low
Degree of Specificity – Specific to the symptom

Primary prevention services are presented to more people, are less expensive, are more effective, contribute to positive outcomes and prevent more serious conditions.  They do not label or stigmatize individuals and families.