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November 2014

Social Impact Bonds: Behavioral Health Opportunities

Author Affiliations
  • 1Division of Public Behavioral Health and Justice Policy, Department of Psychiatry and Behavioral Sciences, University of Washington, School of Medicine, Seattle
JAMA Pediatr. 2014;168(11):985-986. doi:10.1001/jamapediatrics.2014.1157

The past 2 decades have seen remarkable growth in the development of cost-beneficial, evidence-based programs in pediatric health, behavioral health, youth juvenile justice, and child welfare. Despite the economic and system constraints that have slowed broad dissemination, research-proven approaches have exceptional potential to improve population-level well-being while simultaneously protecting society from the burdensome costs of failing to treat the problems they target.

There are examples of the positive impacts of these interventions nationwide. The Regional Asthma Disease Management Program at Mission Children’s Hospital in North Carolina has improved respiratory outcomes and school attendance while simultaneously reducing costly emergency department visits and hospitalizations.1 Nurse home-visiting programs have shown benefits in behavioral health, substance use, and academic gains among high-risk children years after the intervention was completed.2 Intensive family-based psychosocial treatments such as Multisystemic Therapy, Functional Family Therapy, and Multidimensional Treatment Foster Care effectively reduce reoffending and avoid youth incarceration,3 while Homebuilders, a family-based child welfare intervention, reduces removal rates of children referred to Child Protective Services.4

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