Value of early intervention

Underfunded services with high staff turnover, along with ‘‘changing political, policy and funding climates’’, are among barriers to the proper implementation of prevention and intervention strategies.

‘Prevention is better than cure’’ is one of those cliched maxims many of a certain vintage grew up with, but perhaps never fully appreciated. But the underlying wisdom of that sentiment across a range of practical applications is coming into sharp focus. In the past fortnight, two important documents addressing areas of major concern in our society have been released, and both have stressed the vital importance of early intervention in preventing, or at least lessening, serious downstream consequences.

Last week, the report into a mental health inquiry that ran for much of this year strongly made the point that mental health strategy had too narrow a focus; primarily on treating illness, and not enough on intervention to prevent those suffering distress from tipping over into crisis. This issue was partly a function of inadequate funding.

Now a discussion document on reducing family violence, by Dr Ian Lambie, chief science adviser to the justice sector – made up of the Ministry of Justice, Department of Corrections and police – has made a similar point in another sphere, emphasising strongly that young children who are exposed to family violence are most at risk of becoming perpetrators of such violence themselves as adults.

Juliet Gerrard, the prime minister’s chief science adviser, points out that the paper, which addresses family violence as a community problem, rather than an individual one, is ‘‘not intended to present a definitive opinion’’ but to encourage more public discussion.

The document, entitled Every four minutes: a discussion paper on preventing family violence in New Zealand, is the third in a series released by Gerrard’s office, but the first since her appointment, exploring the factors that have contributed to the high prison muster.

It talks of the importance of early intervention, and the ‘‘need to understand the importance of childhood and the lifelong, preventable impact of adverse childhood experiences’’.

Like the mental health report, it sounds a hopeful but cautionary note. ‘‘Prevention of family violence is possible,’’ it says, but in laying out some of the challenges that will have to be overcome in order to do this, makes clear that resourcing, and thus funding, issues will have to be addressed. Underfunded services with high staff turnover, along with ‘‘changing political, policy and funding climates’’, are among the barriers it lists to the proper implementation of prevention and intervention strategies.

Given the context in which it was put together, as part of a series of discussions on addressing the high prison muster, a best-case scenario would see the kind of intervention the discussion document promotes lowering the funding levels required to support the prison population, and creating an ability to direct those towards preventive, earlyintervention strategies. That would represent a culture change.

But that’s a fairly long-term equation, and in the interim, the funding would have to be found to address both needs. However, if the prize is significant reductions in both family violence and in the prison population, that is surely a price worth paying.