When the bough breaks: provider-initiated comprehensive care is more effective and less expensive for sole-support parents on social assistance

This 5-year study conducted in Ontario, Canada is designed to assess the ef fects and expense of adding a mix of provider-initiated interventions to th e health and social services typically used in a self-directed manner by so le-support parents and their children receiving social assistance in a nati onal system of health and social insurance. Results from a 2-year interim a nalysis show that providing social assistance families with proactive compr ehensive care (health promotion, employment retraining, and recreation acti vities for children) compared to allowing families to fend for themselves i n a self-directed manner, results in 15% more exits from social assistance within I year and substantial savings to society in terms of social assista nce payouts. It is no more expensive to provide health and social services in a comprehensive fashion, and equivalent reductions in parent mood disord er and child behavior disorders, as well as equivalent increases in parent social adjustment and child competence levels were also observed. This stud y presents clear evidence that providing comprehensive care to social assis tance recipients produces tremendous short- and long-term financial gains a nd societal benefits. (C) 2001 Elsevier Science Ltd. All rights reserved.