Return on investment (ROI) is the holy grail of quality work, not just in the social services. It was heartening to read this week of a research study (also look here) showing ROI on providing quality mental health services in the foster care system. In this study, 90 youth with PTSD in foster care in Delaware who received state of the art trauma treatment cost the state $167,000 less in the subsequent year than a matched sample of youth with PTSD who received treatment as usual. That comes out to about $1800 a year in savings per kid.

As an aside, but of interest to folks like me,  they found that a very small number of kids were very expensive to serve. Three young people accounted for 27% of the total cost of services, by using very expensive high-end mental health services. This kind of finding is an extraordinary opportunity for quality improvement. If child welfare staff can identify the most expensive youth (or who looks like they are headed to being the most expensive youth) and figure out a way to safely serve them cheaper, there are substantial opportunities for ROI.

The study was published online (in the online first section) in what I call the journal with the bad name, Administration and Policy and Mental Health Services Research. The study was conducted by Delilah Greeer, Damian Grasso, Andrew Cohen and Charles Webb.