Cost-effectiveness

International and UK research indicates that MST is a cost-effective intervention as evidence suggests it reduces the cost of placing children out of home and also costs associated with offending and anti-social behaviour.
 
Data from the Washington State Institute for Public Policy indicates that the savings from implementing MST are between $12 and $28 for every $1 of spend (Aos et al 2001). Data also indicates that the outcomes of MST are sustained over time, with the longest follow up study now following people up to 22 years post intervention.
 
Audit data from existing MST sites in England supports these findings from the USA, suggesting that MST provides cost savings in terms of out of home placement, offending costs, police time and educational provision.
 
An Economic Evaluation of Multisystemic Therapy for Young People at Risk for Continuing Criminal Activity in the UK was carried out by Maria Cary & Sarah Byford at King’s College London, based on data from a randomised controlled trial conducted at the Brandon Centre in North London.
 
Focusing on costs and savings in terms mainly of offending costs, they found that, in comparison to usual care:
  • MST reduced criminal activity and saved £2290 per young person over two years of follow-up;
  • MST reduced the need for youth justice services and saved £1217 per young person over two years;
  • MST cost £2285 per young person, but saved a total of £3,507, resulting in overall (net) savings of £1222 per young person over two years. 
These findings were consistent over time, and showed the same pattern of results when 3-year data were analysed.
 
This study presented some methodological limitations as data were limited to youth justice related costs and the analysis was limited to cost savings, ignoring the impact of MST on outcomes for young people.
 
The Department of Health, in conjunction with the Department for Education, is funding a pragmatic multi-centre randomised controlled trial (the START trial) to evaluate the effectiveness and cost-effectiveness of MST in a UK context. This trial involves nine pilot sites and 684 participants have been recruited. The final results will be available in 2017.