Why we have to invest in prevention and earlier intervention if we want change
With less than two per cent of government spending on the prevention of social and health issues, and services typically only available where the need is acute, it is understandable that charities do what they can to respond to the most urgent need that their resources allow.
The interrelationship between the crises means that a worsening of one or more exacerbates another, and there is a domino effect. For instance, the rise in family and domestic violence fuels homelessness, mental health issues, child abuse and poverty, and weakens social cohesion.
Growing poverty and disadvantage lead to higher rates of family and domestic violence, child abuse, homelessness, mental health issues and lower social cohesion.
Increasing mental health issues generate poverty and disadvantage, homelessness, child abuse and lower social cohesion, which only lead to the escalation of the mental health issues in a vicious cycle.
In this crisis maelstrom, our charities are simply trying to keep up with the urgent day-to-day needs of those most at risk. In the words of the founder of the Brotherhood of St Laurence, Father Tucker, we are rushing ambulances to the bottom of the cliff, rather than building the fence at the top.
Despite every dollar invested in preventive health saving an estimated $14.30 in healthcare and other costs, and health expenditure in Australia being 70 per cent higher per capita than the OECD average, preventive health only accounted for 1.3 per cent of that total compared to an average of 2.8 per cent in OECD countries.
Whether it is preventing recidivism for young people leaving incarceration with in-prison qualifications, intervening earlier in family violence with ‘wrap around services’ to prevent domestic violence and family breakdown and children going into child protection and homelessness, reneging school leavers to complete their education and enabling a pathway to a job, or better designed neighbourhoods and capacity building for community groups to enable stronger social cohesion for less social isolation and mental health issues, we know that investment in prevention and early intervention realises multiple returns.
But in Australia, we are spending more to intervene later. For children and young people, the cost of ‘late intervention’ crisis services until 24 years of age has increased by nearly half in the last five years to $22.3 billion. Spending on child protection comprises 43 per cent, followed by youth crime and justice (22 per cent), youth unemployment (11 per cent) and youth homelessness (8 per cent)[i].
As the Grattan Institute points out, ‘experience here and around the world shows that when budgets are cut, prevention is often the first on the chopping block. Prevention is less painful to slash than other kinds of healthcare, because the payoff from prevention spending is in the future, when current Treasurers and Ministers will be long gone’[ii].
[i] O’Connell M (2025) The Cost of Late Intervention 2024, The Front Project, Melbourne
[ii] https://grattan.edu.au/news/cuts-to-preventive-health-are-a-false-economy/
