See How MST helps Essex County Teens

Young people in the U.K. who enter social care typically have poor outcomes. They are more likely to re-offend, be suspended from school, and be unemployed by the time they turn 19. Out-of-home placement is also expensive for local authorities. They are responsible for children’s social care, but investing in prevention in times of austerity is challenging.

In 2012, there were 1,600 children in care in Essex County, and the number had risen by 28 percent over the previous five years. Essex County Council wanted to commission service with an evidence base for working with this group but was not in a position to take on the financial risk of failure. They decided to try Multisystemic Therapy (MST) to work with adolescent children on the verge of out-of-home placement. Two teams would handle 380 young people over five years. MST itself was not new to the U.K. What was new was a form of social investment called a Social Impact Bond (SIB). 

Michigan can reduce its $2-billion state prison budget partly by diverting juvenile offenders to treatment.

When Michigan Gov. Rick Snyder decided to present his ambitious plan for justice reform, he chose Goodwill Industries of Greater Detroit, which makes it a practice to hire former convicts, as his setting. He also chose to have representatives from the Livingston County juvenile court and a Multisystemic Therapy (MST) supervisor from Highfields, Inc. in attendance. Snyder’s staff learned of the court’s success in implementing programs that help kids, programs that save money.

Parents hold the key to turning their children around, MST helps unlock the door

Imagine this. You hear that two teenagers in your neighborhood are caught shoplifting. They are accused of stealing more than $1,000 worth of merchandise from a nearby department store. This isn’t their first offense, either. You heard they were caught breaking and entering cars and a neighbor’s home. You think they are even involved with drugs. Given this new arrest, they are facing the threat of being locked up for their crimes. Your first thought is “their parents are to blame. They should have taught their kids better.”

There is no debate that juvenile crime is of great concern in the United States. According to the FBI, youths younger than 18 commit almost 20 percent of all serious crimes, 13 percent of violent offenses, and 20 percent of crimes involving property. It’s also been found that a single lifetime of crime amounts to a $1.3 to $1.5 million burden on society. Knowing that makes it even more imperative to keep adolescents from becoming habitual criminals.

Where there is debate is how to deal with this problem and where to allocate funds earmarked for it. There are many who lean toward paying as little as possible upfront. Policymakers and those who sign the checks are under pressure to come up with programs that reduce crime without draining the budget. Often, they choose individual therapy instead of a program like Multisystemic Therapy (MST). What they overlook is the long-term savings when a treatment such as MST is implemented. It has been shown that youths commit fewer crimes following MST. That means lower future expenses for taxpayers and crime victims relative to the expenses associated with individual therapy.

We, as a nation, are sometimes riveted to something in our popular culture that we can’t stop talking about it and wait anxiously for the next episode or revelation. We speculated about Walter White’s motivation and moral compass as we collectively watched “Breaking Bad.” We repeated snippets of dialogue and mourned many deaths on “Downton Abbey.” Today, it’s not a TV show that has captured our national attention. it’s a podcast, “Serial.”

For many listeners, it’s a true “Did He Do It?” Did Adnan Syed, then 17, kill his former girlfriend? Did he, along with a small-time drug dealer named Jay, drive her body and ditch it in a park, as Jay told the police? Or was Syed at a library across from his high school, as one witness named Asia, who was never called to testify, maintains?

It’s a murky, complicated 15-year-old case that sent Syed, declaring his innocence, to jail for life. Most people were drawn to the podcast because of the mystery and anticipation for the next installment. They have theories about the case and how information was highlighted or downplayed, based on personal perspective. The Marshall Project interviewed legal minds right before episode 11, and it’s no surprise that lawyers leaned toward explanations and theories that were consistent with whether they “played offense or defense.”   I am drawn to it, in great part, because I filter everything through my MST lens.

Mental Health Services Conference awards MST a Gold Achievement 

Police in Western Australia described 2013’s 53-percent drop in serious juvenile crime as “extraordinary.” One explanation given for the decline is the expanded use of behavior-management programs. One hundred and sixty of the 297 offenders being handled by youth crime intervention officers were assigned to a program. These 160 youths accounted for 1,098 offenses costing taxpayers $2.5 million. Since being placed in interventions, the number of crimes committed by them dropped to 471.

"Besides the cost-benefit, addressing the underlying issues of these young people has now been shown to reduce reoffending,” said Western Australia acting police inspector Mark Fleskens said.

Identifying an individual solution for each family

"I don't know what to do with her anymore." Ms. Martinez and I sat knee to knee on her black vinyl couch. "Maybe she would be better off living somewhere else. A place where she has lots of rules."

Ms. Martinez's words may have seemed callous but sending her daughter away appeared to be the only viable option to keep her safe. I placed my clipboard on the seat next to me and looked at her face. "I know how overwhelming this all seems right now. We know Gabriela is using drugs, not going to school, and maybe involved in a gang. Sending her away might make some problems go away temporarily but what will happen when she comes home to the same environment? I think we have a better chance of helping Gabriela by looking at all the pieces of the puzzle." 

I knocked on a family’s door. The mother answered, simultaneously shoving the dog aside with her foot and pushing a stack of papers into my hands. Her hair looked rumpled and she wore the same blue t-shirt from the day before.  

“Miss  Longo, the system is broken!” she shouted up at me. I looked at the papers and noted her welfare case had been closed again. The family’s entitlements would be suspended until she endured another full-day battle just to begin the process of reapplication. I could feel her looking at me expectantly. My eyes met hers and I raised one side of my mouth in shared disappointment. “Frustrating,” I said. “I wish you didn’t have to go through the whole process again.”

Evidence-based practice, evidence-informed practice, practice-based evidence . . . to the average Joe, these all sound so much the same that most folks just quit listening and do what is easiest. I am referring to how communities decide which services we deliver to children and families and how they determine whether something actually works, or more importantly, does not. If the information was clear and better options available, wouldn’t most people choose what works and stop choosing what does not? Unfortunately, this is not necessarily the case. 

Full disclosure first. I work for one of the top evidence-based practices in the United States (and 14 other countries)—Multisystemic Therapy (MST). Some might ask, doesn’t that skew my perceptions? To which I would answer, maybe, but it also gives me an inside look at the problems and solutions offered by these treatments. I see a close-up of their efficacy. I see their work. And that’s what this article is all about.