The social safety net has not been adequately adapted to address today’s greatest health and social challenges, including chronic illness, dementia, autism, chronic poverty, and homelessness, among others. The queues, overcrowding, wait times, and worrying statistics demonstrate this. These problems result largely from the fact that the existing social safety net operates on a late-intervention principle. This means, as a general rule, that the individual facing difficulties will only get access to state or state-sponsored support after all other recourses and resources to deal with the issue have been exhausted. As the individual or family tries to work through a problem in isolation, the situation (e.g., health condition, addiction, job trouble, family trouble) often deteriorates. When the deterioration reaches a critical stage, the state is usually able to step in and provide support. Sometimes it doesn’t step in, even then. The point is that a Canadian or a Canadian family has to fall a long way to be caught by the existing social safety net.

The intention of this book is to make the case that we need a different approach to addressing the health and social challenges Canada is facing. It looks in detail at six different parts of the social safety net and contrasts the status quo approach to each, namely late intervention, against research that shows how a different approach, namely early intervention, holds the promise of producing better results.

The term “early intervention” has been defined many different ways. It is commonly used to describe programs for children up to six years of age. This is not how it will be used in this book. Instead, it will be used more expansively to describe any measure designed to address a potential or emerging problem at the earliest opportunity before it is able to escalate into a graver challenge. As such, early interventions can be designed for any point in the course of a person’s life. They can also be deployed across all aspects of the social safety net. Prevention efforts designed to benefit the entire population, such as vaccination programs, are included in this definition as much as interventions of a more targeted nature, such as income supplements for seniors with low incomes.

Early intervention is not an original idea or a new concept. It is an extension of the adage that “an ounce of prevention is worth a pound of cure.” What is new in this book is the proposal that early intervention methods be applied across the entire network of health and social services as the system’s prime directive. In doing so, I hope this work adds to the important debate about how to reform and reconstruct Canada’s care systems in ways that are truly world-class.

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Excerpted from Early Intervention: How Canada’s Social Programs Can Work Better, Save Lives, and Often Save Money (Lorimer, 2015). © James Hughes 2015. Used by permission.

James Hughes
James Hughes is the president of the Graham Boeckh Foundation in Montreal. He was deputy minister of social development for New Brunswick.

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