Scaling Up Behavioral Health Promotion Efforts in Maryland: The Economic Benefit of Positive Behavioral Interventions and Supports

Positive Behavioral Interventions and Supports (PBIS) has been shown to be a promising approach for improving a range of behavioral health and academic outcomes for youth. This study leveraged data from the scale-up of PBIS and a randomized controlled trial, both conducted in Maryland, to estimate the dollars saved per 100 students as a result of the reduced discipline problems and mental health concerns, and improved academic performance associated with PBIS. Shadow pricing results indicated that the largest cost savings were associated with improvements in standardized test scores ($138,658 for elementary and $71,444 for secondary). Reductions in elementary students’ aggressive and disruptive behavior, as well as bullying behavior, were also significant sources of cost savings ($166,028 in total). These cost-saving benefits are complemented by separate benefits associated with a reduction in suspensions ($33,415 for elementary and $11,361 for secondary). Other findings regarding student truancy, office discipline referrals, and mental health concerns are also reported. Taken together, these findings illustrate the broad cost savings associated with PBIS Tier 1 implementation and scale-up. We conclude by considering how the statewide scale-up of PBIS can translate into cost savings across multiple agencies.