Developing capacity for integrated trauma-related behavioral health services for women: Start-up costs from five community sites

Violence against women is a growing public health concern. Many community agencies are interested in expanding their service delivery capacity to better meet these needs, but little information is currently available about the costs of implementing comprehensive services for women who have experienced various types of trauma. This article responds to this need by presenting findings from a study of start-up costs incurred by five regionally-diverse sites in the Women, Co-occurring Disorders, and Violence Study (Women's Study) during the initial two years of a 5-year federal demonstration grant. Using a cost-finding approach that included project-related expenditures without regard to the source of funding, information was obtained with a structured data collection instrument that was completed during in-person interviews with local project staff. Phase I start-up project costs ranged from $0.6 million to almost $1.2 million per site. Of the five sites, start-up costs were lowest in the two mixed urban/suburban settings, and highest in the two rural settings, where few of the project-related services had been in place prior to grant funding. Implications for public health interventions are highlighted.