Mental health report

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▲ Photo by Ashley Batz on Unsplash

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This is an executive summary of our investigation into mental health

Read the full report

Please note this page was last updated in 2019. While our overall views remain unchanged, some details may be out of date.

Mental illnesses such as depression, anxiety, and dementia are a daily reality of suffering for millions of people across the world. In total, mental health, neurological and substance-abuse (MNS) disorders account for 10.5% of the global disease burden, second only to cardiovascular disease. In addition to their health and wellbeing costs, MNS disorders impose a large economic cost: a 2012 report estimated the annual global cost of mental health conditions at $2.5 trillion. Lastly, there is still a large stigma on mental health: those suffering from mental health problems often face marginalization at both the social and institutional level.

Our process

Our research produced three key findings, which helped to guide our search for impactful charities:

1. Mental health is chronically neglected, especially in low- and middle-income countries

Most low- and middle-income countries spend less than US$2 per year per person on the treatment and prevention of mental disorders, compared with an average of more than $50 in high income countries, and international aid has done little to fill the funding gap. As a result of this funding gap, the treatment gap – the proportion of mental illness sufferers that go untreated – in low- and middle-income countries is much greater than the treatment gap in high income countries.

2. There is a strong case for task-shifting in low- and middle-income countries

There is currently a severe lack of mental health practitioners in most developing countries. This lack of skilled personnel means that resource-intensive mental health interventions in developing countries are often not suitable. In this context, development economists and public health practitioners have called for the increased use of task-shifting in countries without the necessary skilled personnel. Task-shifting refers to specialized tasks being undertaken by people with a lower level of training than physicians or psychiatrists. The existing evidence suggests that task-shifting is effective and lowers costs significantly.

3. Evidence generation is of high priority

There is limited evidence on the effectiveness of mental health treatments in low- and middle-income countries. It is therefore crucial that charities working in the space try to generate new evidence.

Our charity search was guided by these key findings. Other things equal, we preferred charities which work in low-income countries, engage in task-shifting, and seek to generate evidence.



Following a search through over one hundred mental health charities, we decided to recommend StrongMinds as the best donation opportunity in the space that we were able to find.

What do they do?

StrongMinds implement Interpersonal Group Psychotherapy (IPT-G), training laypeople to treat women suffering from depression in Uganda.

Does the intervention work?

Evidence for the efficacy of IPT-G in low-resource settings comes from two randomized controlled trials (RCTs) and StrongMinds’s own quasi-experimental impact assessment.

Is the intervention cost-effective?

We estimate that StrongMinds prevent the equivalent of one year of severe major depressive disorder for a woman at a cost of $200–$299, with a best guess estimate of $248.

What are the wider benefits?

There are indications of improvements in employment, nutrition, physical health, housing, and children’s education.

Are they a strong organization?

They have a good track record and a strong focus on generating evidence. They are transparent about their mistakes and lessons, and are committed to continuous improvement.

Is there room for funding?

StrongMinds could productively use an extra $5.1 million in funding through 2020.

About the author

John Halstead

John Halstead

Former head of Applied Research

John is the former head of Applied Research at Founders Pledge. He spent the previous last four years researching climate change catastrophic risk, including writing a detailed report for the Finnish Ministry of Foreign Affairs, and supporting background research on climate change for the leading book on existential risk, The Precipice by Toby Ord.

John has a deep knowledge of both the science and policy challenges of climate change, authoring our 2018 Climate Change Report, which was covered by Vox and the New York Times.