Why Impact Matters in Mental Health Philanthropy

Let’s start here:

Why Mental Health Matters

In my early twenties, I suffered severe depression. My life was otherwise wonderful. I had good relationships, engaging work, I was healthy, financially secure, loved my studies, and yet I felt a numbing, dreadful grey pall across everything I did. There were times I thought it would have been better never to have been born in the first place.

It was then I realised what many of us do when we go through a mental health crisis: if you don’t have your mental health, it doesn’t matter much what else you have. If your material and social circumstances are good, but you don’t feel safe in your mind, that feeling of unsafety goes with you everywhere. I was in an extremely privileged position, with a combination of therapy, SSRIs, and excellent friends getting me through that time. Though it’s never fully left me (the spectre of depression occasionally looms when I feel overwhelmed for too long), I know how to do the self care I need to stay grounded.

It’s this experience that has drawn me – like many others who have been touched by similar experiences for themselves or loved ones – to mental health as a cause. My experience is, sadly, all too common, and it is fair to describe our world as undergoing a mental health crisis. Depression is up, anxiety is up, loneliness is up. These are real people whose lives are marked by challenges that are truly difficult to imagine, even for those who have been touched by similar experiences ourselves. It is my view that mental health is amongst the most pressing problems facing the world today. If we secure our planet, solve AI, end pandemics, cure every disease of ageing, you name it, we’ll still need to ensure we’re not miserable.

Being a human is hard. Some of us are only just holding it together, most of the time. And we rarely talk about it. Many people recognise the importance of mental health, but shy away from engaging with it, due to stigma, fear or bad experiences. And I’m here to say that mental health is not a luxury, it is – excuse the Britishism – the whole bloody point. Unless we can stand up and prioritise these issues directly, we’ll continue to leave countless people suffering unnecessarily in the dark.

Why Philanthropy is Necessary

There are many problems that market-based solutions are ill-equipped to solve. In many cases, mental health issues are amongst them. Subscription-based interventions risk entering antagonistic relationships with their users, whereby the success for the company means keeping users around as long as possible, whilst success for the user means they no longer need the service. Whilst this isn’t insurmountable, my 8 years at the helm of a mental health app company made this challenge pretty clear.

Many mental health challenges have no clear profit motive to solve. A huge number of the world’s poorest people suffer from mental health challenges, their suffering is equally real and important, and their governments are poorly equipped – and in some instances motivated – to help. On average across member states in Sub-Saharan Africa, governments are funding less than 25% of the WHO’s recommendations for mental health care spending per capita, spending US $0.46 per capita as opposed to the recommended US $2 for low-income countries. If you want to help as many people as possible, then targeting the developing world makes a huge amount of economic sense (more on that later).

Charities and non-profits fill the gaps where for-profit companies can’t make a living and governments don’t have the resources to prioritise it. Some of the most impactful, world-improving interventions are funded entirely by philanthropic dollars. From practically eradicating Guinea Worm Disease in the 1980’s, to global efforts removing toxic lead from paint and spices as an ongoing effort today, some problems just require thoughtful and well-resourced people to say, “We can fix this.”

The Importance of Measuring What Matters

So suppose you’re on board, and you want to make a difference for this uniquely crucial area of impact. How do you know what actually works? For many, mental health is seen as some intangible thing, challenging to quantify, never mind measure. We faced this same challenge here at Bloom: how do we evaluate the impacts of our grants? Fortunately, we can stand on the shoulders of giants.

There is a vibrant community of academics, researchers and specialists in the field of “wellbeing economics”. This approach takes happiness seriously, and brings a scientific approach to the task of asking how we can measure, monitor and improve wellbeing. We’re particularly taken with a measurement framework called the Wellbeing Life Year (or WELLBY for short). It works like this: if I ask you how you’re feeling about your life on a scale from 0 to 10, and I can improve your answer to that question by one point for one year, I’ve created a Wellbeing Life Year. One beautiful thing about using WELLBYs is that it empowers each and every recipient of an intervention to reflect on how their life has been impacted: nobody makes judgements on their behalf. It also means we can use the same metric of improvement – how people feel about their lives – across radically different kinds of interventions. The WELLBY has even been taken up by the UK Treasury for evaluating the impact of policies.

Charitable organisations will always espouse the good they do. Measuring impact in terms of a common wellbeing metric gives us a powerful new way to see how much good they do. And we’ve put this into practice: when you evaluate organisations in terms of their WELLBY impacts, mental health as a cause looks exceptionally impactful – far more than even we originally suspected. When you empower people to tell you about their happiness, and you make it a part of the science of doing good, people will tell you what we have long known: that improving mental health fundamentally transforms lives in ways that are profound and long-lasting.

Strategic Giving for Mental Health

So how do we put this all into practice? For one, it puts an emphasis on understanding the landscape of impactful opportunities. And this is one major part of what we do – we seek out and build relationships with the organisations that create the most WELLBYs per dollar we can find (and if you know of some we don’t, we’d love to hear from you).

It means we frame philanthropy as starting from a place of exploration, seeking the best value opportunities for giving and then following the evidence wherever it leads us. And it means thinking like an investor: we’re used to thinking about financial ROI, but less so for philanthropic ROI. Thinking in terms of impact-per-dollar means we engage both the heart and the head; being driven by passions and guided by evidence.

It also means that when you think about making your money go further, then you can spend it where it makes the most economic sense. While mental health interventions are valuable in any context, the impact-per-dollar is often far greater in low- and middle-income countries, where even modest grants can lead to transformative improvements in wellbeing. For Bloom, that leads us to be particularly excited by proven models for scalable mental health support being transposed to LMICs where the same impacts can be achieved for much lower costs.

To wrap: we start by recognising the essential role of mental health, we identify philanthropy as uniquely well suited to addressing it, we figure out what it means to make measurable improvement with it, and then we build a strategy for working with experienced partners to deliver programmes on the ground. With even a small uptick in the number of donors thinking this way, we’re well on our way to building a true wellbeing ecosystem that can elevate hundreds of millions out of wellbeing poverty.