Time to Invest in Mental Health: Part 1

Written by GMH@Harvard Ambassador Board Members: Anna D. Bartuska, Sarah Coleman, William Kriebel

People worldwide are facing ongoing uncertainty and stress as a result of the COVID-19 pandemic, economic instability, and racial injustice. Prior to this year, research found that one out of ten people in the world had a mental health condition (with severe cases leading to a 10-25 year decrease in life expectancy). The cumulative burden of current events further threatens mental health and well-being worldwide. As a mental health wave looms, access to mental health services is limited with up to 90% of individuals not able to receive needed care in some low- and middle-income countries. 

Image from the #ReturnOnTheIndividual report released this year by the Speak Your Mind Campaign

Now more than ever, it is #TimetoInvest in mental health.

But what does it mean to invest in mental health and how do we—as individuals, communities, and societies—take action? To answer these questions, we spoke with Elisha London, co-founder and CEO of United for Global Mental Health. Motivated by her own experience recovering from Post-Traumatic Stress Disorder (PTSD) and chronic depression, Elisha aims to galvanize greater action for mental health so that everyone, everywhere has access to mental health support. Prior to founding United for Global Mental Health, Elisha was the Campaign Director for Heads Together, a mental health campaign spearheaded by Their Royal Highnesses, The Duke and Duchess of Cambridge and Prince Harry.

What does it mean to invest in mental health?

When we talk about investing in mental health we are often discussing finances, but Elisha London emphasized that investing in mental health is broader than the bottom line. “Investing in mental health really means looking at how individuals, business, societies, and funders are prioritizing action on mental health,” she stated. Investing can include each of us promoting and prioritizing our own mental health, businesses supporting the wellbeing of their employees, universities supporting their students and staff and governments allocating resources to prevent and treat mental health conditions.

ElishaLondon
Elisha London, Founder and CEO,
United for Global Mental Health

How has investment in mental health changed over time?

Recalling her professional experience in the past decade, Elisha noted that global mental health is a novel investment stream for many funders. Although individuals and organizations in a position to provide or support funding are likely to know someone who has suffered with a mental condition, a lack of historical precedent has stifled direct investment. Elisha shared insight to the reality that funding global mental health has previously not been on the minds of our local, national, and global investors, and changing mindsets that overlook mental health will take time. As a funding priority, progress on mental health has been limited by stigma, lack of available financial resources, finite human resource capacity, and prioritization of competing health concerns. Nevertheless, efforts emphasizing ‘no health without mental health’ and positioning mental health as a backbone of both emergency and long-term health systems strengthening efforts have helped support the integration of mental health into current priorities and funding streams.

When asked about the current state of global mental health funding, Elisha noted there continues to be a paucity of public dialogue on mental health. “Investing in mental health as we know it today began as a conversation in the research community and moved slightly to the political arena, but we have never had a strong citizen voice calling for action,” Elisha remarked. She further emphasized that the lack of public voice coupled with a need for more data continues to limit investments in mental health.

For future funding in mental health, Elisha suggests that we not only persuade governments to act but look toward the “new next generation of billionaires and new foundations” to help accelerate support, particularly for the non-profit sector. New funders and voices have already begun to emerge. Recently, Beyoncé and Jack Dorsey, the CEO of Twitter, committed $6 million to support mental health during COVID-19. As the dialogue continues to grow and advocacy expands the hope is for strong leaders in mental health funding to arise.

In 2018, when United for Global Mental Health was founded and hired their first employee, they only knew of one other organization that had funding for a professional with the job title of global mental health advocate. Since then the number of professional advocates has grown slowly and investments in mental health are increasing. Many organizations which historically focused on infectious disease, such as Partners In Health, have significantly expanded their mental health programs in the past ten years. Similarly, Sangath in India has been working in the mental health field since the 1990s but began to be internationally recognized over the past ten years for their work with children, adolescents, community health workers, and families. Momentum in the field of global mental health is reflected in increasing investments. According to the Institute for Health Metrics and Evaluation (IHME), US$160 million were invested in mental health in 2019—more than four times greater than a decade prior, but still a fraction of the US$9.7 billion invested in HIV/AIDS during the same year. 

How can we invest in mental health?

There are many ways that we can invest in mental health and all are needed. “Everyone has to invest in different ways and that has to cover promotion, prevention, treatment, and recovery,” Elisha encourages. These types of investments are critical to the expansion of dialogue and action around mental health.

As a growing movement and burgeoning field, the conversation around global mental health has begun to take root. As more individuals find their voice and share their own story, Elisha reminds us that we also must be ready to meet their mental health needs: “We need to make sure there is a supportive system.” This includes investments in innovative interventions, novel delivery platforms, and increased workforce development programs. The growing advocacy has also spurred investors to ask what works and how it can be scaled. To answer these questions, effectiveness and implementation research will be imperative. Addressing the research community, Elisha encourages individuals to “look for the things that the world really needs answers to.”

When founding United for Global Mental Health, Elisha and her team asked, “Where are the gaps? How can we fill them with the skills we have?” Today, we can ask ourselves the same question. Whether you are a researcher, clinician, person with lived experience, student, or organization member—consider how you can prioritize mental health.

The GlobalMentalHealth@Harvard Initiative, will be releasing a mini-series to highlight ways to invest in the mental health of our communities and ourselves during COVID-19, and encourage further discussion about the return on investment in mental health. In upcoming articles, we will be featuring different ways individuals within our communities are investing in their mental health. Let us know how you have been prioritizing investing in your mental health by tagging us on Twitter @GMHatHarvard or emailing us at gmh_admin@hms.harvard.edu.

One way to prioritize mental health today is to add your voice to the rapidly growing global movement for mental health advocacy. Speak Your Mind powered an Open Letter calling on world leaders to protect and scale up mental health support in all COVID-19 responses both now, and for the future. We invite you to invest in mental health by adding your name to the letter. And to learn more about mental health and COVID-19 you can join this webinar series organized by UnitedGMH and partners. 

Image from the #ReturnOnTheIndividual report released this year by the Speak Your Mind Campaign

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Authors:

Anna D. Bartuska, Program Coordinator, Community Psychiatry PRIDE, Massachusetts General Hospital 

Sarah Coleman, Cross-Site Mental Health Officer, Partners In Health

William Kriebel, Master’s of Liberal Arts Student at the Harvard Extension School, studying Management. Certified Peer Specialist, Boston Medical Center