The four strategies and their associated models outlined in this guide represent high-impact philanthropic opportunities to address mental health disorders and SUDs. They are backed by a wide range of evidence, and many have been analyzed for their cost-effectiveness.
However, philanthropy is also uniquely positioned to fund riskier efforts. Political considerations, including the need to be accountable for taxpayer dollars, constrain government-financed efforts, while businesses that provide life-saving products and employment opportunities to communities need to provide a financial return to their owners/shareholders. Philanthropic funding, on the other hand, has supported goals long before those goals were politically popular and where there was no clear opportunity to turn a profit. In other words, philanthropy can serve as ‘risk capital’ for society, funding efforts that are too risky for any government agency or business to fund, but where success means a high social impact.
Here we provide examples—and hopefully inspiration—for how philanthropy might create a new normal by funding opportunities where a deep evidence base has not yet been assembled, but where the potential for transformative change exists.
Improved Understanding of Mental Health Disorders and SUDs
Donors can support opportunities that increase our understanding of the brain or that bridge the gap between science and implementation. Funders can also support the development and use of open data-sharing repositories, digital approaches to data collection and delivering care, research driven by community-based practice, or multidisciplinary research (e.g., neuroimaging specialists and psychiatrists working together to understand changes in the brain).
Promotion of Health and Well-being
Given the increasing rates of depression, suicide, and overdose death, there is a clear need to address the root causes of this crisis and promote population-level health and well-being. Donors can draw on lessons learned from public health approaches to other crises, such as smoking, obesity, and cancer. These approaches prioritize population-level literacy and promote prevention and early detection. Programs in schools, workplaces, and the media that teach people to care for their mental health with stress management, exercise, and self-care, along with practical information on what to do in times of need. Education and public information programs have been shown to increase mental health literacy and help seeking-behavior, and reduce stigma.
Cost is the most commonly cited barrier for not using mental health care services. More than 10% of people with mental health disorders and SUDs do not have access to insurance, and many more do not have affordable insurance that covers all necessary care. These issues are exacerbated by insufficient reimbursement rates. Funders can call for better enforcement of parity between the costs associated with mental health disorders/SUDs and other health care, for insurers to reimburse providers appropriately for the cost of services, or expand coverage allowances for patients (e.g. longer term residential treatment, so no one is discharged arbitrarily). In addition, payment structures that are linked to measurement and outcomes (e.g. value-based purchasing) can incentivize the delivery of better-quality services and the broader financial coverage—and therefore use—of evidence-based practices.
Reimagined Care Delivery
Philanthropy could equip a wider range of community members with the skills and resources to recognize and support those with mental health disorders or SUDs. Funds could also help embed mental health providers in schools, houses of worship, jails, and other locations in the community, or support digital tools and new technologies. While there are ethical concerns that need to be reviewed, new mobile and bio-based technologies (such as wearable devices that track mood) show promise in providing effective personalized relief of anxiety and depression.
New Social Norms
Stigma and societal attitudes are a significant barrier to accessing care for a mental health disorder or SUD. Stigma includes general public prejudice or discrimination, self-stigma, and structural stigma that is entrenched in our social systems. Fear of prejudice or discrimination is the third most frequently cited barrier for not accessing care for a mental health disorder or SUD. Philanthropy can support programs that foster public discourse through the use of accurately portrayed personal stories and images.