Funders key role in global mental health advocacy

In the global debate about how best to support the one billion people around the world who are living with a mental disorder, the role of philanthropy to go where governments cannot has come into sharper focus.

Governments in Australia - particularly Victoria - has garnered recent attention with budget announcements to provide support to the thousands of Australians who have felt the mental health impact of the COVID-19 pandemic.

Elisha London, the Australian-born Founder of the for-purpose organisation United for Global Mental Health, is keen to laud her homeland’s performance on mental health: “As Professor Shekhar Saxena says, every country is a developing country when it comes to mental health, though do I think Australia is a shining light.  The recent commitment from the government to acknowledge the system is broken is progress, and now needs to be followed up with action,’’ she says.

More than 80 percent of people with a mental health disorder live in low- or middle-income countries, where more than three-quarters of people (75 percent) with mental health disorders receive no care at all, according to the WHO. In Sierra Leone, a nation of seven million people, there are only two psychiatrists, two clinical psychologists and 19 mental health nurses. Health experts estimates that a quarter of 44 million Kenyans have a mental health issue, but the government only spends 0.05 percent of its health budget on the issue. Closer to home, it was only several years ago that Papua New Guinea had seven psychiatrists – in comparison, Australia has three times the population but 300 times the number of psychiatrists.

In theory, at least, higher-income countries such as Australia should be better placed to deal with mental health initiatives, programs and support. And yet, governments typically spend only about two percent of their health budgets on mental health, well below the recommended 5 percent in low income countries and 10 percent in high income countries. That confronting statistic suggests there is an opportunity for philanthropy to provide some much-needed help.

Once again, the data is instructive – mental health only receives 0.5 percent of all global philanthropic health funding, the lowest proportion of any branch of health. And here again Australia shows some leadership - $170 million in philanthropic funding spent on mental health, compared to $160 million globally. Still, there is a long way to go.

“Mental health hasn’t been a priority for global funding,’’ Elisha says. “And that was one of the main reasons for establishing United for Global Mental Health.’’

But now, there is an impetus as well as an opportunity for philanthropy to change that. And perhaps ironically, its governments doing more about mental health that can actually create a platform for that to happen.

Consider the Victorian example. Last year, the Victorian government committed to implementing all 65 of the recommendations from the Royal Commission it had established into the state’s broken mental health system. Following on from that commitment, its recent budget committed to levying businesses across the state to fund $3.8 billion in mental health initiatives.

In the face of such an approach, there may be a temptation to accept that government by itself has the issue covered. Not so, Elisha says, especially when it comes to the often-difficult work of advocacy and accountability. She cites the powerful advocacy undertaken by Orygen Executive Director, Professor Patrick McGorry, as an example of how Australia has helped shift the mental health debate, and the broader philanthropic support that enabled Orygen to scale up its work with young Australians.

“Where is it that philanthropy can go where governments can’t?’’ she asks. “Advocacy is critical at this time. For example, a strong citizen movement. The accountability piece needs to be philanthropically funded, including campaigns that mobilise citizens to hold governments to account.’’

And it could also cover the hard work of advocating for other governments – in other states, as well as globally – to hold royal commissions or inquiries to frame a response and a set of recommendations about fixing mental health services. “This provides a massive opportunity for philanthropy to make a difference,’’ Elisha says. “It feels like the opportunity for a once in a generation movement to prioritise and address mental health … and it’s up to all of us to ensure that it’s done.’’

But if there’s one group of philanthropists who increasingly appear to have the motivation – and arguably more direct experience of the problem within their generation – it is the younger and emerging cohort of young philanthropists.

A recent United for Global Mental Health report in partnership with NM Impact and Arabella Partners in to the how next-generation philanthropists can transform mental health funding, identified the distinct characteristics of this group of potential funders: “Next-generation philanthropists tend to demand transparency, want to be more metric driven, collaborative and have high impact.’’

There are clear challenges for this cohort – that progress in mental health is not always clear cut or measurable, which can be a disincentive for some potential funders; investment solutions can be fragmented or disconnected from other government mental health initiatives; conventional power dynamics that can prevent philanthropy from supporting smaller, community-based organisations; and the tension between a philanthropist’s personal interests and local needs.

But the report concludes: “Philanthropists have the opportunity to make revolutionary changes to global mental health and to directly impact the lives of millions of people.’’

For Elisha, her inspiration about the potential for next generation philanthropy to support mental health issues comes from close to home.

“This kind of approach is not written into the traditional philanthropic mandates, and the system is really hard to change,’’ Elisha says. “This generation has less stigma about mental health, and I’m encouraged by that and the attitude of people like Jon Myer (Principal at Social Ventures Australia, Associate Director at Orygen Digital and member of The Myer Foundation), who has a great saying: “Money for the mind, is money you can’t afford not to find.”

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