This article was originally published in the magazine of Via Clarita, a Czech philanthropy advisory group with which RPA has previously partnered. Donzelina Barroso is a Director of Global Philanthropy and Rena Peng is an Advisor at Rockefeller Philanthropy Advisors.

Across the globe, mental health came into sharper focus during the COVID-19 pandemic. As a result, mental wellness generally has become better understood as an important component of the overall wellbeing that donors wish to foster in the communities they serve. Mental health needs are diverse and have not received the widespread support they deserve. Recent data from Candid shows that in the United States, for example, foundations support less than two (2) percent of total mental health funding.[1] There is ample room for growth, both in the United States and abroad.

For those interested in supporting mental health, the field is vast and there is opportunity for donors of all kinds. Recent global research, for example, has shown the COVID-19 pandemic to be a leading cause of distress among teens and young adults. And in the United States and elsewhere, LGBTQ+ youth are at increased risk of self-harm and even suicide. Suicide has also been a pronounced problem in the U.S. military, and among families with financial hardship. There is also a need for mental health support for family members whose loved ones are in hospice care, and for those who serve as caretakers for family members. And surprisingly, among medical professionals, veterinarians suffer among the highest rates of suicide. Mental health of course also includes clinical diagnoses such as depression and other mental illness. There really is something for everyone.

Getting Started

For those who wish to engage more directly in mental health philanthropy, RPA suggests the following:

• Are there mental health needs in the communities you are already serving? Perhaps you could add mental health as a component of your existing portfolio
• Speak with organizations you trust to learn what they are seeing on the ground
• Is there a mental health organization already working in your community? What are they doing? How might you be able to support their efforts?
• Learn what other donors in your area/with your same interests may be doing to support mental health. This will help field opportunities to leverage impact through collaboration, understand gaps, and avoid duplicated efforts
• If you are inclined to start a new program or create an organization, ensure you have a very clear set of goals and an understanding of long-term costs. Are you willing to take this on by yourself, if needed?

Approaches

Once you have a better understanding of the need and the current responses in your area of interest, consider the following ways you could help promote mental health. We include here some U.S.-based examples for your consideration:

• Direct Service: efforts by clinical professionals, nonprofits, and family and community members to prevent severe depression, anxiety, and stress and to help alleviate suffering. An example of a direct service organization is Crisis Text Line, which provides free, 24/7, confidential text messaging service for people in crisis, staffed with peers particularly focused on teens and young adults.
• Awareness: raise awareness and address stigma related to mental health, often through campaigns and public messaging efforts. An example of an organization focused on awareness work is The JED Foundation. JED produces a range of free, digital campaigns and resources to educate the public on mental health issues and to reduce the shame and stigma often associated with these topics.
• Advocacy: advocating for changes to public policy to improve mental health care (i.e. increases in government funding for mental health research, laws requiring mental health parity). The American Foundation for Suicide Prevention, along with other programming, provides up-to-date information on state and federal bills related to mental health and coordinates public policy events bringing together advocates from every state to urge public officials at all levels of government to prioritize suicide prevention and mental health.
• Research: attempts to understand why depression and anxiety occur and how to effectively intervene through a variety of psychiatric and scientific efforts. One example is the Brain & Behavior Research Foundation, which is committed to alleviating the suffering caused by mental illness by awarding grants that will lead to advances and breakthroughs in scientific research.
• Broader Efforts: Funding a regional or national coalition or association is one way to support breadth and coverage while still engaging in some level of direct service. The National Alliance on Mental Illness (NAMI) is a national organization with over 600 local chapters providing mental health support, education, and public awareness.

Spotlight Projects

Below are two innovative initiatives in the U.S. – the first by a private foundation and the second by a nonprofit – whose work focuses on improving mental health systems.

Decriminalizing Mental Health

The Sozosei Foundation’s work focuses on eliminating the use of jail and prisons for the diagnosis and treatment of mental illness. Although mental illness is not a crime, the reality is that many individuals receive their first diagnosis of mental illness in jail or prison, and many of these institutions are not able to meet the mental healthcare needs of those incarcerated. The Foundation is currently focused on the following priorities:

• Implementation of 988, a nationwide crisis hotline number effective July 2022
• Scale evidence-based practices that divert people with mental illness from the criminal legal system to mental health care services in their community
• Increase the size of the mental health workforce by strengthening training, support, skills, and compensation required to do the work
• Support the passage of Medicaid Reentry Act, which would ensure continuity of care from prison to community by continuing benefits reimbursement for services received 30 days before an individual is released, allowing providers to avoid a gap in coverage upon an individual’s return to the community

U.S. Insurance & Mental Health

Studies show that insurance coverage for behavioral health office visits is often inadequate. A 2019 report found that a behavioral health office visit is over five times more likely to not be fully covered by an insurance plan than a primary care appointment. A 2016 report also found that people had more difficulty finding providers and facilities for mental health care covered by their health insurance compared to general or specialty medical care. Inadequate insurance coverage results in higher prices for treatment and limited choices for services.

The Northeast Business Group on Health (NEBGH) is leading a private sector approach to improving mental health care for Americans by addressing the lack of parity in mental health insurance coverage. The project brings together employers, health plans, providers, and other stakeholders to look at the cost of care and to work towards accessible mental health care across the country. In partnership with other regional organizations around the country, NEBGH aims to leverage the power that employers have as purchasers of healthcare to drive change across the system. Employers, both private and public, purchase and pay for more than half of all healthcare in the U.S. As such, NEBGH is organizing the purchasing power and concentrated advocacy of its employer-purchaser members in collaboration with health plans and care providers to achieve comprehensive care and parity in the mental health and substance use system in the New York region. The project has the following five major priorities:

• Enhance access to behavioral health services
• Expand tele-health
• Integrate behavioral health and general medical services (collaborative care model)
• Implement measurement-based care in mental health care
• Achieve parity in coverage and reimbursement rates for mental health services

Creating Impact through Best Practice

Mental Health is a complex topic that requires long-term support and multi-sector partners. If there are needs in your communities of choice, as the above examples illustrate, philanthropy alone will not be able to solve them. You may find yourself needing to partner with local government, or others with whom you have not yet worked. A systems approach that tries to see your identified problem as part of a larger ecosystem will help keep you on task. A few tips for success:

• Consider a cross-sector collaboration, which may appear riskier than other programs you may have funded but may yield more positive results.
• Consider engaging in a donor collaboration at a level you feel comfortable with if those exist in your field of choice.
• Increase general operating support for organizations supporting your community of choice.
• Read about systems change to see how others are thinking about how to address complex, persistent problems.[2]

 

[1] https://blog.candid.org/post/how-philanthropy-can-ease-a-growing-mental-health-crisis-in-the-u-s/, How philanthropy can ease a growing mental health crisis in the U.S., blog by Asia Hadley, May 27, 2020.
 [2] A few resources: https://www.rockpa.org/project/shifting-systems/, https://medium.com/@shiftingsystems, and https://www.fsg.org/resource/water_of_systems_change/.

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