Peter Fonagy, OBE
Chief Executive
Anna Freud

31 August 2023

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What key priorities should trustees of foundations consider when engaging in philanthropy to support mental health causes? Are there any particularly effective strategies or approaches for maximising the impact of philanthropic investments in this area?


Justifying philanthropy: It’s worth bearing in mind that mental health causes receive much less philanthropic support than other health-related areas and is not a priority for many funders. Only 2% of grant-makers support mental health organisations* and, for every £1 given to cancer charities in the UK, 1p is given to mental health charities. But it’s also true that investment in mental health research generates an incredible return (£35 returned for every £1 invested). Historically, this research funding has come from government and statutory sources – so there’s certainly an opportunity for philanthropy to have greater involvement in what is an increasingly important way of demonstrating what works.  


Long-term strategy: In terms of strategies that can maximize the impact of philanthropic investments, a ‘systems change’ approach can be particularly effective. This involves looking at the bigger picture and addressing the underlying systems and structures that contribute to mental health problems, such as social inequality or education policies. Although this approach requires a long-term commitment, it has the potential to bring about more sustainable and widespread improvements in mental health. 


Early Intervention: The earlier mental health conditions are identified and treated, the better the outcomes tend to be. Thus, funding programs that focus on early detection, education, and prevention can make a significant difference.When mental health conditions are identified and addressed early, they can often be managed more effectively, preventing the development of more severe symptoms and reducing the potential for chronic conditions. Early intervention also contributes to a society where mental health is openly discussed and treated. This can help to reduce the stigma associated with mental health conditions, making it easier for individuals to seek help when needed. 


Access to Services: In many regions, mental health services are difficult to access due to geographical, financial, or cultural barriers. Funding initiatives that improve accessibility, such as digital or teletherapy services or local community mental health programs, can have a broad desirable impact. Mental health conditions, when untreated, can have numerous secondary impacts, including poor academic performance, difficulties with employment, and strained relationships. Mental health conditions often co-occur with other conditions, such as substance use disorders. By intervening rapidly, it’s possible to prevent the development of these additional conditions. 


One of the best ways for philanthropy to have a meaningful impact is in supporting innovative charities and programmes of work with unrestricted donations or grants 


Collaboration: Consider partnering with other organizations, both within and outside the mental health sector. Mental health is intertwined with numerous other aspects of wellbeing, such as physical health, education, housing, and social services. Partnering with organizations outside the mental health sector can lead to more integrated and holistic services, thereby addressing the diverse needs of individuals with mental health conditions. Collaborations can help to leverage different skills, resources, and networks, and ensure that services are holistic and comprehensive. Collaborative relationships also foster innovation and learning. Partners can learn from each other’s successes and failures, leading to continual improvement in service delivery.Partnering can also increase organizations’ influence on policy. Coalitions of organizations often have more power to advocate for beneficial policies than individual organizations. 


Outcomes: ‘Mental health’ can be difficult to measure and it takes time to track outcomes that deliver improvement and lead to sustainable and meaningful change. Anna Freud works in this area to help systems improve their measuring and monitoring practices and reporting. Evaluation isn’t an add-on or nice-to-have, it’s an essential element of any serious programme, so funders should continue to interrogate any claims around evidence, especially if evaluation hasn’t been ‘baked in’ from the start. It is advisable to ensure that the initiatives philanthropy supports have robust mechanisms for measuring outcomes. This not only allows the funder to assess the impact of its investment but also helps the organizations funded to improve and refine their services. It’s also reasonable for funders to be judicially sceptical of very expensive interventions and any assumption that good mental health can only be achieved with the involvement of highly specialised professionals/practitioners. While a skilled, well-trained and motivated workforce is obviously important, there is good evidence to show lighter touch/less expensive interventions can have significant positive impact. Routine measurement of clinical outcome of intervention is not common but is both practicable and leads to improved quality of care. 


Involve Beneficiaries: When deciding which programs or interventions to support, it can be valuable to involve those who will benefit from these services in the decision-making process. Beneficiaries have first-hand knowledge of their own needs, which can sometimes be overlooked or misunderstood by those who aren’t directly affected. Their input can ensure that programs and interventions are appropriately targeted and are more likely to be effective. This can ensure that initiatives are culturally appropriate and meet the real needs of the community.Beneficiary feedback can also provide valuable information for continuous quality improvement. They can provide unique insights into what’s working, what isn’t, and how services can be improved. 


Undesignated donations. Unrestricted donations are vital for many charities like Anna Freud which deliver on major public sector contracts and grants that only cover costs. Without core funding, charities will continue to struggle to keep pace in terms of maximising innovation, impact and influence (at a national and international level). One of the best ways, therefore, for philanthropy to have a meaningful impact is in supporting innovative charities and programmes of work with unrestricted donations or grants. This requires a more involved model of philanthropy, where people need to build understanding and trust of the charity they support, but the richness of the relationship that is formed as a result – and the demonstrable impact it has on the charity’s ability to innovate and experiment – makes the effort immensely worthwhile.