Improving mental health has a positive impact on subjective wellbeing; yet it is also a severely neglected intervention, especially in low- and middle-income countries where only 3% of people with depression receive adequate treatment. Active in various parts of Africa, notably Uganda and Zambia, StrongMinds works to close this gap.
We thoroughly investigated StrongMinds and now recommend it as one of our Top Charities. We interviewed their team to hear directly about their work.
Their answers reflect practitioner experience rather than formal research findings. These do not necessarily represent HLI’s views.
In your own words, what does StrongMinds do?
“StrongMinds exists because we believe mental health isn’t a nice-to-have layered on top of “real” health care; rather, it’s foundational to it, and to almost everything else in a person’s life. Depression is one of the leading causes of disability worldwide, yet in the low-resource settings where we work, treatment is often nearly impossible to access. That gap matters enormously, because when depression goes untreated, it doesn’t stay contained: it erodes someone’s ability to work, care for their children, stay in school, maintain relationships, and participate in their community. Treat the depression, and all of those downstream effects reverse.
Concretely, we deliver group interpersonal therapy (IPT-G), an evidence-based talk therapy model, at scale across Uganda, Zambia, Kenya, Malawi, Tanzania, and now Rwanda. We do this primarily through trained community volunteers and government health workers rather than scarce clinical specialists, which lets us reach far more people at a fraction of the traditional cost, down to roughly $11 per person treated. Since our founding, we’ve treated more than 2 million people, with about 75% experiencing clinically significant improvement in symptoms. But we measure success beyond the clinical outcome: the more meaningful gains are that people go back to working, sending their kids to school reliably, feeding their families, and reconnecting with their communities. That’s the case for mental health as core health care, not a peripheral service, but the thing that determines whether all the other investments in a person’s or a community’s wellbeing can actually take hold.”
When people in high-income countries think about mental health in Africa, what do they consistently get wrong?
“There is an old belief that re-surfaces from time-to-time suggesting that depression is a uniquely Western ailment that does not occur in lower-income settings such as in many communities in Africa. There can indeed be different circumstances behind an individual’s depression, but the core triggers of depression – isolation, grief, life-change, and interpersonal conflict – exist for people everywhere. The difference between depression in wealthy countries and depression in less wealthy countries is that there is more stigma around experiencing it in places like sub-Saharan Africa and there is significantly less access to treatment.”
In 2025 you provided psychotherapy for 491,000 people, and you are rapidly scaling your reach. What are the biggest lessons you’ve learnt with this growth? Are there any challenges that you’re proud to have overcome?
“The clearest lesson from this period of growth is that scale exposes what casual delivery can hide. As StrongMinds shifted from a staff-led model to a volunteer-led one, growing annual reach from roughly 100,000 to over 700,000 people by 2025, maintaining quality and fidelity across a much larger network became the central challenge. We addressed this by building our Volunteer Quality Management (VQM) system, which strengthens supervision, fidelity monitoring, and volunteer support at scale, and it’s one of the achievements we’re proudest of, since it’s what allowed rapid growth to happen without compromising outcomes.
We also learned that government partnership, while ultimately the most viable path to sustainable scale, takes real time: integrating IPT-G into public systems in Uganda and Zambia required years of relationship-building and adaptation of our own systems before it worked. And we found that cost reduction and quality aren’t necessarily in tension; shortening the therapy cycle from eight weeks to six maintained outcomes while lowering costs and increasing reach.
Finally, growth tested our resilience in ways we didn’t fully expect, from climate-related disruptions that displaced participants to major funding shocks, including the loss of a $1 million contract after USAID-supported programs collapsed in 2025. Coming through that reinforced how important it is to build redundancy and succession planning into our leadership, not just our program design, so growth doesn’t outpace our ability to sustain it.”
Your facilitators are community members, not clinicians. What do you look for when you recruit them? What makes someone good at this?
“When we recruit facilitators, we look for people who are already trusted and rooted in their community rather than people with clinical training. Candidates go through a three-week process: application, interviews, and reference checks, and to be considered, they typically need to be a resident of the village they’ll serve, recognized or vetted locally (often as an existing Village Health Team member), literate in the local language, and 18 or older, with no record or accusation of sexual or gender-based violence. Beyond those baseline requirements, what we’re really screening for is character and relational skill: honesty, trustworthiness, community respect, a demonstrated commitment to volunteering, and above all, being a genuinely good listener and communicator, since those traits most predict success in delivering talk therapy. Prior training in counseling or safeguarding is a plus but not required, since we build those skills ourselves.
What makes someone good at the role tends to follow from those same qualities, reinforced through training. New facilitators complete a five-day foundational course and then co-lead real therapy sessions under experienced supervision before working independently. From there, we continuously assess performance against our therapy model and counseling standards, with ongoing supervision, ongoing case debriefs, and retraining or disengagement for those who don’t improve. In practice, the facilitators who do best are the ones who came in with strong community trust and natural listening ability, and who stay engaged with feedback to keep sharpening their skills.”
There's evidence suggesting that mental health interventions can improve economic and labour market outcomes. What's your take on this?
“Depression isn’t just a clinical condition sitting alongside someone’s economic life. It directly impairs the capacity to work, plan, and follow through, so treating it tends to unlock economic activity that was already being blocked.
In our own reporting, we see an approximate 27% increase in people who report not missing work in the past week, alongside a 0.5 increase in additional meals consumed by children of therapy participants (1.8 to 2.3). Participants describe, in their own words, being able to re-engage in livelihoods and provide for their families in ways that felt out of reach while they were depressed.”
We thank StrongMinds for their time and their thoughtful answers. To learn more about their work, you can read our evaluation. You can donate to StrongMinds here.
This blog post is part of a series of interviews with our recommended charities. You can read the other conversations with Pure Earth, Taimaka, and Friendship Bench to better understand their work.