In November 2023, we published Version 3 of our psychotherapy analysis. This was a working report in which we estimated the effects of psychotherapy in low- and middle-income countries, as well as the cost-effectiveness of two psychotherapy charities: StrongMinds and Friendship Bench. In the first part of 2024, we have updated several parts of the analysis. This present, interim report, Version 3.5, describes the changes we have made so far. Our analysis suggests that both StrongMinds and Friendship Bench are among the most cost-effective charities we have evaluated to date. Friendship Bench has a cost-effectiveness of 53 WELLBYs per $1,000 donated and StrongMinds has a cost-effectiveness of 47 WELLBYs per $1,000 donated.
Joel McGuire
In this substantial update to our work on psychotherapy we conduct a systematic review, a meta-analysis, and cost-effectiveness analyses of two charities who deliver psychotherapy (StrongMinds and Friendship Bench). This is a working report that will be updated over time, results may change.
In this shallow cause exploration, we explore the impact of lead exposure on subjective wellbeing. We review the literature, model the impact of lead exposure on wellbeing, and conduct some back-of-the-envelope calculations of the cost-effectiveness of various interventions to decrease lead exposure.
In this shallow cause exploration, we explore the impact of immigration on subjective wellbeing. We review the literature, model the impact of immigration on wellbeing, and conduct some back-of-the-envelope calculations of the cost-effectiveness of various interventions to increase immigration.
In this shallow cause exploration, we explore the relationship between pain and subjective wellbeing; assess the severity and scale of chronic pain in terms of life satisfaction; and offer some novel back-of-the-envelope calculations for the cost-effectiveness of several interventions to treat pain.
In this report, we summarise the debate about the efficacy of deworming, present the first analysis of deworming in terms of subjective wellbeing, and compare the cost-effectiveness of deworming to StrongMinds (our current top recommended charity).
How should we compare the value of extending lives to improving lives? Doing so requires us to make various philosophical assumptions, either implicitly or explicitly. But these choices are rarely acknowledged or discussed by decision-makers, all of them are controversial, and they have significant implications for how resources should be distributed.
We raise twelve critiques of GiveWell’s cost-effectiveness analyses. Ten apply to specific inputs for malaria prevention, cash transfers, and deworming. Two are relevant for more than one intervention.
We propose the wellbeing-adjusted life year (WELLBY), the wellbeing equivalent of the DALY or QALY, as the obvious framework to do cost-effectiveness analyses of non-health, non-pecuniary benefits.
We make four recommendations to improve GiveWell’s cost-effectiveness analyses: (1) publicly explain and defend their assumptions about the effect of deworming over time; (2) explain their cost-effectiveness analyses in writing; (3) illustrate the sensitivity of their results to key parameters; (4) make it clear when an estimate is subjective or evidence-based.
We update our previous analysis to incorporate the household spillover effects for cash transfers and psychotherapy. We estimate that psychotherapy is 9 times (95% CI: 2, 100) more cost-effective than cash transfers. The charity StrongMinds is estimated to be 9 times (95% CI: 1, 90) more cost-effective than the charity GiveDirectly.
Drawing on evidence from over 80 studies and over 140,000 participants, we compare the cost-effectiveness of cash transfers and psychotherapy by estimating their effect on the recipient's subjective wellbeing and affective mental health.
This report explains how we determined the cost-effectiveness of StrongMinds using subjective wellbeing and affective mental health.
This report explains how we determined the cost-effectiveness of group or task-shifted psychotherapy in low- and middle-income countries using subjective wellbeing and affective mental health.
This report explains how we determined the cost-effectiveness of cash transfers using subjective wellbeing and affective mental health.
We set out our research priorities.
We know that cash transfers reduce poverty, improve health and enhance education but what impact do they have on how people feel and think about their lives? We find that cash transfers have a small, positive effect on subjective wellbeing, one that lasts for several years.
We show how Wellbeing-Adjusted Life Years (WELLBYs) can be used to estimate the value of different outcomes. We then estimate the values of two key inputs in GiveWell’s analysis: doubling consumption for one person for one year and averting the death of a child under 5 years old.