Mental Health Programme Evaluation Project
Summary
While there are potentially many ways in which we can make lives happier, improving mental health currently stands out as a particularly promising area, given the scale of suffering attributed to mental disorders (Happiness Research Institute 2020, Chapter 4), as well as the relatively low governmental expenditure globally allocated to improve it (Mental Health Atlas 2017).
The Mental Health Programme Evaluation Project (MHPEP) was an HLI-led volunteer project that ran from February 2019 to October 2021. The team consisted of volunteers drawn from the effective altruism community who are committed to promoting human happiness. They included graduates from Harvard, Cambridge, Northeastern University, and the London School of Hygiene and Tropical Medicine with expertise in psychology, psychotherapy, public health, health economics, law, and philosophy.
The principal aim of the project was to identify, and direct donations to, highly impactful mental health programmes. A further aim was to investigate the cost-effectiveness of these programmes in-depth. Relatively little is known about the cost-effectiveness of mental health programmes in low- and middle-income countries (LMICs), at least compared to physical health (Horton, 2016), so there is a high value of information from conducting cost-effectiveness analyses in this area.
When measured via the conventional methods used in health economics, programmes targeting mental health mostly seem less cost-effective than the programmes recommended by GiveWell such as deworming tablets (Levin and Chisholm, 2016; Founders Pledge, 2019). However, as Plant (2019, Chapter 7) argues, if the cost-effectiveness of mental health programmes is assessed using subjective wellbeing (individuals’ reports of their happiness and/or life satisfaction), then mental health programmes appear relatively more cost-effective than they do on conventional metrics.
MHPEP followed a three-step approach:
We identified 76 programmes targeting mental disorders in LMICs, made an initial screening assessment, and reduced the number of programmes to a longlist of 25.
We assessed the 25 longlisted programmes against relevant criteria to create a shortlist of 13 programmes for detailed evaluation.
We conducted an in-depth cost-effectiveness evaluation of one programme: group interpersonal therapy (g-IPT) delivered by StrongMinds, a charity that works with depressed women in Uganda and Zambia.