New Report: Mental Health Philanthropy Inches Up, But Still Lags Far Behind The Need 

An Interview with Kristen Ward

Ever since some preliminary research in 2018 from the University of Pennsylvania’s Center for High Impact Philanthropy found that only 1.3% of all dollars donated by foundations and philanthropists went to mental health, the sector has been called out for giving too little attention – and too few dollars – to address a critical need. 

That research also helped catalyze the creation of Mindful Philanthropy, a nonprofit founded in 2020 to work with funders to help guide their strategic giving and to accelerate and target funding to mental health and wellbeing

Now the researcher behind those pivotal findings, Kristen Ward – a cofounder of Mindful Philanthropy – and her colleagues are back with a new report on the state of charitable giving for mental health. 

The report looked at giving from 2015 to 2022 and found that philanthropic giving has increased a bit faster than the rate of inflation – but still is a tiny fraction of the overall charitable pie. 
In 2022, dollars going to mental health represented just 1.7% of all philanthropic giving and made up less than 6% of all health-related giving. Surprisingly, the portion of health donations going to mental health increased in 2019, the year before the pandemic, but then declined again in 2022.

I sat down over Zoom for an interview with Ward about the report’s findings. The interview has been edited for length and clarity.

Rob Waters: When it comes to philanthropic giving, mental health has always been a bit of a stepchild – perhaps because of stigma or lack of media attention. Before you did this analysis, what was known about the extent of mental health philanthropy?

Kristen Ward: There wasn’t a lot of data out there in terms of what philanthropy was doing to support mental health. We had anecdotal insights from longtime funders who had been supporting mental health for decades, who shared their experiences of being shunted to the back room at conferences to have sessions on the last day. It was not a priority. The only real data was a back-of-the-envelope analysis my team did at Penn, which found that 1.3% of all philanthropic funding in 2018 (we’ve since revised that to 1.4%) went toward mental health and addiction.

So what did your new analysis find about the extent and trends of giving to mental health? 

Big picture, from 2015 to 2022, the magnitude of mental health giving doubled from about $1.2 billion to $2.3 billion. Adjusting for inflation, that is about a 50% or 55% increase. While inflation increased about 8% over that same time period, giving for all issue areas only increased 3%. So mental health giving is outpacing other areas and outpacing inflation, but it’s still a very small percentage of overall giving.

We’ve seen a pretty stark increase in mental health need over the last decade and more — it has been rising steadily for a long time. So while we are seeing a slight uptick in mental health giving, we are still not seeing the level of funding required to really address the need. We also must focus on the impact and effectiveness of that money — to make sure it’s going to the right places – and to invest in data collection.

The mental health crisis had been here for a long time, festering in the background. Then, during Covid, it exploded onto the front pages and into people’s awareness. But surprisingly, according to your data, mental health philanthropy didn’t do what I presumed it had – increase in proportion to the crisis. What’s going on? 

We were somewhat surprised too. We went into this work with the hypothesis that we would see a greater uptick in funding as a result of the pandemic. One caveat: it may still be too early to tell, given the lag in data. 

We found that mental health funding was growing prior to Covid. From 2017 to 2019, we saw greater upticks in funding than we did post-Covid. Partly, it was a reverting to the mean, and I think it’s also a result of the chaos that Covid created and the competing priorities.

If we recall the early days of Covid, some funders were keeping their ink dry to wait and see where there’s need, while other funders were galvanizing great amounts of funding – to support the provision of personal protection equipment, provide specific Covid relief efforts to economic organizations, to healthcare workers, as well as thinking about learning loss and the impact of school closures. So I think we may not know yet the true impact of Covid on mental health funding.

Why do you think mental health has been such a small part of philanthropic giving – and is still today?

Mental health has been seen as a niche area, and part of that is the focus on mental illness versus the broader concept of mental health, or even more broadly, wellbeing, mental health and addiction. But we are seeing a growing understanding among funders and practitioners of how mental health intersects with other areas.

Your analysis finds youth mental health is a top priority for mental health funders. What does your research suggest is working about youth mental health philanthropy, and where do you see the need for change?

About a third of total mental health philanthropy is dedicated to youth as a specific population. We’ve seen a lot of interest and attention among youth funders to two areas. The first is to building resilience and skills among young people and supporting youth wellbeing. The second is around mental health in schools. 

I think what’s working in either of those categories is when there’s a strong emphasis on measurement and evaluation to understand the impact of activities and programs on schools. We need to ensure that there is a clear continuum of care and providing a comprehensive set of resources and services.

How do we build the policy and regulatory infrastructure to support the implementation of these services, for example, in schools? Many states don’t have regulations or standards or guidance for schools to actually implement mental health services and supports. In lieu of that, there’s been a huge focus on supporting things like curricula and one-off programs that are not meeting the full needs of teachers or their students, and therefore leave kind of young people wanting more. Because now they’ve been educated and are aware of mental health concerns, but they aren’t able to access the supports they need.

One thing you talk about in the report is the importance of community wellbeing for youth. What does that mean? 

We’re still in the meat of defining what it is to support mental health and community. We’ve defined it around reducing social isolation and increasing social connection and belonging, and also being able to provide treatment and that first line of support in community. We know we will never be able to treat our way out of the current mental health crisis, and we’ve seen a bit of a shift toward what Tom Insel refers to as people, place and purpose and thinking about upstream opportunities to prevent mental illness.

From young people themselves, we’ve learned that they’re looking for positive adult relationships, whether that be with a parent or a caregiver or another adult. They’re looking for safe spaces where they can be themselves and feel connected to their community and their neighborhood. We also see this with just the level of attention to Jonathan Haidt’s book, Anxious Generation, and thinking about going back to a play-based childhood, and connecting with people in person, and being able to develop those social skills and not have our relationships disintermediated by technology.

How can philanthropy support intersecting areas – the social determinants of mental health, if you will?

Our mission is to engage with funders to help them see how supporting mental health can help achieve the outcomes they’ve already prioritized in other issue areas. Helping education funders understand how supporting mental health in schools can help achieve greater graduation rates, improved test scores, better retention of students. Are there opportunities to weave mental health into the programs and supports and services already being offered.

There’s a renewed appreciation of how incorporating arts and culture back into schools can help support the expression that young people need, some of the positive youth development that we’re lacking in schools, to promote greater resilience, to promote a better understanding of our emotions and emotional regulation. Building those skills through other mechanisms can result in positive mental health outcomes. But it’s sometimes challenging to make the case, because we don’t have really strong data that demonstrates that arts and music in school actually results in fewer mental health issues among 5th graders.

We see the greatest opportunity where mental health is integrated into the fabric of all issue areas, so it isn’t a niche area and it isn’t separate. But part of that integration has to include measurement, and not just kind of check the box measurement, but really focused, rigorous and intentional measurement to understand the long-term impact.  

From the philanthropic side, there needs to be additional resources to support measurement to really understand the impact. But many grassroots organizations don’t have the capacity to do that level of measurement. So we need philanthropy working with those organizations and providing technical assistance or capacity building to really understand what’s working as it relates to prevention. Because many experts we talked to in this space will say we don’t have a lot of good evidence around universal or primary prevention efforts as it relates to mental health.

You note in the report a major gap in philanthropic funding for serious mental illness. But a lot of public funding does go to serious mental illness in the form of expensive health treatment – especially when people have both mental and physical health conditions. How do you see this from a philanthropic lens?

We do see a huge amount of federal dollars, Medicaid dollars, supporting individuals with serious mental illness, but it is primarily focused on delivering treatments, and fewer dollars supporting early intervention. There’s a huge opportunity for philanthropy to do three things.

The first is to innovate and to expand our understanding of what works to support individuals with serious mental illness, especially in those earliest days, to prevent the long-term persistent severity levels that are so costly and have huge impacts on education, on poverty, on other health issues.

The second is to provide linkages between care. What you often see with people experiencing severe and persistent mental illness is that they don’t have that a step-down opportunity. They may be in a residential treatment program, or a coordinated specialty care program, but they can’t graduate into that next level of care because there is no next level of care. Philanthropy can help. We’re also leaning on health systems to bridge those gaps and provide those connections. 

The last piece is wraparound support and services and thinking about care in community, so we’re not only providing health care for serious mental illness, but thinking about how we help prevent people from becoming homeless? How do we support them connect with other people in their community, give them meaningful work and opportunities to engage in career, education, to connect with their family. That type of work is not often supported by the government. Those three areas are opportunities for philanthropy to lean in and create huge cost savings to society and impacts on other issue areas. 

Anything else you’d like to add? 

In the mental health space, the problem is not the lack of effective programs, it’s really the reach and scale of these programs. So how can philanthropy work with public and other private dollars to prioritize scale and build institutional capacity to expand the reach and access of programs? So it’s less about the dearth of programs, and more about ensuring that people can access the care they need, when and where they need it. 

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