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Philanthropy for mental health should focus more on community-led models

A new report by the Centre for Asian Philanthropy India analyses the funding landscape towards mental health in the country, and how knowledge and resource gaps can be bridged to mobilise donors

Divya J Shekhar
Published: Apr 19, 2024 01:19:15 PM IST
Updated: Apr 25, 2024 05:52:44 PM IST

Philanthropy for mental health should focus more on community-led modelsIn India, only a handful of philanthropists and organisations have been supporting mental health-related causes in recent years. Image: Shutterstock
 
India’s private sector often takes cues from government priorities, and the pattern of its philanthropic support to mental health is no different. A new report from the Centre for Asian Philanthropy India (CAPI) shows that while government allocations towards mental health—which forms just one percent of the overall Union health budget—is skewed towards institutions (see box), even philanthropists prefer to donate towards institutions or scientific research, as compared to grassroots community-led efforts.
 

The report by CAPI, which is a non-profit under the trusteeship Jamshyd N Godrej (chairman, Godrej & Boyce Manufacturing Company) and S Ramadorai (former vice chairman, Tata Consultancy Services), analyses the state of mental health care and funding in India, and provides pathways to deal with existing challenges. “There’s very little written about mental health from a non-medical perspective in India. As mental health begins to feature in donor portfolios, there might be others out there looking for guidance. This report aims to fill that knowledge gap,” says Ketaki Purohit, centre head, CAPI.
 
In India, only a handful of philanthropists and organisations have been supporting mental health-related causes in recent years. This includes Infosys co-founder Kris Gopalakrishnan, philanthropist Rohini Nilekani, Marico founder Harsh Mariwala, Wipro chairman Azim Premji, Biocon CMD Kiran Mazumdar-Shaw, Tata Trusts and Aditya Birla Education Trust.
 
Funding to institutions, community and research are three avenues in mental health for donors (see box). It’s easier for them to partner with a well-established institution for programmatic interventions or scientific research than do the additional work of finding communities that need help and can make good use of the funds, says Purohit. “Community organisations have gone out of their way to do impact assessments to show donors their models work, but this becomes an additional burden for them as impact assessments can be expensive,” she says.


Philanthropy for mental health should focus more on community-led models 
The LiveLoveLaugh Foundation started by actor Deepika Padukone is among the few well-funded non-profit organisations in the country that work to address mental health concerns through community models, by aligning its programmes with the district mental health associations within states.
 
Well-planned community-led initiatives for mental health can be very effective in a collectivist society for India, as they focus on social, cultural and economic determinants to address the issue, says Anisha Padukone, CEO, LiveLoveLaugh, over email. “So far, there has not been enough of a mainstream focus on community-based interventions for mental health,” she says, adding that raising awareness among funders and demonstrating successful models from across the country will help this approach gain popularity among funders.
 
The report highlights that while millions of people in the country suffer from mental illnesses, between 70-92 percent of them are left untreated due to factors such as limited awareness, stigma and high treatment costs. There are two mental health workers and less than one psychiatrist for every 100,000 people in the country. The estimated cost of mental health burden to the Indian economy between 2012 and 2030 is pegged at $1.03 trillion.

Also read: Why Kris Gopalakrishnan is spending hundreds of crores to study the human brain
 
Over the years, however, government allocation towards mental health has occupied one percent or less of the overall health budget. In 2024-25, of the Rs 90,659 crore of the health budget, only Rs 1,010 crore (or 1.1 percent) went to mental health. Even this allocation tends to be skewed towards only two major institutions in the country—the National Institute of Mental Health and Neurosciences (Nimhans) in Bengaluru, and the Lokpriya Gopinath Bordoloi Regional Institute of Mental Health (LGBRIMH) in Tezpur, Assam, apart from some allocation towards the National Mental Health Programme (see box).

Philanthropy for mental health should focus more on community-led models
 
In her Union Budget speech in 2022, Finance Minister Nirmala Sitharaman had announced the launch of a national tele-mental health programme (Tele Manas), in order to provide better access to mental health counselling and care services. This programme leverages the telephone, mobile apps, including WhatsApp, chatbots, and online therapy platforms to deliver mental health services and interventions. The CAPI report says that, as of March 6, 2024, the Tele Manas had “received over 733,082 calls, and provided counselling services to over 350,000 individuals through its 51 cells across the country. The helpline receives more than 1,000 calls on an average daily”.

Philanthropy for mental health should focus more on community-led models
 
However, in a country where nearly 70-90 percent people suffering from mental health issues do not receive treatment, it is important to focus on strengthening the availability of skilled professionals, and improving physical grassroots access to services beyond urban areas. “If the tele-mental health programme was one component of a larger programme in which you also had feet on the ground to the requirements of the District Mental Health Programme, then it makes sense, but a tele-mental health programme without any of that is not going to help much,” Dr Soumitra Pathare, consultant psychiatrist and director of the Centre for Mental Health Law and Policy, had told Forbes India after the Union Budget announcement about the platform in 2022.

Philanthropy for mental health should focus more on community-led models
 
Among the philanthropic community too, there has been very little support for mental health despite the scale of the problem, because philanthropists have traditionally focussed on issues with high mortality and basic health care delivery for rural and low-income populations, which is also very important.
 
So even though health care ranks second-highest in priorities for Indian philanthropists after education, there is no data available for how much of it goes towards mental health. It is likely to be miniscule, which would be in line with global trends as well, where philanthropic funding towards mental health, studied between 2015 and 2018, was less than 1.3 percent, according to data from the Center for High Impact Philanthropy in the US.

Philanthropy for mental health should focus more on community-led models
 
Purohit believes that, as per the findings of the report, the cohort of philanthropists offering support to mental health-related causes is not only growing, they are also funding organisations for the long-term and being flexible with their donations to meet emerging requirements.

Also read: Only one in ten people in India receive adequate treatment for mental health disorders

 
“Given that so much government funding goes to institutions, there is an opportunity for philanthropists to move the needle to funding community models of mental health or other avenues like prevention or rehabilitation or innovation, or encouraging disruption in the sector,” she explains. That said, she adds that the government signalling towards mental health as a priority will be among the biggest drivers of philanthropic support.
 
A major hurdle faced by people and organisations is the lack of understanding about mental health issues among the donor community, says Padukone, and building this knowledge would be crucial to form long-term collaborations that will make a meaningful difference. “Additionally, there's a tendency among funders to compare mental health initiatives with other health-related endeavours and expect rapid results. However, progress in mental health, particularly in areas like perception and behaviour change and stigma reduction, often requires a more considerable time to show results,” says Padukone, adding that patience and sustained efforts are needed while assessing the impact of mental health interventions.

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