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Interventions

August 2024 interim update to ‘Talking through depression: The cost-effectiveness of psychotherapy in LMICs, revised and expanded’

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.

Site visit to StongMinds: Kampala, Uganda

Dr Michael Plant conducted an in-person site visit to better understand the StrongMinds programme and the people in it. We don’t expect site visits can, or should, be decisive for evaluation purposes (they are ‘anecdata’), but they can nevertheless be informative. Visitor: Dr Michael Plant, Founder & Research Director at the Happier Lives Institute Date of visit: 11 April 2024 Document written: 19 April 2024

Site visit to Friendship Bench: Harare, Zimbabwe

Dr Michael Plant conducted an in-person site visit to better understand the Friendship Bench programme and the people in it. We don’t expect site visits can, or should, be decisive for evaluation purposes (they are ‘anecdata’), but they can nevertheless be informative. Visitor: Dr Michael Plant, Founder & Research Director at the Happier Lives Institute Date of visit: 04 April 2024 Document written: 10 April 2024

Talking through depression: The cost-effectiveness of psychotherapy in LMICs, revised and expanded

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.

Lead Exposure: a shallow cause exploration

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.

Immigration reform: a shallow cause exploration

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.

Pain relief: a shallow cause exploration

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.

A can of worms: the non-significant effect of deworming on happiness

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).

The elephant in the bednet: the importance of philosophy when choosing between extending and improving lives

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.

Deworming and decay: replicating GiveWell’s cost-effectiveness analysis

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.

Will faster economic growth make us happier? The relevance of the Easterlin Paradox to Progress Studies

Progress Studies has been popularised by academics such as Tyler Cowen and Steven Pinker. However, the Easterlin Paradox presents a real challenge to the claim that if we want more progress, we just need to improve the long-run growth rate - a view that Cowen argues for in his book Stubborn Attachments.

Happiness for the whole family

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.

Global priority: mental health

This report investigates the global burden of mental illness. It sets out how big the problem is, how much spending it receives, and how those resources are allocated. It then focuses specifically on what can be done to reduce anxiety and depression in low-income countries.

Cash transfers: systematic review and meta-analysis

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.