Mental health disorders like depression and anxiety are common and significantly impact wellbeing, yet mental healthcare remains underfunded in low-income countries. Psychotherapy is an effective treatment that can be delivered cheaply by lay counsellors. This in-depth report evaluates the cost-effectiveness of two charities providing such therapy in Africa: Friendship Bench and StrongMinds. We estimate that Friendship Bench has a cost-effectiveness of 49 WELLBYs per $1,000 donated ($21 per WELLBY), and StrongMinds has a cost-effectiveness of 40 WELLBYs per $1,000 ($25 per WELLBY). Our results show that both charities are 5-6 times more cost-effective than cash transfers at improving subjective wellbeing. This is the fourth iteration of our analysis, which includes new data and refined methods. Our results are similar to the last version of the report, and we conclude that these two organisations are the most cost-effective charities (which are also well-evidenced) we have evaluated to date.
Mental Health
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.
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
By: Michael Plant
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
By: Michael Plant
In this report, we provide an overview of all our evaluations to date as well as our conclusions for Giving Season 2023.
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.
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.
The Mental Health Programme Evaluation Project (MHPEP) was an HLI-led volunteer project that ran from February 2019 to October 2021.The principal aim of the project was to identify and direct donations to highly impactful mental health programmes.
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.