Which bilateral donors are supporting mental health?

BARCELONA/MANILA — While the United Nations’ Sustainable Development Goals seek to ensure healthy lives and well-being for all, mental health spending remains relatively low compared with other areas of global health. Last year, donors gave $160 million in aid for mental health, according to data from the Institute for Health Metrics and Evaluation, equating to just 0.39% of the total $41 billion of development aid for health. Evidence suggests that three-quarters of the mental health disease burden is in low- and middle-income countries — settings where there can be fewer than 2 mental health workers per 100,000 people. In 2019, the Netherlands hosted a conference that saw dozens of countries and 10 organizations sign a declaration for mental health and psychosocial support services to become a standard part of the humanitarian response. But the landscape of global mental health funding remains complex, involving multiple stakeholders — bilateral, multilateral, philanthropic, and private — that still leave a huge financing gap. Devex analyzed IHME’s data to highlight the top mental health bilateral donors in 2019. Here, we list the top 14 bilateral donors with mental health spending of $1 million or more and highlight some of the ongoing projects benefiting from this funding. The list does not include donor countries not in the Organisation for Economic Co-operation and Development’s Development Assistance Committee. Many of the donors on this list — including Belgium, Canada, France, Germany, Italy, Norway, Sweden, and Switzerland — were among those that endorsed the 2019 declaration. Between them, these top bilateral donors channeled their financing through NGOs, foundations, the European Union, U.N. agencies, and more. <iframe title="2019 development aid to mental health funding channels" aria-label="chart" id="datawrapper-chart-F6j4J" src="https://datawrapper.dwcdn.net/F6j4J/1/" scrolling="no" frameborder="0" style="width: 0; min-width: 100% !important; border: none;" height="427"></iframe><script type="text/javascript">!function(){"use strict";window.addEventListener("message",(function(a){if(void 0!==a.data["datawrapper-height"])for(var e in a.data["datawrapper-height"]){var t=document.getElementById("datawrapper-chart-"+e)||document.querySelector("iframe[src*='"+e+"']");t&&(t.style.height=a.data["datawrapper-height"][e]+"px")}}))}(); </script> 1. US Spending on mental health in 2019: $17,000,000. Percentage of donor’s total global health financing: 0.14%. Key stakeholders: The U.S. Agency for International Development and Department of Health and Human Services. The U.S. is currently supporting services for enhancing torture survivor mental health in Ukraine, as well as a Health Evaluation and Applied Research Development project, which runs in Bangladesh, Ecuador, Jordan, Uganda, and Colombia and supports studies on community-level mental health and psychosocial interventions. Mental health elements are also now part of ongoing projects in Peru, the Dominican Republic, and Belarus as part of the COVID-19 response. 2. UK Spending on mental health in 2019: $14,000,000. Percentage of donor’s total global health financing: 0.40%. Key stakeholders: The Department for International Development, or DFID, and Foreign & Commonwealth Office. Both departments are now merged into the Foreign, Commonwealth & Development Office. DFID developed a disability inclusion strategy for 2018 to 2023 in which mental health and psychosocial disabilities are a primary focus, specifically mental health research, inclusivity, and the improvement of services to conflict-affected countries. The agency has provided: £63 million to support a World Health Organization program in Syria that set out to provide trauma, mental health, and psychosocial support services, including therapy and medication; financial support for an education program implemented by USAID that, among other things, aims to improve the psychosocial well-being of primary school children, including Syrian refugees, in Jordan; and over £38 million for an ongoing project to scale up flexible health, mental health, and other support to conflict-affected Syrians. In Africa, the U.K Leave No-one Behind Programme provides quality mental health services through primary health care in Ghana, and a joint project between Comic Relief and DFID Aid Match seeks to increase accessibility to services in Kenya. 3. Germany Spending on mental health in 2019: $11,000,000. Percentage of donor’s total global health financing: 0.52%. Key stakeholders: The German Federal Ministry for Economic Cooperation and Development, or BMZ. Of the agency’s funding for mental health assistance, 38%, or $4.2 million, was channeled through NGOs and foundations, while 34%, or $3.7 million, went through the European Union. BMZ’s current mental health efforts are focused on refugees and displaced people in the Middle East, including a project to strengthen psychosocial work in several countries with large refugee populations and another to improve psychosocial support in host communities in Jordan. 4. Italy Spending on mental health in 2019: $5,300,000. Percentage of donor’s total global health financing: 1.20%. Key stakeholders: The Italian Agency for Development Cooperation. Preventing and controlling noninfectious chronic diseases, including mental health issues, is a new and increasingly important area for Italy’s development agency. It recently signed a partnership agreement with UNICEF to provide protection and mental health psychosocial support to vulnerable children in the Gaza Strip and is supporting a two-year health systems project under WHO that addresses mental health care gaps in the Palestinian territories. 5. Canada Spending on mental health in 2019: $4,700,000. Percentage of donor’s total global health financing: 0.43%. Key stakeholders: Grand Challenges Canada. Canada is one of the three founding members of the Alliance of Champions for Mental Health and Wellbeing, which supports and builds on other global initiatives in mental health. With support from the government and other partners, Grand Challenges Canada is investing in high impact innovations that improve treatments and expand access to care for people, especially young people, living with or at risk of mental disorders. The group recently launched a $250,000 proof-of-concept grant to enhance mental health literacy among young people. Canada also supports implementing partners with a strong focus on mental health and psychosocial services, such as Action Against Hunger, which provides psychosocial services for refugees in Bangladesh. 6. France Spending on mental health in 2019: $3,900,000. Percentage of donor’s total global health financing: 0.51%. Key stakeholders: Agence Française de Développement, or AFD. AFD has funded a number of NGO-led projects that focus on building resilience among displaced populations from Syria and Iraq, as well as refugee host communities. One ongoing project, implemented by Action Against Hunger and supported via a grant from the EU, looks to improve mental health and psychosocial support services in Jordan and Iraq. 7. Switzerland Spending on mental health in 2019: $3,700,000. Percentage of donor’s total global health financing: 1.37%. Key stakeholders: The Swiss Agency for Development and Cooperation, or SDC. Integrating mental health treatment into bilateral development programs is a priority as part of SDC’s work on noncommunicable diseases. It aims to improve community-based psychiatric services and provide psychosocial support to people who have been through traumatic experiences, such as women affected by violence in the African Great Lakes region, young people affected by AIDS in southern Africa, or people living in the Gaza Strip. 8. Spain Spending on mental health in 2019: $3,000,000. Percentage of donor’s total global health financing: 1.30%. Key stakeholders: The Spanish Agency for International Development Cooperation, or AECID. Within its health goals, AECID prioritizes noncommunicable diseases, including mental health disorders. It has partnered with the U.N. Population Fund and contributed $472,820 to the agency’s interventions in Iraq, which include survivor centers for women and girls and the provision of psychologists and counselors for those suffering from post-traumatic stress, depression, and severe anxiety. 9. Sweden Spending on mental health in 2019: $2,700,000. Percentage of donor’s total global health financing: 0.38%. Key stakeholders: The Swedish International Development Cooperation Agency, or SIDA. In Gaza, SIDA focuses on providing psychological support for traumatized children and helps fund the Gaza Community Mental Health Programme, which runs three clinics, trains graduates of nursing, psychology, and social work in mental health, and carries out research on the topic. Through partners, Sweden also supports an organization in Ukraine that offers free therapy services for members of the LGBT community. 10. Belgium Spending on mental health in 2019: $2,000,000. Percentage of donor’s total global health financing: 0.71%. Key stakeholders: Enabel. Mental health has been a key focus of Enabel’s work in Rwanda, and the agency has been supporting the development of mental health services there for over a decade through technical and financial support. The agency had not provided further information about its projects at the time of publication. 11. Netherlands Spending on mental health in 2019: $1,900,000. Percentage of donor’s total global health financing: 0.25%. Key stakeholders: The Dutch Ministry of Foreign Affairs. The Netherlands contributed €5.8 million to an ongoing project between WHO and UNICEF that will run until 2022 and focuses on developing a set of essential activities, services, methods, and tools for an acceptable minimum mental health and psychosocial support services package. Between 2020 and 2022, it will also provide €3 million to develop a surge mechanism for such services and establish a pool of experts for rapid deployment, as well as supporting the training of over 17 million Red Cross and Red Crescent volunteers in psychosocial first aid and mental health referrals. 12. Japan Spending on mental health in 2019: $1,600,000. Percentage of donor’s total global health financing: 0.13%. Key stakeholders: The Japanese Ministry of Foreign Affairs and Japan International Cooperation Agency, or JICA. JICA supports various mental health care activities, many of which are integrated within its work around disabilities, gender issues, disaster response, and projects in conflict-affected countries. Through its volunteer program, the agency also dispatches overseas cooperation volunteers, including those who provide psychological education. More recently, JICA has distributed an illustrated guide on children's mental health care during COVID-19 that has been translated into at least 17 languages. 13. Norway Spending on mental health in 2019: $1,500,000. Percentage of donor’s total global health financing: 0.20%. Key stakeholders: The Norwegian Ministry of Foreign Affairs; Norwegian Agency for Development Cooperation, or Norad; and Norwegian Investment Fund for Developing Countries. In Uganda, Norad works in partnership with Y Global Uganda, a local organization, on a project known as Together Building Justice and Peace in Uganda that focuses on mental health and psychosocial counseling. Through partnerships, a child mental health facility has been set up at a children’s hospital in Kathmandu, Nepal. 14. Finland Spending on mental health in 2019: $1,300,000. Percentage of donor’s total global health financing: 1.51%. Key stakeholders: The Finnish Ministry for Foreign Affairs. Finland’s Foreign Affairs Ministry will provide €1.2 million in funding to the Finnish Red Cross to support the International Federation of Red Cross and Red Crescent Societies’ efforts on access to health care in Syria, including mental health clinics. Finland will also provide €4 million by 2022 to UNFPA’s Women and Girls First Programme II, which seeks to improve access to mental health and psychosocial support in Myanmar as part of wider services around sexual and reproductive health. 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