The U.S. Is in a Mental Health Crisis, but Funding Is Still Scarce. This Group Hopes to Change That

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As the U.S. emerges — in fits and starts — from the pandemic, the country is experiencing a mental health crisis. Young people appear to be at particularly high risk, including young adults. 

“‘Depression, stress and anxiety’ is the most prevalent obstacle to learning for secondary students at every grade level, six through twelve,” according to a survey just published by YouthTruth. Experts agree that the crisis in youth mental health preceded the pandemic, but lockdowns, school closures, isolation, the loss of friends and family members, and economic insecurity have exacerbated the problem. 

Last year, the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association declared a national emergency in child and adolescent mental health, and AAP recently renewed this call for action. The U.S. Surgeon General issued a rare public advisory that raised alarms about youth mental health, and a recent survey of mental health practitioners found that “Nearly 8 in 10 psychologists (79%) said that they had seen an increase in the number of patients with anxiety disorders since the beginning of the pandemic, and 66% saw an increase in demand for treatment for depression,” according to the American Psychological Association.

For years, Inside Philanthropy and its contributors have been beating the drum for the sector to prioritize mental health, and indeed, we’ve seen a number of funders old and new stepping up for the cause, a hopeful sign that the landscape is shifting. Writing in IP in 2020, Ken Zimmerman, former director of U.S. programs for the Open Society Foundations who now heads mental health nonprofit Fountain House, urged philanthropy to make mental health a top priority. A year later, Zimmerman pointed out some impressive developments in mental health funding, calling them “preliminary steps on this journey.”

But as mental health problems grow increasingly dire, there’s a lot more philanthropy can do to deploy its vast resources to address the issue, and Alyson Niemann, the executive director of Mindful Philanthropy, wants to make it easier for them to do so. Mindful Philanthropy was created in 2020 by a group of mental health funders, including Peg’s Foundation, Well Being Trust, Scattergood Foundation, and the John Heller Fund. The goal is to “catalyze impactful funding in mental health, addiction and wellbeing. At a time when mental health was left out of conversations around how philanthropy could improve the nation’s wellbeing, our founders recognized an opportunity to create a North Star for the sector,” according to the website

IP’s brief “Giving for Mental Health” confirmed the view of these funders that mental health has been overlooked by philanthropy, despite its outsized impact. “The philanthropic sector’s support for mental health causes is essentially the same in 2020 as it has been for many years: vastly underfunded in proportion to the pervasiveness, seriousness and burden that mental health problems place on individuals and society,” according to the report. 

Despite some recent progress, mental health has yet to become a North Star for the sector — Alyson Niemann points out that just 1.3% to 1.5% of foundation funding goes to mental health and addiction. Like Zimmerman, she has seen interest grow as the mental health crisis has become increasingly critical — but it’s not growing fast enough. “In general, what we’re seeing is that funders are not coming to the table with big commitments.”

Niemann and her organization will continue spreading the word and urging funders to give more. “Our goal is to unabashedly get funding into this space,” she said. 

Offering guidance on a complex issue

Why are so many in the sector hesitant to back mental-health-related causes? A simple answer is that there are so many other issues competing for attention. Given the alarming statistics on youth mental health and the challenges this is posing for schools and educators, for example, it would seem like an area education funders would rush to support. But Alyson Niemann points out that mental health is only one of many pressing issues schools — and ed funders — are grappling with right now. “Education funders are paying attention, but they are also dealing with widespread learning loss, teacher shortages, and other crises, as well,” she said. 

In other cases, Niemann says, funders hold back because they don’t know how or where to plug in. “Mental health is an incredibly complex and overwhelming space,” she said. “What we often hear from funders is, ‘I don’t know how to start.’” 

That’s where Mindful Philanthropy comes in. “We exist, really, as a landscape expert, and to help to guide funders to places where they can have impact,” Niemann said. 

Mindful Philanthropy works with funders in several ways. During the pandemic it offered public education webinars, and more recently, it has organized in-person convenings to educate funders about the issues and how they can get involved; it also works one-on-one with individual foundations. The organization offers a steady flow of public guidance, regularly publishing free guides on topics including homelessness and mental health, youth mental health, mental health in schools, and the 988 emergency hotline, which IP reported on last year.

The organization also provides research, data and other resources from partner organizations. And it is developing a portfolio of nonprofits and programs working in the area of mental health that it has vetted and can recommend to funders. “We really seek to lift up programs that are community-driven and culturally led, and that are in the community doing the work,” Niemann said. 

For funders who are overwhelmed by the size and scope of the crisis, Mindful Philanthropy tries to target specific areas where they can make a difference. One such area is the mental health workforce. The U.S. faces a severe shortage of mental health workers, including school-based counselors and psychologists, given the large and growing need. (A recent JAMA study linked mental health workforce shortages to an increase in youth suicide.) 

 “Obviously, we need to have a healthy workforce and a workforce pipeline,” Niemann said. “We’ve got to think about building the future of the pipeline and getting more people with diverse backgrounds and perspectives into the pipeline. This is an area where philanthropy can make a difference.”

Mindful Philanthropy also tries to show funders how to integrate mental health into their existing funding strategies. “One of the driving principles of our work is that mental health is a foundational issue to so many other social issue areas,” Niemann said. “So whether it’s education, homelessness, criminal justice, or youth, mental health is one of the things you need to address if you want to further impact those areas.”

Overall, Mindful Philanthropy emphasizes the importance of prevention. When it comes to physical health, the healthcare system emphasizes preventive strategies to ward off health problems before they start, but that is not the case with mental health, Niemann points out. “With mental health, you don’t enter the system until you have a diagnosable illness. As a society, we need to do more prevention and looking upstream and creating conditions to help people stay well and thrive, versus just treating illnesses.” 

At the intersection of mental health and philanthropy

The need to build the mental health workforce was just one of the issues that came up during Mindful Philanthropy’s recent summit, which was titled “Activate 2022: Investing in the Future of Mental Health and Well Being.” Niemann calls the gathering, which brought together over 55 funders and business leaders, “the first convening, as far as we’re aware, at the intersection of mental health and philanthropy to highlight how funders can start to make a difference.”

There was a lot of interest in the summit, and many people requested invitations, but the organization deliberately kept it small and invited primarily corporate founders and foundation principals to provide participants the opportunity to get up to speed and interact with peers who might be interested in collaborating.

Pediatrician Nadine Burke Harris, California’s first surgeon general, opened the summit with a call to action for philanthropy. “[Burke Harris] highlighted philanthropy’s ability to ‘empower champions’ in their research and advocacy work, fund capacity building, and help demonstrate effective solutions for government to scale,” according to the executive summary of the summit.

“Now is the time to make game-changing investments,” Burke Harris said. 

Kathleen Pike, professor of psychology at Columbia University and director of the Columbia-WHO Center for Global Mental Health, echoed Burke Harris, warning, “If we don’t fund at threshold, we will be demonstrating to the naysayers that we can’t do anything about mental health. We will be inadvertently reinforcing this myth — not because it is true, but because we are not demanding that things get funded appropriately.”

During the three day-summit, which was held in Healdsburg, California, there were presentations on technology and mental health, workplace mental health, education, and innovative treatment strategies. Funders were also presented with ideas and opportunities for investment and collaboration.

The summit took place in mid-November, so it is too early to assess outcomes and impact, but Niemann was pleased that the event generated so much interest and enthusiasm, and hopeful that will translate into increased support for mental health.

“You know, people almost always come to this work from a personal place, a personal ‘why,’ and that tends to drive funding toward specific initiatives,” she said. “Part of what we wanted to do with Activate is help people see that, yes, you can be involved in funding a specific initiative, but also lift your eyes to the ways we can come together and collaborate and fund at a dosage level that will lead to systemic change.”