The conversation about the mental health crisis is loud, but at a standstill. Stuck on repeat around the challenges of accessing existing treatments, the situation can appear increasingly hopeless.
I see another future — one far more positive and exciting. We are on the cusp of a revolution in mental health science. In five years’ time, the mental health treatment landscape will look radically different. We need funding to keep up with innovation.
As mental health director at Wellcome, one of the largest nongovernmental funders of research in the world, I see scientific discoveries and technological advances sparking a wave of new therapies and solutions to transform people’s lives on a global scale.
The first new pharmacological approach for schizophrenia in more than 50 years, Cobenfy, has just been approved by the Food and Drug Administration. It works in a completely different way from any other currently used schizophrenia drugs and has the potential to change the lives of millions of people. Virtual reality is being used in a novel avatar treatment to help people stand up to highly distressing voices that are undermining their mental health. The latest neuroscience findings in relation to sleep and exercise are laying the foundations for new interventions for young people with depression and anxiety. The Friendship Bench approach, developed in Zimbabwe, is training people in the community such as grandmothers to provide mental health support.
These are just a few examples of the innovations that are emerging that Wellcome supports and promise a brighter future for treating and managing mental health.
What keeps me awake at night is how we can get these solutions out at scale and in an equitable way to the almost one billion people that need them across the world.
The global health community is starting to find ways to rise to this challenge. A key part of the solution is to address lack of funding. There is an annual financing gap of more than $200 billion from government spend on mental health around the world, according to NGO United for Global Health.
To help bridge the gap between the fast-paced scientific developments in mental health and the lack of investment, Wellcome co-founded the Coalition for Mental Health Investment (CMHI). Together with our partners, the African Venture Philanthropy Alliance, Clinton Global Initiative, Kokoro, and McKinsey Health Institute, we are convening funders and experts to help drive investment in mental health at scale, allowing for the fast tracking of innovative solutions. We aim to change the conversation on mental health, but this is more than a talking shop. Drawing on the latest evidence in science and finance, we will push public funders, investors, philanthropists, and experts to find ways to bridge profit, risk, and equity.
There are huge opportunities here for investment from all sections of society — the public sector, philanthropies, and private investors — but there will also be hurdles to navigate along the way.
Turning mental health science breakthroughs into products for those who need them most is not a straightforward task. It needs clinical, technical, and lived-experience expertise, alongside substantial financial investment. Balancing a demand for innovation with a demand for equitable access is a challenge that will have to be collectively solved.
In the business of health care, mental health is not a priority. Recognition by policymakers will be key to open up investment — for early intervention and treatment.
The good news is that the private sector is increasingly recognizing that mental health should not be seen as separate from the rest of health. The global mental health market reached $419 billion in 2022 and is expected to grow to $500 billion by 2028. In 2021 alone, nine mental health reached unicorn status by reaching valuations of more than $1 billion.
But private sector financing alone won’t be enough.
Innovative financing mechanisms, such as philanthropic-public-private partnerships, offer new possibilities for transforming people’s lives. In South Africa, for example, a partnership between philanthropy and an employer is helping secure mental health checks for new mothers, bringing benefit to the individual, the business and society.
In California, a commission is driving transformative change across the state’s mental health system. It oversaw the implementation of a 1% income tax on wealthy residents to pay for mental health services and established a framework to improve mental health care in the state. The commission partners with public and private mental health agencies at all levels to reach those most in need.
The narrative surrounding mental health around the world is understandably one of crisis. Yet there is extraordinary potential in this area for innovative scientific research to change the lives of millions of people around the world with mental health problems. One of the ways we can provide practical help is through connecting researchers to public, philanthropic, and private investors.
As a clinician working in the U.K. National Health Service 20 years ago, I felt the frustration of not having enough effective solutions for people who really needed them. I feel that same frustration from those on the frontline today.
But I want them to know that things are looking better. We have the innovative science to change that. Now we need to gear societies around the world towards prioritizing mental health and drive the investment to power it.
Miranda Wolpert is director of mental health at Wellcome. She is also professor in evidence-based research and practice at University College London.
Disclosure: Wellcome funded the Phase 1 and then Phase 2 trial of Cobenfy in 2015 and 2018. To support the development, Wellcome loaned about $11.7 million to Karuna and converted those loans to equity in the company. In March 2024, Karuna was acquired by Bristol Myers Squibb.Wellcome does not own shares in BMS. The income Wellcome received from the shares can be reinvested in new research.