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Along with philanthropists who are funding research, creating clinics, promoting strategies for helping the mentally ill cope in residential neighborhoods, or pressing governments for different policies, there are donors who are devising alternative forms of care. These include new treatments, new technologies for diagnosis, and care in non-traditional settings like homes, jobsites, and schools.
The Lynde and Harry Bradley Foundation supports clinics and day treatment directly inside inner-city schools—primarily private religious schools participating in the state-funded parental-choice program. The counselors who staff the clinics provide direct services and also train teachers in how to address children with behavioral issues. Schools need only make minor physical accommodations to meet the requirements for licensed mental-health professionals to see students on a consistent basis. The foundation has connected the program’s leaders to legal and policy experts who can help navigate the complex world of insurance and Medicaid regulations to ensure financial solvency and a high standard of care.
Bob Anthony runs a nonprofit called Adolescent Wellness that develops curricula to help young people cope with anxiety and depression. His resource Breaking Free from Depression is an online program that teaches teachers and parents how to recognize and respond to problems in children. He is now funding a referral program that allows school counselors and nurses across the state of Massachusetts to get professional recommendations from a psychiatrist within 20 minutes when a child is in crisis. It is called the Massachusetts Child Psychiatry Access Program.
The Anschutz Foundation gave a $10 million gift in 2016 to launch the National Mental Health Innovation Center at the University of Colorado Anschutz Medical Campus. One project of the center supports new technologies that might be helpful in fighting mental illness. Some people believe, for instance, that virtual-reality devices could be effective in forming empathy where it is lacking. Entrepreneurs like Tom Insel are developing apps for smartphones, now in clinical trials, which may diagnose mental illness more accurately than current survey methods.
The foundation also supports entrepreneurs who have invented a novel technology but need assistance in getting it into health centers. It offers clinical validation, beta assessment, and help with FDA studies. The hope is that new diagnostic devices, wearables, and uses of artificial intelligence might not only improve the effectiveness of psychological care but also reduce its cost.
Telehealth—networks which allow patients to consult with physicians and other experts from a distance—can also be used to improve diagnosis and care. The Robert Wood Johnson Foundation and other grantmakers have funded Project ECHO to link primary-care doctors in rural areas to academic medical centers where they can get advice on mental and behavioral issues.
Social-support services are another area where philanthropy is funding improved attention to patient needs. The nonprofit website 7 Cups organizes hundreds of thousands of volunteers to provide free emotional support via online chat rooms. The chat rooms also offer referrals to low-cost online therapy. The system’s anonymity allows people to engage without stigma, and use of the site has been growing by 12 percent a month, to a current level of two million monthly clients.
A somewhat similar effort has been organized by the Crisis Text Line, a New York-based nonprofit. Its hotline receives about two million messages per month. It is staffed by 6,000 volunteers around the country who are able to respond to an emergency within 30 seconds. This is an alternative to crisis phone lines, which have grown much less popular, particularly among the young.
Not only are philanthropists supporting non-traditional alternatives to care, they are broadening our definition of mental health to include related social and cultural influences. With funding from the John Templeton Foundation, Harvard School of Public Health epidemiologist and biostatistician Tyler VanderWeele is conducting research on the influence of religious attendance and prayer on physical and mental health. He has created new measures of human well-being that are broader than simple behavioral, mental, or emotional indicators. Close social relationships, personal character and virtue, financial and material stability, personal meaning and purpose, and indicators of daily satisfaction and happiness are interlaced in his framework. He is studying the well-being of individuals in businesses, universities, and health systems using his cross-linked measurements.
Many philanthropists are emphasizing the personal skills and habits that lead to mental flourishing, and the cultural practices and institutions that nurture these habits. Rather than funding mental-health clinics in schools (which it found often closed after its grants expired) the Richard M. Fairbanks Foundation decided to invest in classroom programs that teach children how to cope with adversity and build healthy habits and practices that will fend it off. In 2018, Fairbanks distributed $12 million to 24 organizations operating in 151 schools in the Indianapolis area.
Elizabeth Fowler of the Triad Foundation in Ithaca, New York, is a founding board member of Frameworks of Tampa Bay, a nonprofit organization that supports educators in implementing research-based social and emotional learning (SEL) programs. In the 2017-2018 school year, Frameworks impacted more than 41,000 students. Central to Frameworks’ programming is Community Building Sessions, an original SEL program that builds positive culture and climate in classrooms and schools. Through practices that include mindfulness, breathing, compliment giving, greetings, focused activities, and more, students build deeper relationships with each other and with their teachers.
The Anne and Henry Zarrow Foundation of Tulsa, Oklahoma, also funds interventions that boost social connections. It supports activities that get children participating in school nutrition programs—like free daily breakfasts—to engage with each other in healthy ways while eating.
Philanthropists are willing to try novel approaches. They are intervening earlier. They are building approaches that involve new actors within a community. They are moving beyond crisis centers and hospitals and jails and into the preventive-health system. They are seeking alternatives to prevailing mental-health financing. They are interested in new delivery systems. They are experimenting with technology, and with alternative care provided in settings like schools and homes. Some are seeking tighter definitions of mental illness based on molecular, neurocircuit, and genetic biomarkers. Others are broadening definitions to include social, spiritual, and economic factors that correlate with mental health.
One thing all of these philanthropists have in common: They channel empathy for fellow human beings into improved health, stability, and happiness for all.