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this is: Cause profile: mental health, published by MichaelPlant on the effective altruism forum.
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Introduction
In this piece, I argue that mental illness may be one of the world’s most pressing problems.
Here is a summary of the key points:
Not only does mental illness seem to cause as much, if not more, total worldwide unhappiness than global poverty, it also seems far more neglected.
Effective mental health interventions exist currently. These have been improving over time and we can expect further improvements.
I estimate the cost-effectiveness of a particular mental health organisation, StrongMinds, and claim it is (at least) four times more effective per dollar than GiveDirectly, a GiveWell recommended top charity. This assumes we understand cost-effectiveness in terms of happiness, as measured by self-reported life satisfaction.
I explain why it’s unclear if StrongMinds is better than all the other GiveWell recommended life-improving charities (due to inconsistent evidence regarding negative spillovers from wealth increases) and life-saving charities (due to methodological issues about where on a 0-10 life satisfaction scale is the ‘neutral point’ equivalent to being dead).
I make some initial suggestions for the highest-impact careers, as well as alternative donation opportunities. No thorough analysis has yet been done to compare these.
While mental health has the most obvious appeal for those who believe we ought to be maximising the happiness of people alive today, I explain that belief isn’t necessary to conclude it is of the highest priority: someone could, in principle, value what happens to all possible sentient life and still reasonably decide this cause is where they’ll do the most good. I raise, but do not seek to resolve, the many crucial considerations here.
In order to get a sense of how important work on this area is, I examine (i) the scale, (ii) neglectedness, and (iii) tractability of the problem in turn. Ultimately, tractability - which I understand as cost-effectiveness - is what really matters and the preceding two sections should be seen as providing helpful background. I then set out why someone might - and might not - think this cause is their top priority and what they could do next if they decided it is.
Scale (how many suffer and by how much?)
Section summary: mental illness causes more suffering than poverty in developed countries, seems to cause roughly as much suffering worldwide as poverty does and, unlike poverty, is not shrinking.
The 2013 Global Burden of Disease (GBD) report estimated that depression affects approximately 350m people annually, while anxiety afflicts another 250 million.[1] By comparison, the report estimated that malaria affects 146 million people, while a 2015 World Bank report estimated 702 million people living on less than $1.25 a day.[2] While poverty affects many more people than mental health, the share of the world population living in absolute poverty is falling rapidly: there were 1.76 billion in absolute poverty in 1999, a drop of about 1 billion people.[3] By contrast, severe mental illnesses are on the rise.[4] As one example, in the UK the proportion of those reporting severe symptoms of common mental disorders has risen 34.7% between 1993 and 2014 (from 6.9% to 9.3% of the population).[5] It’s unlikely this is solely due to increased reporting: an American birth cohort analysis running from 1938 to 2010 found large increases in all psychopathologies after using standard methods to control for possible increases in reporting.[6]
To properly assess scale we also need to know how much suffering each causes: if poverty makes people miserable but mental illnesses are only mildly bad, poverty will be larger in scale. In a recent analysis of self-reported happiness scores, the World Happiness Rep...
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