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In October 2021 to May 2022, EA Philippines organized the Mental Health Charity Ideas Research project. The project's goal was to find ideas that can become highly impactful and cost-effective charities in improving the well-being of people living in the Philippines and other low- to middle-income countries. It focused on children and adolescent mental health.

This was a follow-up to the participation of Brian Tan and myself in Charity Entrepreneurship’s 2021 Incubation Program, in their region-specific track for training people to research the top charity ideas in a region. The project was awarded ​​$11,000 in funding from the EA Infrastructure Fund in 2021 for 1.2 FTE in salary for the project for 8 months. Brian transitioned to being an advisor of the project early on, and AJ Sunglao was brought on as a part-time project co-lead, while two part-time researchers (Mae Muñoz, and Zam Superadble) were also hired.

Links to our reports

We already held a brown bag session last June 11, 2022 discussing the research process and introducing the top four charity ideas we found last year. Now, we share deep reports on those ideas that detail the evidence supporting their effectiveness and how one might implement the charities in the Philippines. We also share the shallow reports made for the other top mental health interventions.

Access the reports here:

Here’s a quick guide to our top ideas:

Idea NameDescriptionCost-Effectiveness ($ per unit, total costs)
Self-Help Workbooks for Children and AdolescentsThis intervention will develop and distribute self-help workbooks to improve depression and anxiety symptoms in children and young adolescents, particularly 6 to 18-year-olds. Depending on the severity of mental health disorders, the workbook can be accompanied by weekly guidance by lay counselors through telephone, email, social media, or other available platforms.

$2.67 per WHO-5 improvement

School-based PsychoeducationThis preventive approach entails training and supervising teachers to deliver psychoeducation on mental health topics in their respective schools. Through weekly participatory learning sessions, students would learn to apply positive coping strategies, build interpersonal skills, and/or develop personal characteristics that would empower them to care for their mental health and navigate important life transitions. 

$85.93 per GSES improvement

Guided Self-Help Game-based App for Adolescents The intervention is a self-help game-based mobile application for help-seeking adolescents aged 12 - 19 years old. As a self-help format, the app aims to teach service users concepts and skills that will aid them in addressing MH concerns. The content of the app will be based on evidence-based therapeutic modalities. The game-based format is used to enhance service user engagement and prevent dropout.

$69.47 per SWEMWBS improvement


 

$36.89 per CDS-R reduction

Youth-led Mental Health SupportThis intervention is a community-based intervention for adolescents aged 13-18. It uses task-sharing principles in delivering basic para-mental health support by training community members like SK officials and student leaders in basic mental health skills such as psychoeducation, peer counseling, and psychological first aid. The content of the training would be based on other community-based interventions like Thinking Healthy Programme, PM+, and Self Help+. 

$105 per SWLS improvement

Also check out this cause exploration writeup for why we should work on children and adolescent mental health in LMICs.

Note: Due to time constraints, we were not able to finish publicly shareable reports for all ideas.

About the research process

We hope this will help people who want to contribute to better mental health not only in the Philippines but also in other low-resource settings, whether it is through founding an organization or continuing the research. We also want this to be an example of and guide for conducting local priorities research. Thus, we also share with you the following:

This table summarizes the four phases of our research process.

PhaseDescriptionMain ToolsIdea countTime spent
0: Process Design, Training and Onboarding

We drafted the research process, created templates for each phase, did broad research and consulted with different mental health researchers and professionals.

We onboarded our research analysts by introducing effective altruism and our research process. We also practiced some analyses and tools we expected to do during the next phases.

NANA2 weeks
1: Idea Generation

Generating ideas by:

  1. Doing a systematic search to get ideas based on already researched interventions.
  2. Getting from Charity Entrepreneurship (CE) and Happier Lives Institute (HLI)
  3. Coming up with our own ideas and listing local interventions
Systematic Review56 ideas from CE and HLI and 229 studies from the systematic search2.5 weeks
2: Informed Narrowing

We narrowed down the list of ideas through two sorts.

First sort:

  1. Half of the researchers rated the CE and HLI ideas. 
  2. The other half rated the studies from the systematic search. 
  3. The top ideas or programs from both lists were taken.
  4. The ideas or studies were clustered by approach, delivery method and who delivers. These clusters make the top 30 idea clusters that moved to the second sort.

Second sort:

The idea clusters were rated using the following criteria:

  1. Costs (20%)
  2. Effectiveness (20%)
  3. Acceptability (20%)
  4. Ease of Implementation (10%)
  5. Ease of Scaling (10%)
  6. Ease of Funding (20%)

Each researcher was assigned a criterion.

Weighted Factor Model (WFM)

56 ideas and 229 studies -> 30 idea clusters -> 10 idea clusters


 

2 weeks
3: Shallow Reports

We spent 10-15 hours per idea cluster. We looked into the interventions’ effectiveness and quality of evidence, theory of change  and assumptions and summarized their strengths and limitations. We started looking into specific interventions that seem promising and similar existing interventions in the Philippines.

We then rated each intervention individually and their ratings were averaged to come up with one WFM. The following criteria were used:

  1. Effectiveness (20%)
  2. Acceptability (20%)
  3. Ease of Implementation (10%)
  4. Ease of Scaling (30%)
  5. Ease of Funding (20%)
  6. Costs (0 to 1, multiplier)

We took the top 5 idea clusters and created cost-effectiveness analyses on them. We re-ranked the idea clusters with this additional information and took the top 3. 

Theory of Change (ToC) Analysis / Process Mapping

WFM

Cost-effectiveness analysis (CEA)

8 idea clusters -> 5 idea clusters / interventions -> 3 idea clusters / interventions8 weeks
4: Deep Reports

We spent around 80 hours writing a deep report on each of the top 3 idea clusters and Guided Self-Help.

We assessed the intervention and the problem it is trying to solve in the context of the Philippines and other low-and-middle income countries (LMICs). We interviewed experts. We looked deeper into the implementability of the intervention and its cost-effectiveness.

Expert Views

WFM

ToC

CEA

4 idea clusters13 weeks

Contact us

If you are interested in starting a mental health charity based on these ideas, collaborating on a research project, or discussing the project with the researchers, send an email to me: contact.rsjavier@gmail.com. We are very excited for this project to lead to better things so please don’t hesitate to message us!

About the researchers

  • Shen Javier
    • Shen was a graduating Statistics student from the University of the Philippines Diliman when she co-led this research. This research grew her knowledge about mental health and her interest in working for this cause area so in 2022, she co-founded Kaya Guides. It is a mental health charity incubated by Charity Entrepreneurship and aims to provide guided self-help for youth in India. Shen also founded the Effective Altruism student chapter at her university. She is currently studying data science and pursuing a career in health and development.
  • Mae Muñoz
    • Mae is a licensed psychometrician, mental health researcher, and clinician-in-training. She is currently pursuing her Master’s degree in Psychology at the University of the Philippines Diliman, focused in the area of Clinical Psychology. She has had prior work experience in the development, implementation, and evaluation of community-based mental health services in Metro Manila and in several provinces in the Philippines. She also serves as an adviser for Sulong, a volunteer-run organization that aims to link victim-survivors of sexual violence to pro bono legal and psychosocial services. Mae hopes to become a licensed clinical psychologist in the future.
  • AJ Sunglao
    • AJ is a mental health advocate, licensed psychologist, and consultant from the Philippines. His work as a psychologist and a consultant involves designing and implementing interventions within the healthcare, development, and advocacy sectors both locally and globally. His focus is on developing systems, policies, and interventions for more accessible mental health care in disadvantaged communities. He recently finished his master's degree in Global Mental Health from the London School of Hygiene and Tropical Medicine and King's College London. 
  • Zam Superable 
    • Zam is a clinician-in-training, mental health researcher, and design researcher. She is a graduate student taking her Master’s in Psychology at the University of the Philippines Diliman. She also serves as a psychosocial support specialist in training at UP Psycserv. Outside of mental health, she is immersed in design research where she investigates human experience and behavior and identifies key insights that aid organizations in designing meaningful services. In the future, she hopes to utilize her experience to develop mental health programs for underserved communities and contribute to promoting equitable access to mental healthcare. 
  • Brian Tan (Project Advisor)
    • Brian co-founded Effective Altruism Philippines in 2018 and worked full-time as EA Philippines’ main community builder in 2021. He co-led this project early on, but he transitioned to be an advisor as he started working as a Group Support Contractor at the Centre for Effective Altruism (CEA) in December 2021. He now works full-time in this role for CEA and is an advisor to EA Philippines.

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Excited to see more work on mental health charities! Thank you for this. I will need a bit of time to read before I comment I could comment in more detail. 

What's stopping me from have a good overview of your results is that the cost-effectiveness of each proposed intervention is on a different mental-health outcome. If I am not mistaken, these have different scale sizes. Do you have results converted in effect sizes (Cohen's d)? This would mean all the outcomes are converted to the same unit, standard deviations. This makes it easier to compare and allows you to compare them to other interventions that are also evaluated in affect/wellbeing (e.g., McGuire et al., 2022). 

Hi Samuel! We don't have results converted in effect sizes but most of the studies would have those reported. We used the mental health metrics instead of effect sizes since we thought it was easier for showing how effective it was for a certain mental health outcome. Having it in effect sizes would be helpful too though!

Cool work! Thanks for this, I'll pass these on to potential entrepreneurs.  

Regarding the CEAs, could you say a bit more about the metrics used? Ideally, what would be a naive translation to QALYs?

Thank you! Regarding the metrics for the CEAs, we struggled to look for studies on the interventions that used QALYs/DALYs. We also found it challenging to convert the available metrics into QALYs/DALYs since it is not something the team was knowledgeable about. We decided just to use the most common metric we found among the studies for each intervention to be more accurate in describing its effectiveness.

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