Should we give out cash to improve mental health?

This month's guest expert is Professor Vikram Patel , Pershing Square Professor of Global Health at Harvard Medical School ?

For a long time, it was widely thought that mental health was a problem of the affluent – the “worried well”. That poor people had more important things to be concerned about than their mental health.?

In fact, research shows time and time again that there is a strong relationship between living in poverty and a higher risk of depression and anxiety. And this is, unfortunately, the lived reality of billions of people around the world.?

Cash transfers are one way to minimise these risks.?

Receiving just a modest amount of money can be transformative

There can be nothing more damaging to your mental health than not being sure what you can eat tomorrow – cash transfers reduce this uncertainty. They allow you to plan your life in a way that doesn't have to deal with doing everything right now, and you can begin to acquire a longer-term perspective.?

While cash transfers cannot be the only answer – we can't address the problem without also addressing the origins – I believe they are a very powerful tool. It's something governments can do here and now, and many countries already are.?

Brazil has implemented one of the world's largest cash transfer programmes for low-income people, called the Programa Bolsa Família. And we’re already seeing dramatic impacts of the programme on both economic and health outcomes.?

Our first analyses clearly demonstrate that the young people in those families who have received the cash transfer have much lower rates of psychiatric hospitalisation and much reduced suicide mortality rates.?

However, the association between disadvantage and mental health is often ignored in global development

I think people love the idea of a simple solution – a shot that will help cure or prevent some kind of disease or medical problem. They shy away from complex issues, like mental health, that involve interaction between the social, the political and the biomedical.?

The good news is, over the last two or three decades, there has been a flourishing of new science. Science that has investigated how you can deliver mental health care in community settings, with community health workers, peer support workers and nurses.?

More than 100 such experiments have been conducted around the world and they all find the same result: not only are these disruptive ways of delivering mental health care safe and acceptable, but they're highly effective and even cost-saving.?

The science is strong, and I now see the winds of change?

I believe we're at a unique inflection point to be able to build a community-based mental health care system without the resistance that we have faced for many decades.

This is the direction we need to travel. And this is the direction that many governments around the world, the World Health Organization, and many other agencies have started to embrace.

Hear more from Professor Patel in our new podcast, When Science Finds a Way.

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