Rethinking mental health financing through a systems lens

By James Sale, Deputy CEO, and Faith Nassozi, Communications Advisor, United for Global Mental Health

An estimated 970 million people worldwide live with a mental health condition, according to the World Mental Health Report. Despite this burden, mental health remains underfunded and structurally disconnected from broader health financing systems. This contributes towards an annual financing gap of at least $200 billion that threatens progress toward achieving mental health support for all. Closing this gap requires a fundamental shift in how financing, research, and policy interact.

Mental health conditions account for a great share of the global disease burden, yet on average government health budgets worldwide allocated just over 2% to mental health, with most concentrated in psychiatric hospitals rather than community-based services. United for Global Mental Health’s (UnitedGMH) financing mental health report highlights that failure to act on closing this financing gap will cost the global economy trillions in lost productivity. Investing now is a smart economic action.  

Recent evidence suggests the situation may worsen if no action is taken. The Financing Global Health 2025 report projects cuts in aid for health, including critical areas such as mental health, amid shifting donor priorities. These cuts pose risks to service continuity. Furthermore, survey data from the Global Mental Health Action Network (GMHAN) highlight how abrupt funding withdrawals leave national systems exposed, revealing the fragility of mental health financing.

This is not just about insufficient funds; it is about poorly aligned financing with actual needs. Investments continue to prioritise vertical, short-term projects over integrated, sustainable system strengthening. Many national health systems are not adequately structured to deliver preventive services, sustained quality care, or financial protection for people living with mental health conditions and other chronic illnesses. Without better integration, particularly at the primary health care level, mental health will remain isolated. This misalignment builds a cycle of dependency.

A critical but often overlooked aspect of the financing debate is the feedback loop between financing and research. Aligning research agendas with policy needs and community priorities ensures that the evidence generated is both relevant and valued, helping to make a stronger case for investment. A robust feedback loop is essential; financing should support research that addresses real-world system questions, and research should inform smarter, more accountable financing. This systems approach, championed through initiatives like the International Alliance of Mental Health Research Funders’s (IAMHRF) Systems Matter Symposium, is critical if mental health financing is to be effective and sustainable.

The UN High-Level Meeting on Non-Communicable Diseases and Mental Health in September will represent a critical opportunity for meaningful advocacy. The recent drafts of the UN HLM political declaration are promising, with commitments to suicide prevention, child and adolescent mental health, and mental health system strengthening. Governments recognise the value of high-quality research and evidence, and the need to leverage new technologies to inform effective and innovative prevention and treatment of mental health conditions. Whilst the declaration does commit to mobilise donor resources for mental health and its research, the emphasis is firmly on domestic resources to be the bedrock of sustained progress. UnitedGMH has rightly called for defined financing thresholds, embedding mental health into health benefits packages, and mobilising progressive taxes to ensure sustainability.

To bridge the financing gap, global leaders must embed mental health into universal health coverage financing structures, accountability, and aligning research with policy and financing priorities to ensure that evidence aligns decision-makers and communities’ priorities.