Here’s an impressive contrast (courtesy of Shitij Kapur): the British public donate 0.3p to mental health charities for every £1 spent by the government on mental health research. For cancer, it is £2.74 for every £1 spent by the government. The larger context is that the UK government spends a lot of money on biomedical research and also has a strong, tax-subsidised, tradition of giving to charities. Of course, numbers of this kind always need a little caution, but if it is 3p not 0.3p, the difference remains enormous. What lessons does this gulf in relative public donation to mental health research, compared with cancer point up?
First, there is a single main cancer charity in the UK; that helps. There may be as many as twenty (even more) who map onto the mental health space. An enduring failure to co-operate, and a pointless diffusion of effort is instantiated by these figures.
Next, the purpose, the message, call it what you will. Cancer-UK places a simple stress on research – you know that when you give money to them, the intention is to support research. By contrast, the mental health charities articulate a wide range of discontents and promise, for the most part, ‘campaigns’. Indeed, the biggest of these organisations are quite successful at raising money but it is from the government, and to provide services. So, I suppose if you do not want to support research, there should be no surprise when so little money gets given towards it. But is just caring about mental illness and its consequences enough: should donation be driven by pity or protest rather than logic. And isn’t that just a bit stigmatising?
For what it is worth, I think the public is ready for a message that says the priority in mental health is scientific understanding. This is not a tactic; it also reflects what we really need. Pharmaceutical companies have withdrawn from funding R&D in psychiatry and neurology because the scientific understanding of our conditions is inadequate. We need neuroscience advances to be translated remorselessly into reliable knowledge about mental illness. Without that, there will be no progress in approaches to prevention and treatment.
The American charity the Brain and Behavior Research Foundation (formerly NARSAD) has it right. From its simple commitment to ‘alleviating the suffering caused by mental illness by awarding grants that will lead to advances and breakthroughs in scientific research’, its web page (Discover, participate, donate) and it emphasis on the best neuroscience, you know what it stands for. The contrast with the large UK charities is painful; their single reliable guarantee would be that any money you donate will not be spent on research to understand disease mechanisms in mental disorder.
There are important new developments that I know about first hand – the Alzheimer’s research UK, the new research charity MQ, recently set up by the Wellcome Trust in the UK and Fondamentale in France all place a primary emphasis on research. I hope there are already or will be examples in other European countries. They deserve to succeed and we need them to. Caring is not enough.