“An uncertain future” - The impacts of United States and other Government Funding Cuts on Global Mental Health Services
This year’s funding cuts by the US Government (on funds such as USAID and PEPFAR) and other countries' reduction of aid have been felt intensely around the world. Our joint work between the Global Mental Health Action Network and the Mental Health Innovation Network now outlines for the first time the impact of these funding cuts on global mental health.
These cuts have come in a context of a pre-existing monumental public financing gap in global mental health of at least US$200 billion. The majority of countries in the world are far from meeting even modest mental health funding targets.
Globally, only a minority of those living with mental health conditions receive treatment, which is usually of poor quality with far less coverage in low-and middle-income countries. Even less coverage occurs for interventions to prevent associated impacts of mental health conditions, with negligible coverage of interventions to prevent problems or promote mental wellbeing, even in high-income countries.
This implementation gap has widened since the pandemic and results in population-scale preventable suffering, lost potential, broad impacts and associated economic costs. It breaches the right to health and contributes to a lack of preparedness during public health emergencies.
Impact on mental health services
Our global survey covers 131 programmes in 32 countries around the world.
These programmes supported a total of 981,850 people in 2024. Now, only 207,030 beneficiaries will receive support in 2025. ¾ of a million people immediately lost access to mental health care at the time of the cuts.
This means that more than 310,000 torture survivors, 82,000 LGBTQI+ people, 400,000 women, and 255,000 children have lost access to mental health care, often including life-saving services or critical preventative community programmes, such as in Ukraine:
“In conditions of instability, crisis, and social challenges, adolescents and youth often lack access to qualified support. It is necessary to expand free psychological support programs and adapt them to the real needs of young people. With the reduction of funding from the United States, such programs are currently being scaled back in Ukraine.” Service provider in Ukraine.
Watch Beto’s reflections on the impact of funding cuts in Brazil.
People have been affected in many different ways. This is Twaambo’s story from RefuCare in Zambia:
“Twaambo, a second-year nursing student at the University of Lusaka, never imagined she would have to drop out of school. The weight of uncertainty, coupled with the emotional distress of seeing her mother struggle, pushed her into isolation. Through counselling and peer support, she is beginning to rebuild her confidence, but the future remains uncertain. Many families are now left vulnerable, with young women predominantly bearing the silent consequences. This is not just a financial crisis. It is a mental health crisis. The longer funding remains frozen, the more lives, especially those of students like Twaambo, will be put at risk.”
131 Global Programs with 9,343 mental health staff at the time of funding cuts. 73% (6,835) of these positions were immediately cut.
For example, 276,275 people lost access to psychological treatments, such as in Uganda:
“StrongMinds has proven that depression treatment is scalable, cost-effective, and impactful, with a cost per person of just $23 and hundreds of thousands of individuals treated annually. Mental health interventions directly improve school retention, food security, and work productivity, yet mental health receives less than 2% of global health funding. Immediate bridge funding is critical to sustain services, and governments, funders, and global health stakeholders must integrate mental health into development priorities to prevent a deepening crisis.”
348,450 were receiving treatment at the time of the cuts. 79% (276,275) immediately lost services.
Watch Lucy Onen Adoch from StrongMinds outlining the impact of the US funding cuts on their work in Uganda and how the organisation is managing to continue their essential services.
Another 142,451 people lost access to medications, such as in Nigeria:
“I pray this nightmare comes to an end because, due to the hardship in Nigeria which I know of, everyday everyone goes into several mental health cases; many have passed away by stopping treatment and losing hope. Many many other people have gone into drug use with no hope at all; this is a disaster and a total nightmare for all of us here in Nigeria.”
190,601 were actively receiving medications at the time of the cuts. 75% (142,451) immediately lost access to medications.
Suicide hotlines in these 32 countries remain underresourced since January; 13 Suicide Hotline Programs completely shut down at the time of the cuts, and of the remaining hotlines, 7 were cut by more than 75% of their capacity.
Impact on the workforce
The 131 global programmes surveyed employed at least 9,343 staff in 2024. Since early 2024, only 2,508 are continuing in their roles. 6,835 of these mental health staff positions were immediately cut.
“My program works with unaccompanied minors. Due to budget cuts, over 60% of staff have been furloughed and in process of being laid off. The government halted access to funds that directly impact mental health services to unaccompanied minors and their families, as well as access to case management services and connection to community resources such as education and legal services.”
Critically, in a context of already severe mental health workforce shortages, the US government funding cuts have also meant that almost 50,000 people in these 32 countries have lost access to training they were receiving to become mental health practitioners.
Only 5,908 will receive training in 2025 compared to 55,911 in 2024.
The World Health Organization projects the global shortfall of health workers will reach as many as 10 million by 2030, with the greatest strain being felt in low- and middle-income countries (LMICs), which has an estimated shortage of 1.18 million health workers. The main cause of the treatment gap is an insufficient health workforce with mental health skills.
The global median number of mental health workers is only 13 per 100,000 population, and in LMICs and low-income countries that falls to 3.8 and 1.4 per 100,000 people, respectively.
Watch Sia’s recommendations after funding for the work she has been leading in Tanzania was abruptly cut earlier this year.
Where next?
Every dollar invested in expanding mental health programmes has the potential to generate an economic return of $5 to $6 in GDP growth globally. And yet, whilst mental health conditions are a leading cause of disability worldwide, they only receive approximately 2% spending on healthcare by governments around the world. The US government funding cuts (coming on top of other Development Assistance funding cuts) have made an already bad situation, worse.
To improve mental health around the world and ensure adequate resourcing for critical prevention and care, we are calling for:
Immediate actions to reinstate funding cuts by the US Government, including those spent on global mental health services and research. These cuts are a false economy. The economic cost of unaddressed mental illness accounts for losses equivalent to 8% of GDP in North America. Untreated mental health conditions have considerable impacts on the global economy through unemployment, productivity losses, caregiver costs, and other healthcare and social care expenditure. Maintaining these funding cuts only contributes to widespread suffering.
International donors, including bilateral and multilateral organisations, to urgently invest more in mental health to support vulnerable people around the world. Aid for mental health dropped by a third from 2018 to 2021, from $300m to $200m. Government international aid agencies must allocate at least 0.5% of their overall health development financing to mental health which will provide an extra US$179 million to mental health services in low- and middle-income countries. If this was increased to just 1%, there would be almost an extra half billion dollars available per year.
Governments to increase their mental health financing to 5% of their total health spend (for LICs, LMICs and UMICs) or to 10% (for HICs). Domestic resources are the long-term solution to sustainable mental health systems. Mental health financing requires both an increase in the volume of financing available and more efficient and effective use of the available financing.
Private and philanthropic donors to step in to fill these important funding gaps. Where domestic resources are not enough, catalytic donor finance is needed to create systemic change and sustainable financing solutions. Private philanthropy is already making up over half of the total international spending in mental health, and the dire reality is that it is still now needed more than ever. By 2050, scaling cost-effective, evidence-based mental health interventions could reduce the mental health disease burden by over 40%, add 1.1 years to healthy life expectancy, and contribute up to $4.4 trillion to the global economy.
Our global community is used to operating with limited resources. We are coming together to support each other and to use this learning to collectively reimagine funding (development and beyond) for global mental health in times of change.
