Breaking cycle of mental illness and poverty

Breaking cycle of mental illness and poverty

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Last Update: April 2, 2012

Breaking the cycle of poverty facing millions affected by mental health disorders around the world, through social franchising of a community based solution.

Type: citizen sector

The Problem

Globally, 13% of all disease is attributable to mental health disorders. 75% of those suffering from mental illness live in low and middle income countries. 75% to 85% of those are not able to access treatment. Mental illness is both a cause and consequence of poverty and other forms of ill-health. Poverty brings with it stress, exclusion, malnutrition, which contribute to mental illness. Conversely, the stigma, discrimination and abuse those with mental illness face, makes it even harder for them to participate in family and community, and they are more prone to disease. It's widely recognised that innovative and enterprising solutions are needed that will enable scale up, empowering individuals & communities to address the links between poverty, exclusion and mental illness.

The Solution

BasicNeeds programmes follow a unique and highly efficient and effective Model for Mental Health and Development (endorsed by the WHO), which tackles people’s poverty, as well as their health. Social franchising of this model will enable us to scale up our solution to 500,000 users and their families by 2016, without the need to expand our current structure and services. The MHD model builds community mental health services, local capacity, access to livelihoods, as well as having a integral research and management component. At the heart of the model is respect for the integrity of the individual to lead their own development. Working together, mutually supportive self-help groups can improve treatment access, challenge discrimination. We have consulted business advisors who have confirmed that the MHD model is highly suitable to market as a Social Franchise, and can be done so in a way that ensures local leadership, local innovations, sustainability, and quality are maintained.


Quality of service delivery is a significant challenge faced in resource poor settings, so quality assurance is central to our Social Franchising model. An example is our work with Livelihoods Education and Development Society(LEADS), Nepal, who is helping us develop the Social Franchising operational prototype. LEADS works in Baglung and Myagdi districts with people with mental disorders and disabilities, to support them to realise their basic rights and entitlements. Using a quality approach, BasicNeeds trained LEADS in the implementation of the MHD Model in May 2010 and provides ongoing mentoring support. LEADS, using Basic Needs training materials, has trained govt health workers from the regional and district hospitals, who staff mental health follow-up clinics. 400 people access treatment services from these clinics. 80 have already begun to earn incomes and LEADS are supporting them to attend existing community Self Help Groups from which they also access emotional/practical peer support. LEADS also uses BasicNeeds tools such as participatory data analysis, intrinsic to the MHD model, to gather research for advocacy, and to improve the relevance/effectiveness. This has made an enormous difference to the lives of individuals living with mental illness, e.g. Padam, bipolar sufferer says: “Before, nobody was close to me and I could not say my feelings, but now everyone comes to talk with me and I can express my feelings. I am the head of my family and have done nothing for my wife and children, but now I have the hope that I can do something for them.”

Budget: More than $1 million


BasicNeeds has been recognised as a global leader in integrated development responses to the challenges faced by people with mental health disorders in resource poor settings. Social franchising of our MMHD approach is a unique, innovatory response to the challenge of scale up that is facing the sector. Chris Underhill, Founder Director, gave a keynote presentation at the second summit for Global Mental Health in Cape Town in November 2011 on Best Practices in Scaling Up Mental Health Care, and our model has been endorsed by the WHO. BasicNeed's approach is very much one of collaboration within and beyond the mental health sector (including civil society, academic, and government bodies), rather than competition, and this is a key principle that underlies the Social Franchising model.

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