If I had a million dollars

How we might better leverage scarce capital for advancing mental health

As a former executive at a national foundation, I had the privilege of overseeing substantial investments aimed at improving mental health across the nation. During my tenure, I learned invaluable lessons about what works—and what doesn't—when it comes to advancing mental health. I learned how to do a lot of significant work with limited resources. One thing that often stood out to me, which I count as one of my most significant learnings - while the intentions behind many investments are noble, too often, well-meaning foundations miss the mark by focusing on short-term, fragmented solutions rather than investing in comprehensive, long-term strategies that truly make a difference. Said differently, we often play small ball instead of investing in more radical, broad sweeping, and often risky opportunities that have the chance to change the entire paradigm for how we think and approach mental health.

Why a million dollars? Well, if you were a child of the nineties, this song, and the band Barenaked Ladies probably came through your radio speakers more than a few times. Granted a million dollars doesn’t go very far in investing in big solutions for mental health today, it’s still a useful exercise to consider how you would invest resources if you were in charge of distributing them. That being said, any dollar, when used properly, can have a sizeable impact.

Before I get into some of the solutions, let me first point out a few things I would think twice before investing in.

First, and I am totally a broken record in saying this, but simply putting more money into programs that a) can’t scale; b) don't reach; c) have little to no proven effectiveness (at any level); and, d) are grounded in the same fragmented system is a problem. We need to be aware of how much money we already put into some of these places and course correct as appropriate. This means beginning to ask really hard questions about if we are getting what we need from some of these programs. It sounds ruthless, but it’s kind of like cleaning house for a move - get rid of all the things you know you don’t need anymore.

Second, while it's always good to have more research, we have plenty of it that's not implemented, scaled, or even acknowledged. Our academic institutions are amazing at bringing us the latest evidence; however, they also bring in a ton of research dollars from the federal government. Rather than just creating or investing in more research, let's us use what we have! This is to not say that we shouldn’t be constantly evaluating our work, quite the contrary, but that we should consider the balance between more research vs. helping people use what we have - the translation of research into practice.

If you were in charge of the finances of a state, system, or country, how would you invest?

For me, this is something I think about a lot. While my list here is not exhaustive, these are some things that keep coming back up over and over again in my conversations with others. These are three critical areas that I believe hold potential for creating lasting change.

1) Community-Designed Solutions:
One of the most important lessons I’ve learned is that those who are closest to the problem are often closest to the solution. Too often, decisions are made in boardrooms far removed from the realities of the communities they’re meant to serve. Instead, we need to shift our focus to community-designed solutions—initiatives that are created and driven by the people who know their communities best. By empowering communities to take the lead in designing mental health interventions, we can create solutions that are not only culturally relevant but also deeply rooted in the unique needs and strengths of each community. This approach fosters trust, ownership, and sustainability, ensuring that the solutions are more likely to succeed in the long run. Said differently, any effort to go big without community engagement is doomed to fail.

2) Data Infrastructure:
Another critical area for investment is in building robust data infrastructure. To be clear, this is not necessarily new data, but good quality data available in a reliable way. Without solid and consistent data, it’s impossible to know what’s working and what’s not. Yet, many mental health initiatives are launched without the necessary data or data infrastructure in place to track outcomes, measure impact, cost, and learn from successes and failures. Investing in data infrastructure allows us to move beyond anecdotal evidence and gut feelings to make informed decisions based on real-world results in real time. It also enables us to identify gaps, allocate resources more effectively, and continuously improve our approaches. In a field as complex and multifaceted as mental health, data should be our compass—it should guide us to where we need to go and helps us avoid repeating the mistakes of the past and investing in the wrong things.

3) Upstream, Prevention-Focused Solutions:
Finally, if we truly want to make a lasting impact on mental health, we must invest in solutions that are upstream and focused on prevention. Far too often, mental health interventions are reactive, addressing problems only after they’ve reached a crisis point. It’s not to say that there’s not important work to be done there just that we often ignore solutions that would prevent people from being in these situations in the first place. What if we could prevent those crises from occurring? I think there’s a lot of strategies we could pursue that could do just that. By investing in prevention-focused strategies—such as early childhood education, family support programs, and community-based mental health initiatives—we can address the root causes of mental health challenges before they escalate. Prevention isn’t just more humane; it’s also more cost-effective in the long run. It’s about building a healthier, more resilient communities where mental health is nurtured from the very beginning.

In the end, the question isn't just how much money we have to invest, but how wisely we choose to invest it. A million dollars—or any sum—can be a catalyst for profound change if directed towards the right strategies. By empowering communities to lead the way, building the data infrastructure necessary to guide our efforts, and prioritizing upstream, prevention-focused solutions, we have the opportunity to reshape the future of mental health. It feels cliche, but the true measure of our success will be seen not in the dollars spent, but in the lives transformed. That’s something that’s worth all our time.