Kaya Guides- Marginal Funding for Tech-Enabled Mental Health in LMICs

By RachelAbbott @ 2023-11-26T08:05 (+79)

This post was written by Rachel Abbott, Kaya Guides’ founder.

TLDR

What is Kaya Guides and what do we do?

Kaya Guides is a global mental health charity incubated by Charity Entrepreneurship. Our focus is on reducing depression at scale in low and middle-income countries, beginning with India. Youth with moderate to severe depression are our target group.

We deliver a self-help course via WhatsApp that teaches youth evidence-based techniques to reduce depression. During the 5-8 week course, participants have 15-minute weekly calls with trained supporters and practice the techniques day-to-day.

This treatment approach (self-help, plus low-touch human support) is called guided self-help. It was recommended by Charity Entrepreneurship due to its high projected cost-effectiveness. Research indicates that guided self-help has the same effects as face-to-face psychotherapy- even if human support is only 15 minutes per week, the supporter has no clinical background, and the program lasts just five weeks. 

Why should we care about mental health?

Mental health disorders account for 5% of global disease burden and 15% of all years lived with disability. This figure is an underestimate: the Global Burden of Disease counts suicide as an injury, even though an estimated 60-98% of suicides are attributable to mental health conditions and 700,000 people die by suicide each year. Depression and anxiety alone account for 12 billion workdays lost annually. Despite the need for expanded mental healthcare, on average just 2% of government health budgets go to mental health.

Scale of the problem in India

We selected India as our first focus country. Mental health disorders in India account for nearly 15% of the global burden. 200 million people in India suffer from a mental health disorder at any given point in time. This is India’s leading cause of years lived with disability, and 40% of all the world’s female suicides take place in India. 85% of people with depression get no help at all, and in a country of 1.4 billion people, there are only 43 government-run psychiatric hospitals.

Kaya's program

 

We deliver on WhatsApp because:

What we’ve done so far

We launched our program in India this year and are currently running our proof of concept with 108 people. 

To get to this point, we:

We're the first NGO in the world to implement the WHO's program outside of a research context, having gained early access. We'll be sharing our learnings with the WHO to help shape the program for future implementers. We recently contributed to their manual for self-help programs, which will serve as a guide for implementing organizations worldwide.

Initial findings

We expected recruitment to be difficult, as it’s one of the biggest challenges mental health nonprofits face. Instead, we saw the following results:

Individuals had to fulfill each step in this process to join the program

Overall, these are some promising early indicators that we may have found product-market fit.

Further results on retention, engagement and treatment response are forthcoming after our pilot has concluded.

Expected Impact

Results of the WHO's 2022 RCT:

In India, the WHO program will have larger effects than what's reflected in the RCT: the control group in their study still received psychological treatment, whereas very few of our participants would receive any other form of mental healthcare.

Based on the WHO's program structure, we should be able to significantly reduce a person's depression for less than two hours of staff time.

Additional impacts of our program may include:

Cost-Effectiveness and Scale

Because this is a tech initiative, we can scale exponentially in a short time. These are initial rough estimates, but we believe we can scale to a point that we're treating 100,000 people per year in Year 5.

 

We estimate that at a scale of 15,000 participants, projected for Year 3, the cost per participant (direct costs) could be $9.32 and the marginal cost of treating an additional person could be $3.93. This would make us 30x as cost-effective as direct cash transfers at increasing subjective well being.

Our research into future expenses and growth potential to date has been relatively shallow, so our uncertainty is fairly high. However, we believe these metrics represent a reasonable initial best guess.

Team

Kaya Guides Founder Rachel Abbott has worked in global development since the start of her career. She's worked in early-stage NGOs, social enterprises, and large development organizations such as the world's largest USAID contractor. Having lived and worked in East Africa, Latin America and South Asia, Rachel’s background includes program design and management, impact measurement and analysis, partnership development and fundraising.

Clinical Director Rashi Sinha is a clinical psychologist who has consulted for large global NGOs such as Girl Effect. She focuses her private therapy practice and consulting work on serving marginalized populations.

Developer Akashdeep Bhagat specializes in WhatsApp chatbots and has led tech teams for organizations such as Saajha, a reputable Indian education NGO engaging 100K users on WhatsApp.

Guide Para Raturi is a psychology student with prior digital mental health experience and certification in suicide prevention.

What we’re going to do now

Next year, we’ll 10x our impact from this year by treating 1,000 people with moderate to severe depression. However, our main goal for 2024 is to set ourselves up for rapid scaling from 2025 onward. 

We will:

  1. Adapt the program based on lessons learned during the pilot
  2. Strengthen our tech to be able to accommodate large numbers of people
  3. Run A/B tests to identify the product design that leads to the highest retention and behavior change, reducing the risk of high participant dropout
  4. Automate our M&E systems to enable accurate, real-time insights on our impact
  5. Build a strong team capable of scaling our work to help millions of people

Marginal funding- what we need

Our total 2024 budget is $160K, and so far we’ve raised $80K from the EA Mental Health Funders Circle. We're raising another $80K to meet our goals for next year.

This is a high-level budget breakdown:


In 2024, our team will include:

Impacts of different donation amounts

Why should you contribute?

How to Donate

You can donate here! Donations are tax-deductible for US tax residents.

We really are grateful for any level of donation and would be happy to have a conversation. Please reach out- rachel@kayaguides.com.

 

*A few of the numbers on this post have been slightly revised- we caught an error, we originally reported 111 participants but actually had 108.