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Inga
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Hi Lukas,
Thank you for this thoughtful comment. I hope you allow me to quote our program manager, Sam. She crafted a beautifully phrased answer to something similar in a former post:
”I’m the Mental Health Program Manager at Rethink Wellbeing, and I’d like to offer my perspective on framing the program as a way to increase productivity. My thoughts are my own, not an official RW statement, but I have given my colleagues a chance to review this message before sending it.I agree that basing one’s self-worth on one’s productivity can be a recipe for poor mental health (and rarely is effective at increasing productivity!).[...]
Despite agreeing with you, there are several reasons why RW highlights productivity in some of our marketing materials.
Many members of the EA community who struggle with mental health problems are very motivated to increase their productivity (see, e.g., the EA mental health survey results, under “Topics people struggle with or would like to improve the most”), so emphasizing this as a possible benefit might encourage people to take care of themselves.
Sometimes members of the EA community don’t feel like they “deserve” to engage in self-care for their own sake. If we note the possible benefit to others, it might alleviate some guilt about investing time in one’s own well-being.
I believe that everyone in the world deserves access to a program like this one (or whatever tools for mental well-being are appropriate for them). But resources are limited. People in the EA community are no more or less deserving than others, but as Jason notes, we can justify prioritizing support to this community if there’s a multiplier effect because it allows them to do more good. Taking into account the productivity / impact increase is important for making strategic decisions when calculating the potential impact of such an intervention; plus, EA funders will want to see that RW is keeping its eye on productivity as an outcome metric.
With all that said, because we agree that obsessing about impact is often harmful, we aren’t planning to emphasize productivity as a goal throughout the program. We are measuring it as one outcome, since it is a meaningful part of flourishing, even if just one; we also may briefly invite people to reflect on the effects of mental health on productivity if that is an effective source of motivation for them. But during the core of the program, we want to give people a chance to work on exactly this: the dysfunctional relationship they may have with productivity and impact, such as believing one needs to be productive, or close to perfect to be worthy.[1]
Talking about productivity is a way of getting people in the door by addressing a common core concern for EA community members. However, our model is that helping people increase their well-being, including developing a well-rounded life and engaging in self-care, should have a side effect of increasing their capacity to do good for others … without needing to focus on it or put any pressure on people. Rather, we hope to alleviate pressure. And participation in the program does not “obligate” people to do any particular EA work or change the world.
I expect that the team will continue to reflect on how to walk this tightrope in our marketing. It’s tough to get it right, because the messaging lands different ways with different people, so feedback like yours is incredibly valuable. Thank you.”
Hi Gabriel,
I agree that this number seems surprising at first. You can a more in-depth analysis in our main end-of-the-year-report post. This is how we arrived at the number (N=42): To assess productivity, we employed the Work Productivity and Activity Impairment Questionnaire: General Health V2.0 (WPAI:GH, 2015). This helped to quantify the actual amount of productive hours gained. We basically measured the hours worked as well as the productivity during those hours.
The results: Five hours or 18% more hours are worked overall (pre-mean=23, post-mean=28), and 57% fewer hours are lost due to mental health issues before and right after the program. Also, within the hours worked, productivity was claimed to be 13% less impaired by mental health issues, which is equivalent to 3.6 hours of more work. This mounts up to an overall productivity increase of 8.6 hours or 37% per week. This finding is aligned with the larger increase in executive function we observe.
This is great content! Thank you for writing and sharing it. I added the tag “High Impact Psychology” because this is an example of how psychology can help to increase EA impact.
First: I like the framework and the fact that you help to make impact vesting a viable option for the EA space. It indeed might open more opportunities for entering a multitude of markets and funding. Having a streamlined standard EA-aligned framework for this in the Global Health and Wellbeing Space could make the investment process more attractive (smooth), more efficient (options clearer and better comparable), and lead to better decisions (if the background analysis is high-quality).
Some points that jumped to my head for this specific case:
Might it be useful to add something like “neglectedness” of funding”? E.g. in the Mindease Case, I believe it was moderately likely (depending on the quality of the presented scaling strategy) that another investor would have jumped in to take the lead. There might be value in identifying and helping (1) ventures that have a promising impact prospect but low funding chances or (2) ventures that look like they might not have a promising impact prospect but since you have some rare specialists in the corresponding field, you know it is better than other options in the field. E.g. if Mindease had a really promising approach (evaluated by the specialists) to solve the low retention of users or the lack of sustainable effects of mental health interventions.
The evaluation of neglectedness (of the solution/problem) seemed partly confusing to me. It is correct that lots of people suffering from mental health issues do not receive treatment. This is also true in HIC where digital solutions are widely available. The real neglected problem seems to be the distribution of these interventions and this has been hard for all companies out there offering services like that and is only possible if you adapt your service to the specifics of the different cultures and countries and then also tailor the distribution strategy. This means, that currently Mindease just does something in HIC that other apps such as Sanvello are offering already (maybe no additional value for people that in this calculation is added to the DAILYs) and does not have product or market strategy for LMIC—where it would be neglected. Convincing providers like Sanvello to offer their services in LMIC, and then just specializing in tailoring the product for people in a specific large country (e.g. Nigeria) as well as nailing distribution there, might be much more impactful. E.g. the UK-based charity Overcome does something along the lines of this.
Having said this, maybe the impact evaluation should be done by an expert in the field: in this case an individual that knows the current state of research, practice, and industry and has a background in the field (here: mental health interventions).
Would it be useful also to add a “people’s time resources” needed to the equation? E.g. it is a difference if 10 or 30 EA spend their time working on this solution because they could also help to make an impact elsewhere.
Thank you, Akash, for sharing these papers. They are fascinating! Here is another paper that I sometime cite when referring to the “retention”-problem. It is a systematic analysis of infield data, estimating that 90% of users trying unguided mental health apps drop out after 7 days (Baumel & Edan, 2019).
Thanks for sharing. Really insightful, especially the comparison of effect sizes. What would be great to follow up on some time:
(1) comparison of all relevant different substances with their effect sizes, medication but also supplements, e.g. I missed L-Dopa, Amphetamine, L-Carnitine, healthy diet, etc., e.g. Methylphenidate seems to help healthy adults https://www.sciencedirect.com/science/article/abs/pii/S0924977X20302145
(2) display of which substances do NOT work
(3) differentiation in terms of not only effect size but of how many people are likely to experience an effect by the substance.
(4) differentiation in terms of what helps whom better. E.g.
Lisdexamfetamine seems to work a little better than Methylphenidad and Modafinil for ADHD people: https://journals.sagepub.com/doi/abs/10.1177/1060028018795703
Exercise also seems to help more for people with ADHD:
https://www.sciencedirect.com/science/article/abs/pii/S0022395619306168
(5) Cognitive “enhancement” can also happen by not eating certain things e.g. diverse toxins, sugar-fat, etc. Maybe that can be a good add-on as well.
Thanks again for sharing.
Thank you for this useful content! It made me decide to listen to content instead of reading it and to increase the speed of the reading even more.