:)
so appreciate you and everyone there.
Joy Bittner
Karma: 748
really great post, and as someone who lives in the global south, you’re money probably when so much further than one would ever expect. thank you
A Thanksgiving gratitude post to EA
Hi Mike, thanks so much for all your support and these thoughtful points.
Yes, there are additional costs associated with geographic expansion, and we believe these costs are justified for several reasons:Testing Demand and Adaptation: By expanding to more rural locations, we aim to assess the demand for and adaptability of our services. Urban life in Quito is fast-paced, and we’ve noticed various factors competing for people’s attention, making it challenging for group attendance. Most other g-IPT programs operate in rural settings, where individuals may have more time. This expansion allows us to explore whether there are better rates of treatment adherence, with participants completing all eight sessions.
Building a Demonstration Case: As you suggested, this expansion helps us build a demonstration case, primarily for provincial and local governments. Regional government staff are generally more accessible than national government officials, and showcasing the value of providing mental health care can influence policies at these levels (hopefully leading to national government adoption)
Higher Counterfactual Value: In general, the counterfactual value of providing mental health care is higher in third-tier cities and rural communities due to the concentration of government services in larger cities. If we can effectively manage costs and prevent an overall increase, we believe there is a moral imperative to extend support to those with fewer alternatives.
thank you so much again and welcome further questions and feedback!
Similarly, would like to know if it’s possible to add Vida Plena? (I would imagine many orgs would like to know how they can also be considered for the donation election.)
Thank you so much, Philippe! Yes, we are excited about the possibilities of combining insights from different fields and seeing what the date shows us.
TLDR: Vida Plena, which provides WHO-endorsed group therapy for depression in Ecuador, seeks $200,000 for behavioral science research, $50,000 for expansion to new regions, $9,600 annually to hire an additional Group Facilitator or $120 to provide treatment to one person.
See our full marginal funding forum post here.
I’m the co-founder of Vida Plena, a nonprofit organization tackling Ecuador’s mental health crisis through cost-effective, proven group therapy led by local leaders from vulnerable communities. We do this through the direct implementation of Group Interpersonal Therapy, which is the WHO’s recommended intervention for depression. We are the first to implement it in Latin America.We launched in early 2022 (see our introductory EA forum post) and participated in the Charity Entrepreneurship Incubator program that same year. In the fall of 2022, we carried out a proof concept alongside Columbia University, which found positive results (see our internal report, and the report from the Columbia University Global Mental Health Lab).
So far this year, we’ve made a positive impact on the lives of 500 individuals, consistently showing significant improvements in both depression and anxiety. Our strategic partnerships with local institutions are flourishing, laying the groundwork for our ambitious goal of scaling our reach to treat 2,000 people in 2024.
For this marginal funding proposal, we seek $200,000 to expand our work and research to apply behavioral science insights to further depression treatment in Latin America. This enhanced therapy model will be evaluated through rapid impact assessments, deepening the evidence base for our work, and culminating in a white paper and a RCT in 2025.
In addition to the “Enhancing g-IPT via Behavioral Science” proposal described above, there are several other ways that Vida Plena could benefit from additional, marginal funding:$120 - Individual Support:
Provide comprehensive treatment for one person, covering 9 sessions and ongoing follow-ups.
$800 Monthly / $9,600 Annually—Community Facilitator:
Hiring an additional Community Facilitator will extend care to approximately 400 more individuals, ensuring continued support.
$50,000 - Expansion to New Region:
Facilitate our expansion into a new region in Ecuador. This includes the establishment of training and outreach teams, bringing vital mental health care to areas currently underserved and neglected, beyond our current operations in Quito.
Vida Plena: Transforming Mental Health in Ecuador—First Year Updates and Marginal Funding Opportunity
same! the 5am start time is a bit rough. thank you so much!
Hi Jason, thank you so much for thoughtfully bringing up this important question. While we do concur that the likelihood of Vida Plena increasing suicidal risk is low, we firmly believe in the importance of considering all possibilities.
Firstly, we want to emphasize that we are following the suicidal risk protocols established by the expert team at the Global Mental Health Lab at Columbia University, and we have been fortunate to receive ongoing mentoring from them throughout the course of these cases.
Broadly speaking, research shows this is unlikely. For example, a literature review conducted by Dazzi in 2014 failed to uncover any evidence supporting “a statistically significant increase in suicidal ideation among participants asked about suicidal thoughts.” Instead, “The findings of this review suggest that in both adolescent and adult populations, acknowledging and talking about suicide may, in fact, reduce rather than increase suicidal ideation.”
More likely, we expect that our cultural context is an influential factor. Several practitioners we consulted with emphasized that due to the stigma surrounding mental health treatment in Latin America, the people who finally reach out to seek treatment are very likely facing more severe levels of mental distress compared to what is commonly observed in the US or UK.
This is a question we’ll be able to answer more fully once we conduct further monitoring and evaluation with a control group. We promise to keep you posted!
HI Jemina,
The program is made up of 9 sessions in total, once a week. So aprox. 9 weeks.
Thank you so much for your support! Yes, its been a great journey!
From Vision to Reality: Vida Plena’s Pilot Results
Muchas gracias, Simón, por llamar la atención este tema. A pesar de que no soy hablante nativo de español, estoy muy de acuerdo contigo sobre la importancia de no solamente traducir materiales al español, sino crear materiales desde el español para generar nuevas formas de pensar, mejor vinculado al contexto regional. Aunque entiendo la decisión de los organizadores del EAGx tener un gran parte de las presentaciones en ingles en esta primera edición, los anima que al futuro la mayoría sean en español.
Cuando tuve la oportunidad de hablar frente de los estudiantes en el retiro en Bogotá, este fue mi mensaje principal para ellos: No coges simplemente las prioridades de EA que hayan creado en EEUU o EU y trasladarlas acá. Mejor, vea a tu alrededor, a las realidades y a las presiones locales que tú conoces a fondo y use los principios de EA para crear nuevas prioridades, causas y conceptos. El EA de América Latina no debería ser una réplica del EA actual, sino algo propio- con su propia paleta de colores, no con los tones sobrios de Oxford, sino los azules vivos del Caribe y el arcoíris de colores del Altiplano Andino.
Hi Jason! Thank you so much for all your very thoughtful comments and ideas! (and also for your decision to support us in 2023!) Want to take a minute to respond to some of your points:
Funding from non-EA sources: absolutely! We are so grateful that the EA-community is willing to take some risks on new organizations before they have a track record. With the results that we are able to demonstrate early on, we are absolutely planning on applying for counterfactual funding. In fact, as an example of this we were just selected to be part of the South Park Commons Social Innovators Fellowship, which is hosted in collaboration with the Agency Fund.
Mixed-payer model / sliding fee scale: yes, this is also a possibility we are keeping in the cards if needed, always keep in mind our mission. Our target populations are low-income communities and refugees: people who would not otherwise be able to access services (for example, we’ve found for some people even the $0.50 bus fees to attend are prohibitive). Additionally, I have talked with other mental health program founders (from Europe) who have warned me of being careful about the mission drift that can happen when taking on high-value paying customers (even with the positive goal of them subsidising other people...seems even with the best of intentions, they say it can be hard not to end up focusing more on the people who pay...).
Local fundraising / government funding: yes! This is actually part of our long-term plans. There is significant research that demonstrates improving one’s mental health results in improvements to physical health. We would like to demonstrate that this program can actually be a cost-savings to the national public health system. Furthermore, a recent UNICEF study found that untreated mental illness costs $30B a year in Latin America, making a very good case for national governments to dedicate more of their current public health budgets to mental health (currently less than 2% according to the PAHO).Local leadership and talent: I completely agree, - this is one of my favorite points that you bring up! Latin America is full of highly educated, very experienced professionals, and so this is who we will continue to hire. Something that differentiates us from Strong Minds. I am committed that our staff from all levels be locally based in Latin America, both as a cost-savings measure and especially to benefit from this incredible local talent- their professional connections, local knowledge, and personal understanding of the needs of the people we serve.
Happy to chat with you further or answer any other questions that might come up—open invite to anyone to find a time on my calendar.
Thank you so much, Judith! I am so deeply grateful for all that CE has been for me personally and Vida Plena!
Hi Simon, thanks for your questions and you bring up good points!
For the facilitator training hours, it was a mix of in-person and virtual:
- 2 days of orientation in person
− 4 days of interpersonal therapy training. We had the group gather in-person, but the training was actually led virtually by a team from Columbia University. So potentially in the future, people who are unable to attend in person could attend virtually only
- the remainder of the training hours occurred during weekly supervision meetings which happens fully virtually
Our plan for future trainings is to hold them in cohort groups of people who are all from a specific geographic region, so we could just send the trainers for the duration of the training days.Alternatively for cohorts groups who are more disperse, we will likely have to help with the public transportation costs, but we have a partnership with a local conference center who has promised to house us for free.
In general, this is a we have budgeted for a 30% turnover rate for our facilitators each year.
Happy to share the training budget details with anyone who is interested: joy@vidaplena.global
HI Simon, thanks for the feedback—while I don’t have access to the StrongMinds budget, based on their public tax returns, one difference I can point to is that we do not have any US-based staff (and subsequently, any US-rate salaries). In general, I would also add that we only have one type of intervention, whereas StrongMinds has added additional services/departments, which are likely critical and very beneficial, but harder to measure impact.
I’m happy to share our 2023 budget with anyone who would be interested: joy@vidaplena.global
Thank you Stephen, I feel really blessed to get to be part of this team, and grateful for all the people who trust us to help them.