Underfunding of Innovative Mental Health Research: A Call for Action

As researchers in mental health and funders of mental health research through the Royal-Mach-Gaensslen Prize, we believe that support for mental health research is crucial in Canada today and needs to be increased. There is much public discussion about the substantial burden that mental illness represents for society and the economy, but support for research that will lead to novel ways to prevent, diagnose and treat mental illness remains inadequate.

Underfunding of Mental Health Research in Canada

The 2020 report The Inequities of Mental Health Research Funding found that mental health in Canada receives less research funding than cancer, neurological diseases, or infectious diseases. ¹ Funding per year lived with disability for mental health was US$95 (C$126), compared with US$1,701 (C$2,257) for cancer, US$304 (C$403) for neurological diseases and US$2,468 (C$3,275) for infections. Funding per year of life lost was US$77 (C$102) for mental health research, compared with US$105 (C$139) for cancer research, US$430 (C$571) for neurological disease research and US$2,646 (C$3,511) for infection research. (Unpublished data: International Alliance of Mental Health Research Funders. Average annual funding for 2015 to 2019 inclusive; underestimated due to incomplete data. Conversion to Canadian 2019 dollars by the authors).

Further, mental health research spending in Canada has declined overall, from US$122.2 million in 2015 to $US89.9 million in 2019. ¹ The median size of individual grants for mental health research in Canada (US$52,000 for 2015 to 2019 inclusive) was the lowest among developed countries studied (US, UK, Australia/New Zealand, Europe [combined]).

As the report points out, 98.3% of funding for mental health research in Canada is from government and other public sources, including agencies and non-profit organizations that disburse government grants or funds. ¹ Funding is mainly from the Canadian Institutes of Health Research (CIHR), through its various programmes. Mental health forms part of CIHR's Institute of Neurosciences, Mental Health and Addiction (INMHA). According to data provided by CIHR, INMHA received approximately 9% of all research investments for 2016–2017 to 2020–2021 fiscal years inclusive (5 years), ranking fourth after the institutes for gender and health, genetics, and infection and immunity. Furthermore, research specifically in mental illness and behavioural conditions accounted for $413.6 million over that period or approximately 3% of total CIHR investments.

Federal granting agencies also fund 2285 Canada Research Chairs in universities across Canada. Currently, 32 are in mental and behavioural disorders, although some chairs in psychology also have a mental health focus. ² Early in 2022, the government added 188 chairs to the existing stable, but these have not yet been allocated to specific research areas. ³ The agencies also support Canada Excellence Research Chairs, but none of these chairs is in a mental health area.

Some provincial governments also fund health research, and a few have funded mental health researchers or research projects.^4–6 Independent foundations and other non-profit organizations, including the Mach-Gaensslen Foundation (represented by several co-authors of this Commentary), fund mental health research in Canada. Individual and corporate donors are also an important part of the funding landscape in Canada. Philanthropy provides important direct or indirect support to mental health research, through hospital and other research foundations. Yet philanthropic sources are fragmented, and some organizations have been much more successful in fundraising and attracting philanthropic donations than others. Together, fundraising charities and philanthropic sources provide only an estimated 1.7% of funding for mental health research in Canada. ¹

Finally, some academic and clinical research units in mental health also receive funding from international sources (e.g., U.S. National Institute of Mental Health, Brain and Behavior Research Foundation, MQ Mental Health Research, One Mind, and the Wellcome Trust).

What Mental Health Researchers Say They Need

As a limited but valuable insight into the needs of mental health researchers, we provide some of the responses to a qualitative survey of the six winners to date of the Royal-Mach-Gaensslen Prize, a $100,000 prize awarded every year to an outstanding Canadian mental health researcher or research team. Funded by the Mach-Gaensslen Foundation and administered by The University of Ottawa Institute of Mental Health Research at The Royal, the prize is one example of the potential contribution of philanthropic sources to mental health research. The survey took the form of open-ended questions, and prize winners have agreed to share their responses anonymously.

Prize winners highlighted the difficulty in obtaining funding for innovative, high-risk / high-reward or underfunded areas of research. They also emphasized the need for long-term funding. One noted the lack of research funding for essential mental health research: “A large proportion of research resources are spending on adapting knowledge to the new societal context … and relatively less is being done on the core business of finding new treatments for mental illness, effective prevention and personalized treatment choice.”

Flexibility in the use of research funding was also valued. Another recipient stated, “The very focused funding directives from other agencies make access to flexible funding—such as funding to attend a conference not specifically tied a priori to a federal research grant, or to purchase a specialized piece of equipment for a truly exploratory project—increasingly important.”

Several mentioned the need for support for participant recruitment for studies, data collection, knowledge translation, community engagement, student training, and extension of existing projects. One prize winner emphasized the difficulty in attracting and retaining young researchers to the field. “There is a growing dearth of mental health clinicians in Canada occurring alongside growing demand for mental health services. The academy is also becoming increasingly competitive, with a rise in workload expectations for professors … Accordingly, there is a need to inspire, motivate, grow, and support the sustained interest of young researchers to stay engaged with mental health research activities.”

A Call for Increased Funding for Mental Health Research

Mental health research in Canada cannot keep pace with the growing need for prevention, diagnostics, and treatments. The percentage of Canadians expressing the need for mental health care in a given year continues to increase,^7,8 while overall funding for mental health research in Canada remains low. ¹

Altogether, the “funding ecosystem” for mental health research is insufficient and has significant gaps, including:

Low amounts of individual grants.

A need for more long-term and sustained funding.

A need for funding for mid-career researchers (5–15 years after appointment), the career stage targeted by the Royal-Mach-Gaensslen Prize.

Lack of funding for non-project and curiosity-driven basic research, and for application of research to patients.

Lack of funding for hospital-based research, and especially support towards scientists’ salaries, as highlighted in our survey results.

Need for more dedicated research chairs in mental health.

One way to further boost funding is to “leverage” donations and funding from not-for-profit organizations with matching grants from public agencies. Canada also lacks a national philanthropic organization to fund mental health research, with public visibility and fundraising clout, similar to the Heart and Stroke Foundation and the Canadian Cancer Society. To grow the philanthropic and private-sector contributions in this area, the creation of a national organization would be beneficial.

We call on public and not-for-profit funders of health research to increase flexible funding for innovative mental health research and to hold a summit on addressing the challenge of funding for mental health research. Adequate research funding could go a long way to addressing prevention, care, and treatment for the one in four Canadians ⁸ who experience mental health problems in a given year, improving outcomes for individuals and for Canada's society and economy.