The MINDS Act: Incorporating Mental Health Services in Foreign Aid


CHANHASSEN, Minnesota — Before the pandemic, almost one billion people worldwide suffered from mental health disorders. Uncertain conditions due to the COVID-19 pandemic have only increased cases of depression, anxiety and stress, especially for those struggling financially. On June 17, 2021, Sen. Bob Casey (D-PA), along with Rep. Ted Deutch (D-FL-22) and Rep. Joe Wilson (R-SC-2), introduced the Mental Health in International Development and Humanitarian Settings Act, or the MINDS Act, to incorporate psychological health services into foreign aid programs. If passed, the Act would support countless individuals struggling with mental health disorders and illnesses.

The Link Between Poverty and Mental Health

Poverty and mental health interact within what the World Health Organization (WHO) calls a “vicious cycle.” Those who live in poverty often do not have adequate resources to support themselves, to receive access to mental healthcare or to obtain an education or employment. These circumstances increase the chances of developing a mental health disorder. On the other hand, mental disorders may prevent individuals from working and can be a cause for discrimination due to established stigmas, increasing individuals’ chances of living in poverty. Moreover, according to the National Alliance on Mental Illness, depression and anxiety disorders cost global markets $1 trillion every year due to lack of economic productivity.

Tumultuous social, political and economic conditions such as poverty and conflict can have a great impact on mental health. The WHO reports that mental disorders are almost two times more likely to affect low-income groups compared to wealthier individuals, yet more than 75% of people with severe mental illness in lower-income countries do not receive the aid they need. Despite its importance, only 2% of health budgets around the world are allocated to mental healthcare.

Conditions that facilitate mental wellness are also extremely important for development. According to a study published in the National Center for Biotechnology Information, “poverty and deprivation are key determinants of children’s social and behavioural development and adult mental health.” Unfortunately, two-thirds of children around the world reside in countries plagued by conflict — an instability that could be detrimental to long-term mental health.

COVID-19 and Mental Health

In the past year, the COVID-19 pandemic has increased rates of mental health disorders around the world due to unpredictable health and economic conditions. Moreover, the rise of mental illness cases is disproportionately affecting those in poverty. Loss of employment, death of a loved one, isolation, possible exposure to COVID-19 and violence resulting from close contact with abusers have all contributed to a rise in mental health disorders during the pandemic. Additionally, the interruptions to education and social interaction have been especially hard on children and could severely impact their cognitive and social development.

The pandemic has also limited access to essential services. Risk of infection prevents in-person meetings with mental health professionals and entry into long-term facilities. This is particularly challenging for lower-income countries that lack sufficient healthcare personnel, technology needed for remote services and necessary medical equipment. Moreover, 93% of mental health services could not remain active during COVID-19, displaying the pressing need for the MINDS Act and mental health programs in foreign aid initiatives.


The bipartisan legislation, introduced by Sen. Casey in the Senate and by Rep. Deutch and Rep. Wilson in the House of Representatives, aims to integrate mental health services permanently into foreign aid programs. If passed, the MINDS Act would codify the role of USAID Coordinator for Mental Health and Psychosocial Support (MHPSS) who would “oversee and support the integration of MHPSS into U.S. foreign assistance programming” for those in need of psychological support. This programming would be incorporated into all USAID offices and would address the needs and cultural standards of each community, devoting specific resources to care for children experiencing hardship.

The MINDS Act would also establish a MHPSS Working Group managed by the USAID Coordinator. This group, consisting of USAID managers and representatives from the State Department, would monitor the effectiveness, persistence and quality of programs. The Act also requires USAID to report to Congress about the progression of the bill’s initiatives, including its finances and any obstacles that arise.

The Progression of the MINDS Act

In a press release on June 17, Sen. Casey emphasized the urgent need for the programs outlined in the Act. “Addressing mental health needs is especially important as we reckon with the effects of COVID-19 on communities around the world, especially communities already at conflict,” said Sen. Casey. “Investing in the mental health and well-being of children ensures that they continue to thrive into adulthood and can help break cycles of poverty and violence and further their country’s future potential.”

In addition to The Borgen Project, Heartland Alliance International, American Academy of Pediatrics, International Rescue Committee, RISE Institute, Save the Children and UNICEF USA have all praised the groundbreaking legislation.

After its introduction in Congress, the Act must be released by committees in both the House and the Senate and receive a majority vote in both chambers in order to advance to the president to sign into law. The MINDS Act is the first U.S. bill to require mental health services in foreign aid programs, and, if passed, it would be revolutionary in addressing the global need for psychosocial healthcare. To help pass the proposed bill into law, U.S. citizens can contact their congressional leaders and ask for their support of the MINDS Act.

– Sarah Stolar
Photo: Pixabay


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