Building Mental Wealth
Rebuilding our foundational infrastructure
We need to step into a phase of rebuilding. Rebuilding not towards what we had but towards an increasingly antifragile and empathetic society. This transition will require governments, institutions, companies, and associations to rethink and reconstruct the contextual settings [FIGURE 1] in which people operate - society’s platform for the future. It is increasingly clear how the micro molecular violences of late 20th century society e.g. air pollution, noise pollution, light pollution, household stresses, nutrient decline, etc. foundationally impact our mental health and wellbeing and thereby limit the collective capacity of our society.
Remaking our institutional, environmental and cultural contexts will be essential to the development of people’s cognitive, emotional, and social capacities. In a time of complexity and uncertainty, these capacities provide foundational infrastructure for our 21st- and 22nd-century society and economy. They are of the highest priority during the nascent rebuilding phase.
But how do we work towards rebuilding people’s cognitive, emotional, and social capacities when there are increases in depression rates, suicides, domestic violence, and unemployment? How do we rebuild public good and the ability to imagine another future when existential hope seems lost?
Drawing from our experiences across Sweden, Canada, and South Korea, we have identified five vital areas of focus during the rebuilding phase. This blog post examines key lessons that have been learned.
Five key take-aways
1. Language and metrics for a systemic policy architecture
Through conversations and research it has become clear that the taxonomy of mental health is largely associated with treatment, failure to treat and the clinical space of operation. This reality has structurally limited our capacity to systemically perceive and allocate resources to prevention and perhaps more critically thriving. (We define thriving as the substantial improvement of mental health at a societal scale; an achievement equivalent to the 20th century feat of doubling life expectancy).
Further, if we are to rebuild a societal-scale and entangled infrastructure, we need to start by describing the same thing, using a shared language. Currently, our taxonomy landscape is not only varied, but also a driver of different objectives. Either it encourages the legitimate need to increase funding for treatment and support services or it encourages the genuine investment in deep prevention and thriving. A plurality of perspectives visible across contexts: New Zealand, Wellbeing Budget; the World Health Organisation, Mental Health; the UK Government, Mental Capital and Wellbeing; and the Swedish Government, Psychological Health.
We believe we currently don’t have the descriptors necessary to make a case to for this entangled infrastructure, thereby operating in a state of ambiguity and challenge, trying to chart a shared way forward. Therefore, our next step needs to be shared language and taxonomy; taking into account the nuanced cultural, historical, and contextual differences and the added complexity they generate.
In software engineering, ubiquitous language describes the idea of domain specific languages. While this is not directly comparable, it is possible to learn how shared language among actors in a single domain can enable rigorous and reliable communication between them, unlocking the potential for collective problem-solving. In the absence of existing terminology, we will refer to a shared language for society’s cognitive, emotional, and social capacities as mental wealth.
In addition to providing clarity and direction, shared language can further encourage the design of shared metrics. These metrics help us understand the current mental wealth of a specific context, its evolution over time, and how it compares to other contexts. What is learned from data collection and analysis can inform the development of new policies that consider the entangled challenge of rebuilding our mental wealth.
There are already some metrics in place for mental health using zoning systems. However, these are based on the individual scale while mental wealth is concerned with the societal scale. Once again, language becomes important. As mental wealth involves multiple actors and domains, we need to be able to make sense at scale, as well as across sectors and departments. Without this common ground, it becomes difficult to write cross-contextual policies. It seems to be that this is one of the reasons why a systemic policy architecture for mental wealth is nowhere to be seen.
2. Investing in an entangled infrastructure
We believe that mental wealth can not be seen as a cost. Instead, it needs to be seen as an infrastructure enabled through societal-scale investments. By nature, mental wealth is a systemic problem, driven by multiple factors [FIGURE 2]. Investing in it requires us to move beyond short-return cycles and single-point investments. We need to co-curate portfolios of investments that are able to reach into the future, span across sectors and departments, and unlock innovation.
Building a mental wealth portfolio requires us to focus on improving the contextual settings in which people operate. These settings create the foundation on which society’s cognitive, emotional, and social capacities can develop. This could include:
- Increasing a community’s nature-based areas. For example, by introducing urban forests.
- Reducing nighttime light pollution. For example, by adopting dark-sky solutions.
- Supporting the availability of sports and other activities. For example, through initiatives like Sparks Generation.
- Developing non-polluting public transport that provide citizens with access to their surroundings, as exemplified by Mobility as a Service.
Each intervention of this type has spillover effects across sectors and departments. They require us to build the capacities and the elements that coordinate, measure, transact, pool, and aggregate the co-beneficiary results, their spillover effects, and their beneficiaries [FIGURE 3]. Without the ability to do this, we will struggle to invest in the entangled infrastructure of mental wealth.
3. An accounting framework for the future
It is often said that we make what we measure. If this is the case, there is a risk that investment in mental wealth could be under-prioritised as a result of missing metrics. Without them, we lack the data to build a case. More importantly, we are deprived of the ability to account for, drive, and value the co-beneficial results and spillover effects of a mental wealth portfolio.
For example, healthcare institutions know well how to account for the cost of treatment. They have done so for generations, with balance sheets remaining within health departments. However, when it comes to health budgets and accounting for prevention, it is unclear how they account, individually or collectively, for the costs and values created, especially as these often relate to future risks and the liabilities of not addressing the risks.
There is, then, a case for introducing an accounting framework that spans across silos and is able to account for the long-term effects of our mental wealth infrastructure, including benefits, risks, and liabilities. Values which might otherwise have disappeared from the public good become the very reason for investment in the first place.
4. Capacity for horizontal collaboration
Unless we are able to build distributed capacity to collaborate and drive a co-beneficial thesis, we risk becoming permanently stuck in silos. Today, many of us are trained to optimise one silo at a time; a reality where the boundary of a problem is defined by the name of the department. However, mental wealth is a wicked problem that ignores and spans boundaries. It is necessary, therefore, that we build the human capacity to (re)organise for an entangled and dynamic system.
Governments need to be able to collaborate across multiple domains and actors, creating a shared portfolio of interventions to invest in. These should enable:
- Horizontal innovation across whole value chains.
- Shared understanding of the portfolio created.
- A foundation to make collective decisions
- Distributed agency to move different interventions forward.
This approach can move us beyond departmental and sectoral divisions and address the reality of a dynamic system.
Building the human capacity to collaborate horizontally is, at the same time, dependent on our mental wealth. Without developing people’s social and emotional capacity, it becomes difficult to unlock complex collaboration. It is necessary, therefore, to design capacity-building processes that incorporate social and emotional training. Without it, we will struggle to implement co-beneficial solutions where the human is no longer optimised to be a ‘bad robot’ but, rather, a highly cognitive, emotional, and social being.
Horizontal collaboration further requires the enabling of cross-departmental and sectoral budgeting. The healthcare sector is facing a treatment crisis and the education sector a learning crisis. Asking these sectors to move significant budgets from doctors, nurses, and teachers in order to invest in an urban forest becomes problematic. Even in cases where it could prevent more people from showing up at the socially distanced waiting rooms or from drifting away during an online class owing to a neighbourhood’s poor air quality. Therefore, we need to build the elements that allow us to pool funds horizontally. Allowing health and education sectors to use seed funding as a directional tool, inviting other investment-strong departments to follow and provide the societal-scale investments required.
Once the horizontal budget is on its way, we need to talk about procurement. Procurement is the most common tool for investing in infrastructures, especially in relation to the public sector. It has many upsides and downsides, laid out well by our colleague Alastair Parvin in ‘After the Crisis’. The most significant challenge regarding mental wealth is the ability to procure for co-beneficial outcomes across departments. The European Commission refers to public-public cooperation as an enabler of contracts between departments without having to call for tender. However, it is clear that these corporations are still rare cases and do not allow the involvement of private bodies. This reality prompts the question: How do we increase procurement for co-beneficial outcomes within and beyond the public sector, for the public good?
We do not have all the answers to this question. However, we have shared initial thoughts about it in our ‘Bridging the Investment’ series and look forward to continuing to unpack how to enable horizontal collaboration for mental wealth.
5. Insuring societal scale innovation
Today large investment goes towards treatment related innovation. However, the societal scale innovation required to rebuild an entangled infrastructure goes beyond treatment and sits between sectors and departments. Traditional financing models for grants and public funding struggles to provide the speed or quantity of capital required to bridge this innovation gap. Impact investing also falls short, as risk models cannot price the scale or nature of the societal solutions required. As such, innovation for mental wealth tends to fall outside eligibility criteria.
Therefore, we ask ourselves: how do we fund at speed the scale of the necessary innovation? The answer may not lie in innovation itself, but in the ability to dynamically match innovation to future and societal scaled liabilities. In an age of complexity and uncertainty, the matching of these liabilities with potential hedges or solutions is a structural issue for innovation financing. It is what is called a settlement risk and unless we bridge the risk between liability holders and innovators we might not be able to ensure the societal scaled innovation required to rebuild our mental wealth.
There are still many questions related to how this could be done. Currently we are exploring the potential of creating financing ecosystems for multi-actor innovation capacity and a contract that can transfer the settlement risk to underwriters. At the centre of such an ecosystem, a Public Interest Trust operates to 1) pool the liabilities of mental illness and 2) aggregate the investment required to fund innovation for mental wealth. The high investment risk would be underwritten by grant and philanthropic funds, rather than being provided by them [FIGURE 5]. Thereby, larger investments can be attracted, creating a financial hedge against the settlement risk. Over time this hedge would be transformed into a natural hedge, as the innovation becomes the insurer of the liabilities.
Due to their size and density, cities are currently the main liability holders of mental wealth and innovators are the ones providing the solutions able to hedge these risks. Therefore, we see cities (including public, private and civic) and innovators (public, private and amateur) as the main actors in the ecosystem. An ecosystem, which we argue could help us bridge the innovation gap and support the systemic rebuilding of our mental wealth [FIGURE 6].
Moving towards rebuilding
As we look forward to a society that no longer favours precariousness and starts rebuilding an antifragile foundation for mental wealth, we recognise the need of a “boring revolution”. A revolution focused on delivering a co-beneficial economy that transitions our contextual settings. A revolution of how we account, how we bridge silos and how we invest in societal infrastructures.
Our mental wealth is the foundational entangled infrastructure that enables society to build back better. It is an infrastructure in need of a revolution to manifest and without it, we will not be able to create the inclusive societal capacities that unlock the full potential of our 21st-century and 22nd-century reality.
This is a revolution necessary for the future and of equivalence to the late 19th century/20th century revolution of public health which yielded the 2nd industrial revolution.
We are grateful having had the chance to explore these questions with passionate people. Today we like to give special thanks to: Fredrik Lindencrona, Camilla Evensson, Caroline Steinersted, Dan Hill, Gabriella Dahlberg, Sebastian Meijer, Tomas Bokström, and the team at Dark Matter Labs: Anna Rosero, Eunji Kang, Hyojeong Lee, Indy Johar, Linnéa Rönnquist and Pam Sethi.
Text by Linnéa Rönnquist, Indy Johar and Richard Martin. Graphics by Linnéa Rönnquist and Hyojeong Lee
