Mental Health Access Initiative: Expanding global access to psychotropic medication for severe mental disorders

Mental health accounts for ~16% of global disease burden, with four disorders – schizophrenia, bipolar disorder, major depression and anxiety – contributing ~80% of this burden. Severe mental disorders remain underprioritized despite driving most mental health disability. Governments in low- and middle-income countries (LMICs) dedicate 70% of people with psychosis receive no care. Safe, effective medications available in high-income countries remain inaccessible in many LMICs. Building on consensus-based momentum from Wellcome’s recent mental health convening, we propose a 12-month pathfinding program to expand access to treatment for schizophrenia, major depression, bipolar disorder, and anxiety in up to 5 LMICs. Our strategy is two-fold: 1\. Cost-effectiveness analysis: Develop open-access cost-effectiveness tools – built in collaboration with country and lived-experience partners – to drive action towards high-impact interventions, beginning with those for psychosis, in focus LMICs. 2\. Market shaping: Deliver targeted access gains for proven, quality-assured psychotropic medications. Engage manufacturers and policymakers to support the rapid, cost-effective introduction of newer treatments. Secure supplier commitments, improve pricing transparency, and provide framework for scalable access agreements. By achieving early access gains and delivering tools for action, our efforts will help catalyze a future where all people with severe mental disorders can access the best-available treatments – reliably and affordably.