MindShift: Innovative Financing for Youth Mental Health
Summary
In 2025, the British Asian Trust (BAT) committed to launching Pakistan’s first outcomes-based financing (OBF) model for youth mental health, a breakthrough in applying outcomes-based approaches to the sector. The initiative will begin with a design phase to define measurable outcomes, map the sector, and assess delivery partners using BAT’s outcomes readiness tool, developed through impact bonds in Pakistan and India. A feasibility study will produce an investible proposition outlining the target group (at least 50% female) , intervention model, outcomes framework, verification methods, and indicative budget. Leveraging its expertise in youth programming, mental health, OBF, and its leadership in the Pakistan Mental Health Coalition, BAT will mobilize funds, align stakeholders, and build partner capacity. With catalytic support from Grand Challenges Canada, the program will strengthen delivery systems, ensure accountability through verified results, and provide a scalable blueprint for equitable, accessible youth mental health services in Pakistan.
Approach
The British Asian Trust (BAT) is launching Pakistan’s first outcomes-based financing (OBF) model for youth mental health. This groundbreaking initiative will improve outcomes and expand access to mental health services by creating a replicable, scalable framework.
The project begins with a structured design phase to define specific, measurable outcomes for youth mental health. BAT will map the sector, validate findings with a cross-sector working group, and use its own outcomes readiness tool to assess potential delivery partners. A detailed feasibility study will then identify key enablers and barriers, culminating in an investible proposition. This document will outline the target group—with a special focus on young women and underprivileged populations—as well as the intervention model, outcomes framework, verification methods, and budget.
BAT will leverage its extensive experience in youth programming, mental health, and outcomes-based financing, alongside its leadership of the Pakistan Mental Health Coalition (PMHC) . The PMHC, a network of over 100 organizations, will provide guidance on outcome selection and ensure the project aligns with provincial government and policy priorities. Grand Challenges Canada will contribute both catalytic funding and technical expertise.
The ultimate goal is to create a viable, investment-ready program that provides a blueprint for scaling outcomes-based approaches throughout Pakistan’s mental health sector. During implementation, BAT will coordinate a consortium of funders, delivery and verification partners, and legal advisors. Payments to service providers will be contingent on the independent verification of achieved outcomes, ensuring a high degree of accountability and adaptability.
This commitment is part of the Coalition for Mental Health Investment’s (CMHI) portfolio, which aims to connect, inspire, and integrate mental health investment globally. By championing CMHI’s inspire pillar, BAT will not only strengthen Pakistan’s mental health ecosystem but also create a framework that can be replicated in other countries and contexts. The project’s focus on underserved young men and women will help promote more equitable outcomes.
Action Plan
This Commitment will be delivered in three structured phases.
In Phase 1 (Sept 2025 to June 2026) , BAT will lead the design of a scalable OBF model tailored to youth mental health. A PMHC-led working group,will define and validate measurable outcomes through cross-sector engagement. Sector mapping will identify service gaps, underserved populations, and high-potential delivery partners, assessed through BAT’s outcomes readiness framework. Listening exercises and stakeholder analysis will ensure alignment with local needs. By June 2026, deliverables will include: (i) a PMHC learning report with potential outcomes, cost insights, and recommended tools; (ii) a shortlist of around five delivery partners with identified capacity-building needs; and (iii) a stakeholder map of aligned investors, partners, and financing instruments. Findings will be publicly shared to build broader sector capacity.
Phase 2 (July 2026 to February 2027) , BAT will finalize the OBF model co-designing implementation and verification plans with delivery partners, refine payment structures, engage outcome funders, and establish governance and performance management systems. Deliverables will include an investment-ready OBF initiative with validated outcomes, committed partners, and a launch roadmap. Indicative validated outcomes include: (i) improved access to mental health information, drawing on BAT’s Milkar campaign and youth engagement networks; (ii) increased access to services, such as expanded telehealth and helplines; and (iii) improved quality of provision through capacity-building of providers to better serve underserved communities, with attention to gender-responsive needs.
In Phase 3 (March 2027 to March 2029) , with funding secured, implementation will begin. A multi-stakeholder Steering Committee will oversee delivery, evaluation partners will implement MEL frameworks, and delivery partners—selected through a competitive process—will provide services. A financial model will detail cashflows tied to verified outcomes, with adaptive management to maximize impact.
Background
Pakistan faces a deepening mental health crisis, with estimates indicating one of the highest prevalence rates of mental health conditions globally (Alvi et al., 2023) . Approximately 50 million people are affected by common mental health issues yet Pakistan continues to score poorly on almost all indicators relating to governance, resources, and service availability and uptake for mental health (Aga Khan Foundation, 2016) . This crisis is driven by a complex interplay of factors including chronic poverty, climate-induced displacement, and a pervasive lack of mental health awareness and education. Radical change is required to drive a step change in mental health provision.
The crisis is particularly acute among young people. Nearly one-third of Pakistan’s population is between the ages of 10 and 24, and youth represent around 40% of those experiencing mental health challenges (UNFPA, 2024) . Alarmingly, research shows that 17.2% of adolescents face depression, while 21.4% experience anxiety (Khalid et al., 2019) . Yet, close to 90% of people in need receive no mental health support. Gender dynamics also play a part, with evidence suggesting that women face higher levels of depression than men.
Pakistan’s mental health ecosystem is severely under-resourced and fragmented. Just 0.04% of Pakistan’s health budget is allocated to mental health, dramatically below the global average of 2.1% (WHO, 2020) . With a population of over 240 million, there are only 500 psychiatrists and approximately 100 clinical psychologists, with almost no community-based care infrastructure (International Journal of Mental Health Systems 2024) . Despite the passage of mental health legislation at both federal and provincial levels, implementation is inconsistent, lacking inclusivity, coordination, and resourcing. Compounding these systemic issues, widespread stigma and low awareness suppress demand and discourage help-seeking behaviour, limiting investment, innovation, and the scalability of solutions.
With deep experience pioneering Outcomes-Based Financing (OBF) in South Asia, the British Asian Trust sees urgent opportunity to embed an outcomes-driven approach in Pakistan’s mental health sector to enable sustainable, scalable impact.
Progress Update
Partnership Opportunities
BAT is seeking partnerships to test and scale of best practice in outcomes-based financing for youth mental health in Pakistan. Specifically, BAT is looking for funders who share its vision and can provide catalytic capital, as well as help engage with other aligned donors and investors. BAT welcomes collaboration with design partners and technical experts who can support the development of a robust OBF ecosystem, co-creating models, sensitising key stakeholders, and strengthening local capacity. Organisations committed to improving mental health in Pakistan are invited to work with BAT to shape innovative, sustainable solutions that deliver measurable outcomes. BAT also seeks to connect with global mental health actors to share learning, align efforts, and build momentum for outcomes-focused approaches across regions.,BAT offers world-leading expertise in outcomes-based financing, having pioneered its application across South Asia. BAT offers the design of high-impact, performance-linked financing models, alongside the development of a comprehensive learning document to provide insights, tools, and a replicable playbook for others in Pakistan and globally. BAT offers technical assistance and capacity building to partners to become outcomes-ready, supported by the ecosystem.
m mapping and stakeholder engagement instruments. BAT offers delivery of a robust proof of concept that demonstrates the power of OBF to transform youth mental health outcomes, alongside exceptional convening power and networks, through leadership of the Pakistan Mental Health Coalition, collaboration with influential partners such as the Jang Media Group and the Advisory Council, and strong relationships with government stakeholders, including participation in government taskforces and committees on mental health as well as impact financing, to drive scalable, systemic impact.