Hide table of contents


Samantha has spent a lot of time thinking about the mental health problem space, and thinks she sees an opportunity for a high-impact online intervention. She has also spent a lot of time in startup environments and decides to found a company. 

As she is not medically qualified, she cofounds the company with a 'CTO' Kathrine, who has a PhD in clinical psychology. Samantha handles operations and pitches to potential investors, while Kathrine works on cataloguing research and developing RCTs that can validate their intervention. 

The end product is an online resource that is freely accessible and thoughtfully crafted for maximum global impact.

How is this structuring charities (even more) like tech startups?

Charity Entrepreneurship is the main charity incubator I'm familiar with in the EA space, and they already leverage numerous startup ideas.

The main way they differ from my above idea is they provide founders with highly effective interventions that they have carefully explored themselves, such as this research on a potential air quality advocacy intervention for 2022.

I think this leaves space for additional charities to work on interventions where the research cannot be frontloaded in this way. These organizations would lean on funding to perform research and technical innovation.

This is similar to how a tech startup will only begin to make meaningful progress and receive most of the feedback on their software after being founded.

The bet

Clearly, investors would be betting that this organization can build interventions better than other existing research groups. There are a couple of 'startupish' reasons they might think this.

There would be a reduced regulatory burden in this setting compared to, e.g. a hospital's research department in the US. See Scott Alexander's My IRB Nightmare for an example of what they'd be trying to avoid.

The company would benefit from a tight feedback loop with users of their intervention. They have built a strong scientific case, but there is still a lot of marginal impact to be gained from tweaking some of the finer parameters, or effectively localizing it to new regions. 


Probably the biggest tradeoff here is that the company is taking on a lot more work compared with implementing a pre-baked intervention. Risk is higher, so the company would have to demonstrate a high potential impact to compete with charity-entrepreneurship-style interventions for funding.

It would also be possible to found an independent research group with the same 'reduced regulatory burden' benefits as this company, so the live updates or 'tight feedback loop' element to the intervention would have to carry the bulk of the justification for setting up in this way.

More generally, this kind of company setup will not suit all problem spaces. I picked mental health as an example as I think that could be workable: self-help is already an unregulated established phenomenon, and a mental health intervention could very plausibly be served and updated as a website/app. But none of this applies for an intervention that requires prescribing medicine, for example.

Advice on doing this?

Despite the tradeoffs, I am interested in starting a mental health charity that looks like what I've described above. What suggestions would you have for me?





More posts like this

Sorted by Click to highlight new comments since:

Thanks for the great post! 

I completely agree and have been thinking about many of the same things. Many of the properties that make for-profit startups such a source of innovation (razor focus, fast decision-making, competition, rapid iteration) could also apply to nonprofit startups aiming to become highly effective. Here's a bit of a challenge that I see in this:

  • The EA community has high standards of evidence for effective interventions. 
  • Interventions that now have the highly effective label probably had high R&D costs to begin with, but now their unit costs are low. 
  • It's going to be very hard to achieve the highly effective benchmark when you're just getting started (building an intervention, piloting it, evaluating it).
  • Central to the startup approach is the idea that you continuously and rapidly improve your intervention - iterating towards becoming highly effective.
  • Therefore, funders need to accept a high level of initial risk and be prepared to fund for some time before the highly effective label can be achieved.

To extend your analogy to for-profit startups further, it seems there's a need for a VC-like ecosystem, with multiple rounds of funding in escalating amounts and milestones based on progress towards highly cost-effective benchmarks. 

Also agreed that Charity Entrepreneurship is leading in this space. :)

Therefore, funders need to accept a high level of initial risk and be prepared to fund for some time before the highly effective label can be achieved.

Yep, I agree that this is the rub. There's been a lot of chat about megaprojects recently though (e.g. https://forum.effectivealtruism.org/posts/ckcoSe3CS2n3BW3aT/), and building an ecosystem to fund high risk, high return projects of this sort could be a good candidate for that.

Super excited to see more interest in this space, and people starting things in general, kudos!

Have you talked with the people working on Mind Ease and/or Canopie? (As far as I understand, Canopie was originally a Charity Entrepreneurship incubated charity, then became a for-profit).
Also might be interesting to talk with the people that worked on hippo.

Did you consider applying to Charity Entrepreneurship career coaching?

Curious about what resource specifically you have in mind!

Did you consider applying to Charity Entrepreneurship career coaching?

Yep, and I might still do that, but I suspect what I have in mind isn't a good fit for the reasons mentioned in the post.

Curious about what resource specifically you have in mind!

I think resources for family/best friends/employers of mentally ill folks is a neglected space. You have a group of people who are extremely incentivised to help (maybe employers less so), have the opportunity for a high marginal impact, but who in my experience usually have no idea what they're doing. 

I'm also attracted to potential knock-on benefits from something like this to how mental health is discussed more generally, which I'd currently characterize as at best well-intentioned but pretty poor (and far worse than that in some areas of the world).

Here's something with a different focus (training a more general 'first line of defence' support network at a university), but that shares some features with what I have in mind: https://www.ox.ac.uk/students/welfare/peersupport .

Thanks for the concrete company recommendations!

The career coaching seems different from the incubation program, as far as I can tell your points apply mostly to the latter, right?

I had not noticed that those aren't the same, thank you for correcting me! And I agree that applying to it makes a lot more sense than applying to the incubation program.

That sounds awesome! 

Any thought about the process of coming up with intervention ideas?

I think there is a huge gap between the backed researched interventions to the fact there is a lack of solutions and a lot of suffering.

It seems to me that we need to invent and test new solutions. Coming up with them is challenging :)   

I suspect getting more people with diverse experiences/ideas interested in helping is a good approach. Then just let them do their thing.

I wrote a short piece here basically trying to argue EA should do more to diversify its skillpool as others have 'unseen data' that could help tackle important problems: https://forum.effectivealtruism.org/posts/MpYPCq9dW8wovYpRY/ea-undervalues-unseen-data .

tl;dr: I think more people == more data && more data == better ideas.

Curated and popular this week
Relevant opportunities