How to evaluate a mental health charity

The short answer

You don't need a clinical framework to evaluate a mental health charity in Canada. You need to know whether people get help quickly, whether the organization checks how they're doing before and after, whether it asks about their experience, and whether it notices who stopped coming. A two-person counselling charity can answer all four, and so can CAMH.

Last reviewed 4 min readMental health

A starting point, not a checklist. The questions are the same at every size, and only the form of the answer changes.

The seven questions that apply to any charity
  1. Is there a clear theory of change?
  2. Do they measure outcomes, and ideally impact, not just outputs?
  3. Is there a credible counterfactual, or an honest attempt at one?
  4. Do they ask the people they serve?
  5. Are the financials transparent and proportionate?
  6. Does the board provide real oversight, and can the organization change course?
  7. Do they publish failures, or only wins?

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Why access comes first

A large share of Canadian adults with a diagnosed mental health disorder say their needs are unmet or only partly met, and it's worse for young adults and for people who can't afford to pay. A charity in this space exists because the system isn't reaching people, so whether it reaches them is the first thing to ask.

What a mental health organization actually controls

  1. How long from first contact to first real help. Not the first phone call, but the first conversation with someone who can help. Every organization can track this, with a spreadsheet if nothing else.
  2. Whether it checks how people are doing at the start and again later. The standard instruments are free and take minutes. The PHQ-9 for depression and the GAD-7 for anxiety are public domain. An organization doesn't have to use those, but it has to use something and be able to say what.
  3. Whether it asks people about their experience. CAMH uses a validated provincial tool. A small charity can use five questions on a card. What matters is that the answers change something.
  4. Whether it knows the difference between people who finished and people who stopped coming. A planned last session and a no-show look the same in a session count. An organization that tracks them separately, and has someone reach out after a no-show, is paying attention. Knowing why is often out of reach, but noticing isn't.

There's a fifth thing, and you can get at it without sounding like an auditor: whether the counsellor someone starts with is still there six months later. Ask who someone sees at their first appointment, and how long that person has been here. It's the question you'd ask of any firm, and it answers the one you can't. Caseloads and burnout decide the answer, much of it comes down to pay, and a funder can have a real effect on that.

Direct services

Counselling, therapy, community mental health, youth programs.

  • How long from first contact to first session, and how does that compare with services like yours?
  • What do you measure at intake, and when do you measure it again?
  • For youth programs: is the service designed for young people, or is it an adult service with a younger waiting room?

Good: names a wait time, names an instrument, and knows the difference between a planned ending and a dropout. Weak: reports sessions delivered.

Crisis

Lines, text services, mobile teams.

  • Within the resources you have, what share of contacts get answered, and how fast?
  • When someone needs more than the call, what does the handoff look like?

Good: knows its answer rate and can describe a warm handoff. Weak: reports contact volume. Follow-up is often impossible by design, because anonymity is what makes people call, so don't hold that against a line. Ask what happens when someone agrees to more.

Peer support and recovery

Clubhouses, peer workers, programs run by people with lived experience.

  • How are peer workers trained, supported and paid?
  • What counts as a good outcome here, given that clinical measures may not fit?

Good: has thought about what success means and can describe it in participants' terms. The clinical frame doesn't apply well here, and saying so is honesty, not evasion.

Awareness and advocacy

Campaigns, anti-stigma work, public education.

  • What changed because of it, beyond how many people saw it?

Reach isn't an outcome. Some campaigns can point to measured increases in help-seeking, and those are the ones worth funding on that basis. Most can't, and a donor should know which kind they're looking at.

Scale, and what it changes

CAMH holds Accreditation Canada's highest standing and files an annual quality plan with the province. A counselling charity with four staff will never match that and doesn't need to, because the questions above are the same at both sizes. CAMH answers with a validated instrument and a published dashboard, and a small charity answers with a spreadsheet and a straight conversation, and both are fine. The concern is an organization of any size that can't say how long people wait, doesn't check how they're doing, and doesn't know who left.

What the questions can't reach is what it's like to sit across from someone here on a bad day, and whether they get patience or a clipboard. Ask the organization to describe a first appointment. You won't be introduced to clients, and shouldn't be, but many organizations have people with lived experience on staff or on the board, so ask them.

Then check the organization behind the program, which is a separate job.

Questions people also ask

What is the single best question to ask a mental health charity?
How long from first contact to first real help, and how do you know?
How many Canadians cannot get mental health care?
In 2024, 41% of adults with a diagnosed disorder reported unmet or partly met needs. For adults 18 to 34 it was 52%, and about one in three people with a diagnosis avoided care because of cost.
Does a small charity need a clinical outcome measure?
It needs to check how people are doing before and after. The PHQ-9 and GAD-7 are free, public domain, and take minutes, so size isn't the barrier.
How does CAMH measure whether care is working?
Through Accreditation Canada, an annual quality improvement plan filed with the province, and validated patient experience surveys. It's the reference for measurement at scale, not the standard a community charity has to meet.