Mental health has climbed higher on the global agenda (finally) in recent years. But a new World Health Organization (WHO) report reveals that most countries remain woefully underequipped to deliver the care and support that people need.
The “WHO Mental Health Atlas 2024,” published this week, paints a dim picture of modest progress marred by persistent gaps.
Pulling data from 144 countries – roughly 75% of WHO’s member states – the report is the group’s most comprehensive update of how the world is (and isn’t) meeting mental health needs in the aftermath of the COVID-19 pandemic.
“Transforming mental health services is one of the most pressing public health challenges,” WHO Director-General Tedros Adhanom Ghebreyesus, PhD, explained. “Investing in mental health means investing in people, communities, and economies. [It’s] an investment no country can afford to neglect. Every government and every leader has a responsibility to act with urgency and to ensure that mental health care is treated not as a privilege, but as a basic right for all.”
According to the report, 81% of the reporting countries have dedicated mental health policies or plans in place. And most of them insist that what they’ve built so far aligns with established human rights standards.
But translating policy promises into real-world action is something else. Only half of reporting nations had the resources to implement their plans effectively. And just 43% had mental health laws fully compliant with international human rights guidelines.
Budgets Stall Out
The finances are sobering. Despite increased awareness, mental health spending has hardly budged in recent years, stalled out at a global median of just 2.1% of health budgets. That works out to a per capita spend of $2.69. But the gap between rich and poor countries remains staggering. In lower-income countries, governments spend as little as four cents per person on mental health, compared with nearly $66 a citizen in wealthier nations.
The workforce mirrors that divide. Globally, there are 13.5 specialized mental health workers for every 100,000 people. But in low-income countries that number tumbles to fewer than three. While in high-income countries it soars to more than 67. Nurses make up the largest share of the mental health workforce, followed by psychologists and psychiatrists.
Services Still Hospital-Heavy
When it comes to care delivery, the shift from institutions to communities has been slow. Fewer than 10% of countries have fully transitioned to community-based models. More than half remain in the early stages, with psychiatric hospitals still dominating the landscape. Globally, 62% of mental health inpatient beds are in specialized hospitals, not in general or community settings.
Outpatient services also reflect that divide. High-income countries report two or more community outpatient facilities per 100,000 people; in low-income settings, the number drops below 0.1. Meanwhile, nearly half of all psychiatric hospital admissions worldwide are involuntary, and more than one in five involve stays longer than a year.
Digital Records On The Rise, But Gaps Persist
One bright spot: the proliferation of digital health records. More than half of responding countries (58%) now boast nationwide digital health record systems that include mental health data. Most of these assign unique patient identifiers, allowing better tracking of care across services.
Yet data gaps remain frustratingly widespread. While 82% of countries track psychiatric hospital admissions, only 46% regularly measure treatment outcomes. And nearly 40% fail to monitor the physical health of people with mental health conditions, despite the well-established links between chronic illness and mental disorders.
Suicide Prevention Gains Ground
On prevention, countries are starting to make headway. Two-thirds report having at least two functional national mental health promotion or protection programs, often focused on early childhood development, school mental health, and suicide prevention. Almost half of countries now have a national suicide prevention strategy, and among a smaller group that reported in detail, 80% have functioning suicide prevention programs.
Still, global suicide rates have hardly moved – from 9 per 100,000 in 2019 to 8.9 in 2021 – highlighting a pressing need for more effective strategies.
Emergencies Spark Change
Perhaps the most encouraging gains have come in emergency preparedness. The pandemic and other crises have pushed countries to strengthen mental health and psychosocial support in emergencies. In 2020, only 45% of countries had such systems in place. By 2024, that percentage edged closer to two-thirds of the participating countries, with 81% reporting they had provided psychosocial support during emergencies.
The atlas is also a scorecard against the “Comprehensive Mental Health Action Plan 2013–2030,” which established targets on policy, service integration, prevention, and data reporting.
Countries appear to be making some progress on policy development and emergency preparedness, but remain off track on service coverage, workforce expansion, and integration of mental health into primary care. Only about a third of nations report full integration of mental health into primary health care systems. The authors of the report warn that without meaningful new investment, the world will almost certainly fall short of its 2030 goals.
WHO Issues Call to Action
WHO officials stress that data should not just make headlines while sitting idly by in academic reports. It should work as a way to drive real change.
This new report calls for the world’s governments to make funding a priority, expand community-based care, safeguard individual rights through stronger legislation, and close existing gaps in the workforce.
“Awareness has never been higher,” the report’s authors concluded. “But awareness without sustained investment risks leaving millions without the care, protection, and dignity they deserve.”
Further Reading
Global Study Reveals Who’s Most Vulnerable to Misinformation
Rethinking Mental Health in a Post COVID World
Global Experts Unveil New Schizophrenia Treatment Guidelines
