Mental health exists on a complex continuum, which is experienced differently from one person to the next. At any one time, a diverse set of individual, family, community and structural factors may combine to protect or undermine mental health. Although most people are resilient, people who are exposed to adverse circumstances are at higher risk of developing a mental health condition.

Mental health conditions include mental disorders and psychosocial disabilities as well as other mental states associated with significant distress, impairment in functioning, or risk of self-harm. Many mental health conditions can be effectively treated at relatively low cost, yet health systems remain significantly under-resourced and treatment gaps are wide all over the world.

Risks and protective factors

The risks and protective factors that influence mental health operate at multiple levels.

Individual factors such as emotional skills, substance use and genetics can increase vulnerability to mental health problems.

Social and environmental factors – including poverty, violence, inequality and environmental deprivation – also increase the risk of experiencing mental health conditions.

Risks can emerge at any stage of life, but those occurring during sensitive developmental periods, especially early childhood, are particularly harmful. For example, harsh parenting and physical punishment can damage child health and bullying is a leading risk factor for mental health conditions.

Protective factors similarly occur throughout our lives and help build resilience. They include individual social and emotional skills, positive social interactions, access to quality education, decent work, safe neighbourhoods and strong community ties.

Mental health risks and protective factors can be found at different scales. Local challenges affect individuals, families and communities, while global threats – such as economic downturns, disease outbreaks, humanitarian emergencies, forced displacement and climate change – impact entire populations.

No single factor can reliably predict mental health outcomes. Many people exposed to risk factors never develop a mental health condition, while others may be affected without any known risk. However, the interplay of these determinants collectively shapes mental health over time.

Mental health promotion and prevention

Promotion and prevention efforts aim to improve mental health by addressing individual, social and structural determinants of mental health. Interventions can be designed for individuals, specific groups or whole populations.

Because many determinants lie outside the health sector, effective promotion and prevention programmes require cross-sector collaboration. Education, labour, justice, transport, environment, housing, and welfare sectors all have vital roles. The health sector can contribute by embedding promotion and prevention into its services and by leading or supporting multisectoral coordination.

Suicide prevention is a global priority and part of the Sustainable Development Goals. Key strategies include limiting access to means, promoting responsible media reporting, supporting social and emotional learning for adolescents, and ensuring early intervention. Banning highly hazardous pesticides is a particularly inexpensive and cost–effective intervention for reducing suicide rates.

Promoting child and adolescent mental health is another priority. Effective approaches include policies and laws that protect mental health, support for caregivers, school-based programmes and improvements to community and online environments. Among these, school-based social and emotional learning programmes are especially effective across all income levels.

Mental health at work is a growing area of interest and can be supported through legislation and regulation, workplace policies, manager training and targeted interventions for workers.

Mental health care and treatment

National efforts to strengthen mental health must focus not only on promoting mental well-being for all, but also on addressing the needs of people with mental health conditions.

This is best achieved through community-based mental health care, which is more accessible and acceptable than institutional care, helps prevent human rights violations, and delivers better recovery outcomes. Such care should be provided through a coordinated network of services that comprise:

• integrated mental health services within general health care, typically in general hospitals and through task-sharing with non-specialist care providers in primary health care;
• dedicated community mental health services, such as community mental health centres and teams, psychosocial rehabilitation, peer support and supported living; and
• mental health support in non-health settings, including child protection services, school health programmes, and prisons.

The vast care gap for common mental health conditions such as depression and anxiety means countries must also explore innovative approaches to expand and diversify care. These include non-specialist psychological interventions and digital self-help tools, which can be scaled efficiently and affordably.