As the world comes to live with, and learn from, the far-reaching effects of the COVID-19 pandemic, we must all reflect on one of its most striking aspects – the huge toll it has taken on people’s mental health. Rates of already-common conditions such as depression and anxiety went up by more than 25% in the first year of the pandemic, adding to the nearly one billion people who were already living with a mental disorder. At the same time, we must recognize the frailty of health systems attempting to address the needs of people with newly-presenting as well as pre-existing mental health conditions. Mental health is a lot more than the absence of illness: it is an intrinsic part of our individual and collective health and well-being. As this report shows, to achieve the global objectives set out in the WHO Comprehensive mental health action plan 2013–2030 and the Sustainable Development Goals, we need to transform our attitudes, actions and approaches to promote and protect mental health, and to provide and care for those in need. We can and should do this by transforming the environments that influence our mental health and by developing community-based mental health services capable of achieving universal health coverage for mental health. As part of these efforts, we must intensify our collaborative action to integrate mental health into primary health care.

In so doing, we will reduce suffering, preserve people’s dignity and advance the development of our communities and societies. Our vision is a world where mental health is valued, promoted and protected; where mental health conditions are prevented; where anyone can exercise their human rights and access affordable, quality mental health care; and where everyone can participate fully in society free from stigma and discrimination.

To achieve this ambitious transformation, a concerted and renewed effort is needed in all countries, whether they are rich or poor, stable or fragile, affected by emergencies or not. WHO will play its part as the lead agency for global health and will continue to work nationally and internationally to provide strategic leadership, evidence, tools and technical support. Ultimately, there is no health without mental health.

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