Map reveals countries with the best mental health in the world, and where distress is most prevalent

Map reveals countries with the best mental health in the world, and where distress is most prevalent
  • The largest survey to consider global mental health is out this week with data from 34 countries.
  • English-speaking countries had some of the lowest mental health scores on average.

Results of the largest survey of global mental health are out this week from Sapien Labs, the non-profit research organization behind the Mental Health Million Project, an effort to track mental wellbeing on a global scale.


The project launched in eight English-speaking countries in 2019, and it has since expanded to reach 223,000 people across 34 countries.

The second annual Mental State of the World Report offers a snapshot of wellbeing around the globe in 2021; based on responses to a 15-minute anonymous survey that is accessible online in English, Spanish, French, and Arabic.

The survey, known as the Mental Health Quotient (MHQ), was designed by Sapien Labs to consider six aspects of overall wellbeing: mood and outlook, the social self, motivation, cognition, adaptability and resilience, and the mind-body connection.

MHQ scores can span from -100 to 200, where positive scores represent a "normal" range of functioning and negative scores indicate the possibility of a clinical mental disorder.


Average national scores calculated for the report ranged from 46, or "enduring" mental health, in South Africa; to Venezuela's national average of 91, which was deemed to be on the cusp of "managing" and "succeeding" according to the MHQ scale.

The lowest average mental health scores came from the English-speaking world

Eight out of 10 of the countries with the lowest average MHQ scores were from the region the report calls the Core Anglosphere. From the worst reported mental health to the best, the list includes; South Africa, the United Kingdom, Australia, Ireland, India, New Zealand, Canada, and the United States.

In contrast, most of the highest-ranking average mental health scores came from Latin America, Spain, and a few French-speaking countries in Europe and Africa.

National economic indicators of prosperity, like high GDP per capita, turned out to be correlated with lower average mental health scores for the surveyed populations, much to the researchers' surprise.

"This belies the commonly held belief that national economic prosperity translates to greater social wellbeing, where these correlations would be expected to be positive and not significantly negative," the report reads.


The authors also considered how cultural values vary between countries. Populations that reported prioritizing work performance and individualism in surveys for the separate GLOBE Project tended to score lower on the mental health quotient, indicating some distress.

Internet access, education, and employment may have contributed to mental health scores

Access to the internet was a prerequisite for completing the open, online survey. With that in mind, the data solely reflect the experience of Internet-enabled populations.

People of color are less likely to use the internet to access health services compared to their white counterparts, Patricia Escobar, a consulting manager for culturally responsive and inclusive care at Kaiser Permanente, told Insider.

Research from the early stages of the COVID-19 pandemic point to significantly lower levels of telemedicine usage among Black and Hispanic patients in the US, particularly those over age 65, as compared with white patients. This trend, when compounded with cultural biases against mental illness, could translate to a lesser inclination to complete an online survey related to mental health, Escobar said.

"Anecdotally, from my family experience, you do downplay and you use more 'benign' words," said Escobar, who immigrated to the US from Bolivia as a young girl. "As immigrants and people of color … we tend to be more resilient because we've encountered so many other hurdles that potentially our neighbor has not."


Across all countries, higher education and employment were associated with higher mental health scores. The association with employment was strongest in Western, English-speaking countries.