DigiWELL
Published October 8, 2025 | Version v1
Journal article Open

Mental health in Central and Eastern Europe: a comprehensive analysis

Authors/Creators

  • 1. ROR icon National Institute of Mental Health
  • 2. WHO Collaborating Centre for Public Mental Health Research and Service Development, National Institute of Mental Health, Topolová 748, Klecany 250 67, Czechia
  • 3. St. Mary's University, London, United Kingdom
  • 4. University of Medicine, Tirana, Albania
  • 5. Global Initiative on Psychiatry, Sofia, Bulgaria
  • 6. Zagreb School of Medicine and Zagreb University Hospital Centre, Zagreb, Croatia
  • 7. University Psychiatric Hospital Vrapče, Zagreb, Croatia
  • 8. Tallinn University of Technology, Tallinn, Estonia
  • 9. Tallinn University of Technology, Tallinn, Estonia; London Imperial College, London, United Kingdom
  • 10. Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary; Department of Mental Health, Heim Pál National Pediatric Institute, Budapest, Hungary
  • 11. National Directorate-General for Hospitals, Budapest, Hungary
  • 12. Alma Mater Europaea Campus College Rezonanca, Pristina, Kosovo
  • 13. UBT Higher Education Institution, Pristina, Kosovo
  • 14. National Centre of Mental Health, Riga, Latvia
  • 15. Mental Health Perspectives, Vilnius, Lithuania
  • 16. Mental Health Perspectives, Vilnius, Lithuania; Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
  • 17. Faculty of Medicine, University "Ss. Cyril and Methodius" Skopje, North Macedonia; University Psychiatry Clinic, Skopje, North Macedonia
  • 18. Center for Early Development, Clinical Centre of Montenegro, Podgorica, Montenegro
  • 19. Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova
  • 20. Institute of Social Studies, University of Lower Silesia, Wroclaw, Poland
  • 21. Military Institute of Medicine - National Research Institute in Warsaw, Poland
  • 22. University of Medicine, Pharmacy, Science and Technology George Emil Palade, Târgu Mureș, Romania
  • 23. Department of Social Work, Faculty of Health Care and Social Work, Trnava University, Trnava, Slovakia
  • 24. Tenenet o.z., Senec, Slovakia
  • 25. Institute of Mental Health of Ukrainian Catholic University, Lviv, Ukraine
  • 26. Institute of Public Administration, Governance and Professional Development of Lviv Polytechnic National University, Lviv, Ukraine
  • 27. The National Mental Health Center of the Ministry of Health, Baku, Azerbaijan
  • 28. Ilia State University, Tbilisi, Georgia
  • 29. Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyz Republic
  • 30. Department of Propedotherapy of Family Medicine, International Higher School of Medicine, Bishkek, Kyrgyz Republic
  • 31. World Health Organization, Barcelona Office for Health Systems Financing, Spain
  • 32. Global Initiative on Psychiatry, Sofia, Bulgaria; Global Initiative on Psychiatry, Vilnius, Lithuania
  • 33. Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom

Description

The post-communist WHO European region, often called Central and Eastern Europe (CEE), includes 28 countries with over 770 million people. Mental health systems remain shaped by the communist legacy of centralized institutions, a narrow biomedical focus, and neglect of social and psychological dimensions. Chronic underfunding persists, further strained by shrinking civic space in some countries and the war in Ukraine. Substantial progress has been made in the past decade, with modernization and rights-based approaches gaining ground. Yet reforms face entrenched barriers: underinvestment disproportionate to the burden; pervasive stigma, weak advocacy, and limited involvement of people with lived experience; dominance of institutional care over prevention, promotion, and community services; reliance on donor-driven projects that falter once funding ends; and human resource problems. Governance is often unstable, with low prioritization, clientelism, and personal biases undermining reforms. Research and data remain scarce, leaving systems unevaluated and vulnerable to reversal. Poor decision-making compounds these barriers: systemic missteps, driven by limited expertise, weak evidence, and personal biases, prevent resources from achieving the best possible outcomes. To move forward, CEE must integrate health, social, and education systems, secure sustainable crisis services, strengthen professional skills, involve people with lived experience, expand public mental health expertise, and, above all, commit greater and more transparent investment, closer to western European levels, if resilient and effective systems are to be built.

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Additional details

Funding

Ministry of Education Youth and Sports
Research of Excellence on Digital Technologies and Wellbeing CZ.02.01.01/00/22_008/0004583

Dates

Submitted
2025-05-06
Accepted
2025-08-25