The document discusses how coordinated policy approaches can promote population mental health and well-being. It notes that mental health plays a central role in people's lives and was severely impacted by the COVID-19 pandemic, with rises in mental distress across OECD countries. The document advocates applying a well-being lens to mental health policies and provides several policy examples for integrating mental health considerations across sectors like health, employment, education, and social policies.

1. How to Make Societies Thrive?
Coordinated approaches to promote mental health and well-being
WISE – the OECD Centre on Well-Being, Inclusion, Sustainability and Equal Opportunity
Key Findings
CENTRE ON WELL-BEING, INCLUSION,
SUSTAINABILITY AND EQUAL
OPPORTUNITY (WISE)

2. Why look at mental health?
27%
0%
10%
20%
30%
40%
Share of people at risk of depression
2021 2020 2014
Source: OECD (2021), COVID-19 and Well-being: Life in the Pandemic, OECD Publishing,
Paris, https://doi.org/10.1787/1e1ecb53-en
In all countries with comparable
baseline data, the share of the
population at risk for depression rose
sharply in 2020
Coalition building across sectors is limited,
intersectoral task forces are given little authority,
lack of M&E, general resource constraints
Mental health plays a central role in
people’s lives
 Rise of mental distress across OECD countries
during COVID-19
 Impact of mental health conditions pre-dates
the pandemic
 Positive mental health as explicit policy target
We see renewed calls for (mental) health in
all policies approaches, but challenges
remain:

3. This project – and two accompanying reports – applies a
“well-being lens” to population mental health
BETTER DATA FOR PREVENTION & PROMOTION
How can we improve the quality and availability of
comparable data on population-wide mental health
status?
WELL-BEING & MENTAL HEALTH NEXUS
How do life experiences shape mental health? And,
conversely, how does mental health shape
outcomes in life?
INTEGRATED APPROACHES IN PRACTICE
What are lessons learned about systemic barriers
and incentives to collaborate, from selected mental
health initiatives across OECD countries?

4. OECD (2020) How’s Life? 2020: Measuring Well-being, OECD Publishing, Paris https://doi.org/10.1787/23089679 www.oecd.org/howslife
• The analysis is grounded
in the OECD Well-being
Framework
• The report tries to
understand how mental
health relates to each
dimension of well-being,
and the causal
mechanisms that
underpin these
relationships
• It identifies examples of
“win-win” policies that
involve agencies outside
the health sector and that
tackle both mental health
and its upstream
determinants

5. People with
mental
distress fare
worse in
every
dimension of
life
Poor life outcomes, measured through the OECD Well-being Framework

6. Income and
Wealth
Two-way relationship
Poor mental health is
associated with a higher
likelihood of poverty.
Debt, as well as the financial
strain and long-term stress of
poverty can negatively affect
mental health and its risk and
resilience factors.
Broader macroeconomic
conditions (income inequality,
general economic uncertainty,
interest rate rises) also shape
mental health.
Cross-lag panel model showing psychological flourishing
and difficulty making ends meet, GBR, 2009-20
Source: OECD calculations based on University of Essex (2022), Understanding Society: Waves 1-
11, 2009-2020 and Harmonised BHPS: Waves 1-18, 1991-2009. [data collection]., 5th Edition. UK
Data Service., https://www.understandingsociety.ac.uk/.

7. Policy
examples
to support
financial security
and mental
health outcomes
Increase access to social assistance programs, while decreasing the
cognitive burden of enrolment
Universal schemes to improve quality of life and reduce stigma of
social service use
Intervention 3
Increase access to mental healthcare through new technology and
expansion of community services
Intervention 2
Intervention 1
Social policy and service provision, financial departments responsible for debt relief
and targeted inflation support measures
Social policy and service provision
Health care and social policy
For further details and concrete examples of existing policy practice, refer to Box 2.1 in the full report

8. Work and Job
Quality
Work, job quality and mental health are highly
interrelated, showing the need for integrated approaches
The quality of employment
matters. Job instability and
poor working conditions can
lead to increased fatigue, risk
of burnout or depression.
Unemployment can worsen,
or lead to the onset of
mental health conditions,
partly due to prolonged
stress, low self-esteem and
feelings of helplessness.
Experiencing mental ill-
health can also increase
the likelihood of future
unemployment, and is
linked to challenges to
productivity in the
workplace.
Long-standing OECD calls for integrated approaches to mental
health policy in the 2015 OECD Recommendation of the
Council on Integrated Mental Health, Skills and Work
Policy and its follow-up work.
A framework to integrate mental health considerations into:
 Health systems
 Youth support systems
 Social protection systems
 Workplace systems

9. Policy
examples
to support
labour market
and workplace
as well as mental
health outcomes
Integrate mental health service provision into unemployment
services through Individual Placement and Support (IPS)
programmes
Encourage employers to prioritise mental flourishing at work
Intervention 3
Extend social protection schemes to platform workers
Intervention 2
Intervention 1
Employment promotion, adult and continuing education, health care
Employment and labour, corporate affairs
Social policy, employment, and labour
For further details and concrete examples of existing policy practice, refer to Box 2.2 in the full report

10. Housing
0%
10%
20%
30%
Overcrowded
accomodation
Housing cost
overburden
Noise from
neighbors or street
No Internet
at home
Those with worse mental health are more likely to experience
problems with housing conditions than the general population
Share of people with deprivations in housing, by mental health outcome, OECD 26
Note: Risk of mental distress is defined using the Mental Health Index-5 (MHI-5) tool.
Source: OECD calculations based on the 2013 and 2018 European Union Statistics on Income and Living Conditions (EU-SILC),
https://ec.europa.eu/eurostat/web/microdata/european-union-statistics-on-income-and-living-conditions.
Residential areas are
important for mental health:
neighbourhoods that are safe,
facilitate social interactions,
provide access to green space
and areas to exercise, and are
close to services are key.
Mental health conditions
can increase the likelihood
of becoming homeless;
homelessness increases the
risk for developing a mental
health condition.
Housing unaffordability
– especially housing
debt – and instability in
housing tenure can
drive poor mental
health.

11. Policy
examples
to support good
housing,
neighborhood
as well as
mental health
outcomes
Housing First as strategy to tackle homelessness and help alleviate
mental distress
Integrate mental health considerations into housing design guidelines
Intervention 3
Create supportive and inclusive neighbourhoods to promote
connectedness and psychological well-being
Intervention 2
Intervention 1
Housing and social policy
Housing, social policy, healthcare, environment and urban planning
Housing, social policy, health care, sports and culture, environment and urban
planning, law enforcement and safety
For further details and concrete examples of existing policy practice, refer to Box 2.3 in the full report

12. Physical
Health
Poor physical and mental health often co-occur
Physical activity and healthy
eating habits positively
influence mental health;
exercising can lead to
improved mood, higher self-
esteem and lower levels of
anxiety, worry and stress.
Smoking can be a way to
self-medicate, but tobacco
use may actually worsen
symptoms of anxiety or
depression.
Excessive alcohol
consumption can occur
alongside symptoms of
depression and anxiety.
Mental health conditions can
make it harder to adhere to a
treatment plan or manage
symptoms; some psychiatric
medications have side effects.
Positive mental health may
provide resilience against
future health risks.
Close association between
poor mental health and
many physical ailments,
leading to increased
morbidity and premature
mortality.
Some physical health
conditions lead to social
isolation; others to
feelings of hopelessness
or lack of control.

13. Policy
examples
to support
physical health,
healthy
behaviours and
mental health
outcomes
Better integrate physical and mental health care
Encourage physical activity to promote good mental health
Intervention 2
Intervention 1
Health care
Health care, sports and culture, education, employment and labour,
environment, urban planning, transport
For further details and concrete examples of existing policy practice, refer to Box 3.1 in the full report

14. Knowledge
and Skills
Poor mental health can make it
more difficult for students to
perform well in school:
completing assignments on
time, focusing in class.
Not doing well academically
hurts self-esteem, which
heightens risk for mental
distress.
Educational attainment and
mental health are linked, but
hard to disentangle from
income and employment
pathways.
People at risk of mental distress have
lower levels of educational attainment,
compared to the general population
Note: Risk of mental distress is defined using the Mental Health Index-5 (MHI-5) tool. Low education
indicates the highest level of education is less than primary or lower secondary
Source: OECD calculations based on the 2018 European Union Statistics on Income and Living Conditions (EU-
SILC), https://ec.europa.eu/eurostat/web/microdata/european-union-statistics-on-income-and-living-
conditions.
0%
10%
20%
30%
40%
Low education
(full pop)
Low education
(young people)
Share of people with low levels of education, by
mental health outcome, OECD 26, 2018

15. Policy
examples
to support
knowledge, skills
and educational
attainment, as
well as mental
health outcomes
Promote school-based interventions for mental health prevention
and promotion
Incorporate social and emotional learning into curricula
Intervention 3
Promote life-long learning
Intervention 2
Intervention 1
Education, health care
Education, sports and culture
Education, including adult and continuing education, sports and culture,
employment
For further details and concrete examples of existing policy practice, refer to Box 3.2 in the full report

16. Environmental
Quality
Younger people are more likely to be emotionally affected
by climate change than are older people
Climate change and its implications –
biodiversity loss, increasing extreme
weather events – harms mental health and
has given rise to new forms of ill-health.
The natural environment shapes our
mental health. Clean air, access to green
and blue spaces and more time spent in
nature are all associated with better
mental health outcomes.
0%
10%
20%
30%
40%
Afraid Anxious Despair Ashamed Depressed
Ages 18-24 Age 65+
Note: OECD 12 refers to Belgium, France, Germany, Ireland, Italy, Japan, Mexico, Spain, Switzerland, Turkey, the United Kingdom and the United States.
Source: OECD calculations based on AXA (2023), Toward a New Understanding: How we strengthen mind health and wellbeing at home, at work and online, AXA Group,
https://www.axa.com/en/about-us/mind-health-report.
Reported feelings on climate change in OECD 12, share of respondents, 2022

17. Policy
examples
to support
environmental
and
mental health
outcomes
Ecotherapy and green social prescribing
Building green, connected cities to promote mental well-being
Intervention 3
Strengthening government service systems, including mental health services, to better
respond to climate disasters and foster resilience among the population
Intervention 2
Intervention 4
Highlighting the hidden costs of climate change through innovative environmental
accounting and well-being cost benefit analyses
Health care, environment and conservation, urban planning
Urban planning, environment, transport, sports and culture
Emergency response, health care, social policy, environment, housing, urban planning
Budgeting, health care, environment, urban planning, transport, housing, social policy
Intervention 1
For further details and concrete examples of existing policy practice, refer to Box 3.3 in the full report

18. Safety
Neighbourhood crime and
feeling unsafe can worsen
mental health directly and by
influencing health protecting
behaviours and social cohesion.
Intimate partner violence is a
gendered risk to safety with
substantial mental health
consequences.
Experiencing the psychological
stress and structural
consequences of
discrimination has been linked
to depression and anxiety.
Note: OECD 12 refers to Belgium, France, Germany, Ireland, Italy, Japan, Mexico, Spain, Switzerland,
Turkey, the United Kingdom and the United States.
Source: OECD calculations based on AXA (2023), Toward a New Understanding: How we strengthen mind
health and wellbeing at home, at work and online, AXA Group, https://www.axa.com/en/about-us/mind-
health-report.
Experiencing discrimination
has been linked to worse mental health
(compared to those not experiencing it)
Share of people with mental health deprivations, by
self-reported experience of discrimination in the past
year, OECD 12, 2022
0%
10%
20%
30%
40%
Report depression Report anxiety Feel life is not worthwhile

19. Policy
examples
to support
safety and
mental health
outcomes
Improve neighborhood safety and resulting time-space inequalities
(in the ability to use the neighborhood space fully, at all times, for
mental health protecting activities such as sport and socialising)
Address intimate partner violence and improve support for survivors
Intervention 3
Tackle the roots of discrimination and racism
Intervention 2
Intervention 1
Urban planning, transport law enforcement, social policy, healthcare, environment
Law enforcement, justice, social policy, health care, statistics, education
Justice, health care, education, employment and labour
For further details and concrete examples of existing policy practice, refer to Box 4.1 in the full report

20. Work-Life
Balance
Time is a necessary resource for good
mental health
People with low levels of positive mental health are less satisfied with how they
spend their time compared to the overall population
0%
10%
20%
30%
40%
50%
Too tired after work for
household chores
No time to do things I enjoy Long hours in unpaid work Difficult to concentrate on
work because of family
responsibilities
Share
of
people
with
deprivations
in
time
use,
by
mental
health
outcome,
OECD
24
Note: Positive mental health is calculated using the World Health Organization-5 (WHO-5) tool. OECD 24 includes: Austria, the Czech Republic, Denmark, Estonia, Finland, France, Germany,
Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Norway, Poland, Portugal, the Slovak Republic, Slovenia, Sweden and the United Kingdom.
Source: OECD calculations based on the 2016 European Quality of Life Surveys(EQLS), https://www.eurofound.europa.eu/surveys/european-quality-of-life-surveys.

21. Policy
examples
to support work-
life balance and
mental health
outcomes
Promote work-life balance for all groups
Reduce the unpaid work gender gap
Intervention 3
Recognise the value of unpaid work
Intervention 2
Intervention 1
Employment and labour, corporate conduct, transport, urban design
Employment and labour, taxation, family policy, social policy
Statistics, economy, social policy, education
For further details and concrete examples of existing policy practice, refer to Box 4.2 in the full report

22. Social
Connections
People with poor mental health are more
likely to distrust others, feel lonely and have
infrequent contact with family and friends,
compared to the general population
Social connectedness causally
protects and promotes mental
health.
Social isolation may alter
social cognition and loneliness
can contribute to increased
cortisol levels, disrupted sleep
patterns, and a lowered
likelihood to engage in
protective behaviours.
Young people have emerged
as risk group for both
loneliness and mental distress
since the COVID-19 pandemic.
OECD 26, 2013 & 2018
Note: Risk of mental distress is defined using the Mental Health Index-5 (MHI-5) tool.
Source: OECD calculations based on the 2013 and 2018 European Union Statistics on Income and Living
Conditions (EU-SILC), https://ec.europa.eu/eurostat/web/microdata/european-union-statistics-on-income-
and-living-conditions.
0%
10%
20%
30%
40%
Dissatisfied
with personal
relationships
Feel lonely Live alone Do not see
friends
and family
monthly
No trust in
others

23. Policy
examples
to support social
connectedness
and mental
health outcomes
Make improving social connectedness an explicit policy priority
Expand support for existing social connection interventions, for
example, into existing community and government service structures
(e.g. social prescribing) or by increasing opportunities for social contact
(e.g. creating public civic and green spaces)
Intervention 3
Strengthen the evidence base on effective and scalable interventions
for different population groups
Intervention 2
Intervention 1
Central government target setting, social policy, local development
Urban planning, health care, social policy, housing, education, sports and culture
Social policy, healthcare, family and youth policy, sports and culture, education
For further details and concrete examples of existing policy practice, refer to Box 4.3 in the full report

24. 0%
10%
20%
30%
40%
50%
60%
70%
No trust in politics No trust in the legal
system
No trust in the police Feel excluded from society
Civic
Engagement
There is emerging evidence
that ‘political stress’ and
concerns about polarization
can be risk factors for mental
health.
Experiencing depression is
associated with lower
likelihood to vote and
engagement in political
participation.
The significant stigma of
mental ill-health might
deter entry into politics
(and representation on
the agenda).
Note: Risk of mental distress is defined using the Mental Health Index-5 (MHI-5) tool.
Source: OECD calculations based on the 2013 and 2018 European Union Statistics on Income and Living Conditions (EU-SILC), https://ec.europa.eu/eurostat/web/microdata/european-
union-statistics-on-income-and-living-conditions.
People with poor mental health are more likely to feel alienated from
public institutions and society, compared to the general population
OECD 26, 2013 & 2018

25. Policy
examples
to support civic
engagement
and participation
as well as mental
health outcomes
Ease participation and representation in politics of those with lived
experience of mental ill-health
Address political stress, or concerns about polarisation, as an
emerging mental health risk factor
Intervention 2
Intervention 1
(Civic) education, parliaments, voting and participation
Health care, education, sports and culture, urban planning
For further details and concrete examples of existing policy practice, refer to Box 4.4 in the full report

26. Western Australia, Denmark, Faroe Islands, Finland, Norway: Act
Belong Commit (the ABCs of Mental health) Programme
Western Australia: Western Australian Mental Wellbeing Guide
Canada: Mental Health Promotion Innovation Fund &
Positive Mental Health Surveillance Indicator Framework
Finland: National Mental Health Strategy and Programme for
Suicide Prevention 2020-30
New Zealand: Mental Health and Wellbeing Commission
(Te Hiringa Mahara)
Norway: Programme for Public Health Work in Municipalities
Sweden: “It’s about life” Proposal for the new National Policy for
Mental Health and Suicide Prevention
Wales: Public Service Boards & North Wales Public Service Lab and
Insight Partnership
 REALIGN:
Whole of government approach
 REDESIGN:
Well-being determinants for
prevention and promotion
 REFOCUS:
Emphasis on positive mental health
 RECONNECT:
Building broad partnerships
The final part of the report
uses case studies to see how
mental health initiatives
around the OECD can …

27. Multidimensional frameworks can provide the mandate
for agencies to contribute to common goals
Implementation plans that address intersectoral
collaboration can support delivery
 Sufficient resources – both time and money – are needed
for success and relationship building
 New ways to align: independent oversight agencies;
strategic grantmaking for broader well-being work
at the local level
REALIGN
Whole-of-government approach, across sectors and levels of government

28. Designing and implementing policies that jointly
address mental health and other areas of well-
being – as showcased in policy examples
throughout the previous section
Creating new tools, such as mental health or
well-being impact assessments
REDESIGN
Social, economic, environmental and relational well-being determinants for mental health prevention
and promotion

29.  Publishing data on positive mental
health helps with agenda setting
 Strategies and funding are
increasingly explicit in targeting mental
health promotion
REFOCUS
Emphasis on positive mental health

30. Many strategies have a participatory
element but it needs to continue beyond
the planning stage
Knowledge brokering is essential to
share learnings
 The depth of partnerships matters for
impact
RECONNECT
Building broad partnerships across society

31. The Centre on Well-being, Inclusion, Sustainability and Equal Opportunity (WISE):
https://www.oecd.org/wise/
OECD work on mental health:
https://www.oecd.org/wise/well-being-and-mental-health.htm
https://www.oecd.org/els/mental-health.htm
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lara.fleischer@oecd.org
jessica.mahoney@oecd.org
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