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Mental & Physical Health20256 min read
The Surprising Global Map of Mental Well-Being
A cross-national analysis of demographic variation in self-rated mental health across 22 countries
- By
- Okafor, Chukwuemeka N. et al.
- Participants
- 200,000
- Countries
- 22
- Journal
- Communications Medicine
- DOI
- 10.1038/s43856-025-01038-8
§1
Key Takeaways
01
Self-rated mental health varies significantly across the globe, with people in several African nations like Tanzania and Kenya reporting the highest scores and those in Japan, Türkiye, and the United Kingdom reporting the lowest.
02
Across most of the 22 countries studied, men, older adults, and those who frequently attend religious services tend to report better mental health.
03
The relationship between mental health and factors like marital status or education is not universal and changes depending on the country, highlighting the importance of cultural context.
§2
Why It Matters
To improve well-being everywhere, we must look beyond economics to the social and cultural fabric that shapes people's lives.
This research matters because it challenges assumptions about mental health. Wealthy nations often assume they have the best outcomes, but this study suggests that money and healthcare access alone do not determine how people feel about their mental health. Cultural attitudes, community support, and religious participation all appear to play meaningful roles. For policymakers, this means one-size-fits-all mental health strategies will fall short. A program that works in Sweden may not suit Tanzania, and vice versa. For healthcare providers, understanding that patients from different backgrounds may interpret the same mental health question very differently is essential. The study also highlights vulnerable groups — particularly young adults, unemployed people, and those identifying as a gender other than male or female, who reported the lowest scores. These findings can help target resources where they are needed most and encourage culturally sensitive approaches to mental health worldwide.
This research matters because it challenges assumptions about mental health. Wealthy nations often assume they have the best outcomes, but this study suggests that money and healthcare access alone do not determine how people feel about their mental health. Cultural attitudes, community support, and religious participation all appear to play meaningful roles. For policymakers, this means one-size-fits-all mental health strategies will fall short. A program that works in Sweden may not suit Tanzania, and vice versa. For healthcare providers, understanding that patients from different backgrounds may interpret the same mental health question very differently is essential. The study also highlights vulnerable groups — particularly young adults, unemployed people, and those identifying as a gender other than male or female, who reported the lowest scores. These findings can help target resources where they are needed most and encourage culturally sensitive approaches to mental health worldwide.
To improve well-being everywhere, we must look beyond economics to the social and cultural fabric that shapes people's lives.
§3
The Story
How would you rate your overall mental health, from 0 (poor) to 10 (excellent)? Over 200,000 people across 22 countries answered exactly that question in a massive global survey. The results paint a surprising picture.
National wealth does not guarantee mental well-being; people in some of the richest countries report the lowest scores globally.
People in Tanzania, Kenya, and Nigeria reported the highest mental health scores — near 9 out of 10. Meanwhile, people in Japan, Türkiye, and the United Kingdom gave themselves the lowest ratings, around 6 out of 10. This is striking because Japan and the UK are wealthy nations with strong healthcare systems, while Tanzania and Kenya have far fewer resources. So why the gap?
Researchers think culture plays a big role. In some places, admitting to mental health struggles carries stigma, so people may rate themselves more positively. Strong family networks and community ties in many African countries may also help people feel supported. The study also found patterns within countries. On average, older adults rated their mental health higher than younger people.
Men rated themselves slightly higher than women. Married people tended to score higher than those who were separated or divorced. And people who attended religious services frequently — more than once a week — reported the highest mental health scores of any group in the study. But these patterns were not universal. In some countries like India and Tanzania, mental health scores actually declined with age. In others, students reported the highest scores. The takeaway? Mental health is deeply personal, but it is also shaped by where you live, who you live with, and the culture around you.
Figures
1.45x
Top vs. Bottom Country
Residents of Tanzania, the country with the highest self-rated mental health, reported scores 1.45 times higher on average than residents of Japan, the country with the lowest scores.
+0.81 points
Religious Attendance Impact
On average across 22 countries, people who attend religious services more than once a week rated their mental health 0.81 points higher on a 10-point scale compared to those who never attend.
11.9%
Employment Status Gap
Across all countries, retired individuals reported average mental health scores that were 11.9% higher than those who were unemployed and looking for a job.
-1.9 points
Gender Identity Disparity
Individuals identifying as a gender other than male or female reported significantly lower self-rated mental health, scoring on average 1.9 points lower than males on a 10-point scale.
§4
Reader Questions
Research Details
& Citation
Chat with this paperPublished
2025
Journal
Communications Medicine
Participants
200,000
Countries
22
Cite this paper
Okafor, C. N., Jean-Berluche, D., Paltzer, J., Kwon, E., Grigoropoulou, N., VanderWeele, T. J., & Johnson, B. R. (2025). A cross-national analysis of demographic variation in self-rated mental health across 22 countries. Communications Medicine, 5(1). https://doi.org/10.1038/s43856-025-01038-8Tags
mental-healthcross-culturallife-satisfactionservice-attendanceagemarriage
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