Scaling up mental health services through the primary health care approach: implementation strategies from across the WHO European region

Mental health conditions affect around one in six people in the WHO European region, contributing substantially to morbidity, disability, and premature mortality. However, services too often remain underprioritised, under-resourced, and concentrated in institutional settings. Integrating mental health services within the primary health care (PHC) approach offers a timely and necessary response, particularly as needs rise in the context of conflict, economic insecurity, climate-related crises, digitalisation, and population ageing. Despite longstanding policy commitments, implementation of community-based, PHC-oriented mental health care remains uneven and insufficient across the region. Drawing on a WHO Regional Office for Europe policy paper , we describe implementation strategies for policy and practice from across the WHO European region. We identify four key strategies for scaling up mental health services through PHC—enhancing the mental health competencies of primary care workers, integrating dedicated workers with mental health competencies into primary care teams, strengthening links between primary care and specialist mental health services, and improving collaboration between health and other sectors. Across all four strategies, the core principle is to match care to need within connected service networks anchored in PHC. Progress depends on political commitment alongside coordinated action across workforce education and training, human resources, physical resources, financing, and governance, supported by sustained efforts to reduce stigma and monitor coverage, quality, equity, and outcomes over time. Crucially, expansion of services needs to be aligned with system capacity, ensuring that increased identification of need is matched by the availability of timely and effective follow-up care.