Mapping European mental health policies: a scoping review and policy recommendations

The rising burden of mental health problems requires effective, comprehensive, and evidence-informed policymaking. Despite their importance, mental health policies often remain poorly implemented.

This review aimed to map European mental health policies, identify patterns in the types of policy instruments used (e.g., legislation, guidelines, funding mechanisms, initiatives), assess which stages of the policy cycle are most addressed, and examine the role of stakeholders in shaping policy effectiveness.

This scoping review narratively synthesised data from peer-reviewed research and transnational policy documents on mental health interventions across health, education, employment, and social equity. Policy recommendations were derived from identified gaps and best practices.

Of 3084 articles retrieved from databases and 197 documents from grey literature, we obtained 102 reports of 101 studies. These were released from 2009 to 2025, with gradual increase in the last ten years. The main themes covered were healthy workplace (17.8%), mental health services (15.8%), and child and adolescent health (10.9%). Our synthesis also highlights the types of instruments employed: guidelines and recommendations (54.5%), initiatives (21.8%), legislation (17.8%), and funding mechanisms (5.9%). Stakeholder engagement was accounted for in 46.6% of studies, with multi-level participation strongest in community-based initiatives and weakest in legislative processes. Additionally, many studies reported policies in evaluation (54.5%), formulation (42.6%), or implementation phase (19.8%), with smaller contributions to agenda setting (4.0%).

Aligning policies with evidence-based recommendations, strategically selecting policy instruments, addressing policy cycle gaps, and enhancing stakeholder engagement can improve implementation and outcomes of mental health policies in the European region.