Winkler, PetrGuerrero, ZoeKågström, AnnaPetrášová, MichaelaPashoja, Arlinda CergaQirjako, GentianaHristakeva, ValentinaGermanov, DimitarKuzman, Martina RojnicKuharić, Dina BošnjakHavlíková, LucieEek, HermanMaron, EduardŐri, DorottyaWernigg, RóbertFanaj, NaimKrasniqi, ElonaSile, LieneBrinkmane, KlintaLevickaitė, KarilėGrigaitė, UgnėGrigaite, UgneManusheva, NensiKalpak, GjorgjiIvanovic, IvaChihai, JanaMihaela, BelousGondek, Tomasz M.Todzia-Kornaś, AgataMihai, AdrianaMolnar, Rebeca IsabelaLetovancová, Katarína MolnárováKopcová, ElenaSuvalo, OrestKhudoba, OleksandraIsmayilova, JamilaMuradova, GunelMakhashvili, NinoDumbadze, MishikoPanteleeva, LiliiaPopkov, MikhailAl Tayara, Lynnvan Voren, RobertThornicroft, Graham2025-12-052025-12-052025-102666-7762PURE: 136236899PURE UUID: 51de0eb1-7d2c-4b86-8d71-2898f51e17f0Scopus: 105021853843http://hdl.handle.net/10362/191554Funding Information: We would like to thank all interviewees across 19 countries who contributed to country reports. Funding: The study described is from the project \u201CResearch of Excellence on Digital Technologies and Wellbeing CZ.02.01.01/00/22_008/0004583\u201D which is co-financed by the European Union. Funding Information: There are promising examples of efforts to integrate these services into a broader mental health care system. In Slovakia, for instance, the Central Office for Labor, Social Affairs and Family is implementing a project financed by the European Social Fund aimed at establishing 46 family counselling centres across the country. These centres are intended to operate with multidisciplinary teams and provide psychological support to individuals, couples, and families. However, the project has not yet been fully implemented. Funding Information: Funding: The study described is from the project \u201CResearch of Excellence on Digital Technologies and Wellbeing CZ.02.01.01/00/22_008/0004583\u201D which is co-financed by the European Union. Publisher Copyright: © 2025 The Author(s)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.834558engCentral and Eastern EuropeChildren and young peopleCommon mental disordersEarly detectionEarly interventionMental healthMigrantsPost-communist EuropePreventionPromotionInternal MedicineOncologyHealth PolicyPublic Health, Environmental and Occupational HealthSDG 3 - Good Health and Well-beingreview10.1016/j.lanepe.2025.101464https://www.scopus.com/pages/publications/105021853843