Mental ill-health affects millions of people, and drives economic costs of more than 4% of GDP. A good mental health system helps people stay in good mental health, and connects those in need to appropriate support to manage their mental health condition or even fully recover from it. However, mental health care has long been neglected and under-funded, and unmet need for care is still high. The long-lasting COVID-19 crisis and the toll it is taking on mental health has made mental health systems more important than ever. This timely report provides an in-depth analysis of how well countries are delivering the policies and services that matter for mental health system performance. The report highlights recent reforms countries have taken to strengthen mental health performance, including by increasing access to mental health care, ensuring that service users take the lead in planning and even delivering services, and prioritising integration and mental health promotion. The report also identifies promising approaches countries should pursue to better meet their populations’ mental health needs. This report sets up a framework for understanding mental health performance through internationally comparable indicators, an approach set to grow stronger still in the coming years as more data become available.