Mental Health and Well-Being in the Modern Era: A Scoping Review of Challenges and Interventions
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Abstract
Background: Mental health and well-being are increasingly shaped by intersecting clinical, social, technological, occupational, environmental, cultural, and health-system factors. Contemporary challenges such as digital dependency, post-pandemic psychological distress, climate anxiety, occupational burnout, structural inequities, stigma, and limited access to care have expanded the scope of global mental health beyond disorder-specific treatment alone. Objective: This scoping review aimed to map the major modern-era challenges affecting mental health and well-being, categorize intervention approaches reported in the literature, summarize regional and equity-related patterns, and identify evidence gaps relevant to future research, practice, and policy. Methods: A scoping review approach was used in accordance with established scoping review methodology and PRISMA-ScR guidance. Sources were selected if they addressed mental health challenges, well-being, classification frameworks, access barriers, intervention approaches, or policy responses relevant to modern mental health. The final synthesis included 44 substantive sources from a 52-reference manuscript set. These comprised 37 peer-reviewed evidence sources and 7 grey-literature, policy, classification, or organizational sources. Evidence was synthesized descriptively and thematically across mental health challenge domains, intervention categories, regional contexts, and evidence gaps. Results: Seven major challenge domains were identified: depression and anxiety, youth and adolescent mental health, digital and technology-related mental health concerns, post-pandemic mental health sequelae, climate-related distress, occupational burnout, and social determinants with structural inequities. Five intervention categories were mapped: pharmacological interventions, psychotherapeutic interventions, community-based and task-shifting approaches, digital and technology-mediated interventions, and systems-level or policy interventions. Stronger evidence was found for common mental disorders, global burden, psychotherapy, pharmacotherapy, stigma, service-access barriers, and digital mental health. Weaker evidence was identified for climate-specific interventions, AI governance, long-term implementation in low-resource settings, and equitable intervention models for marginalized populations. Conclusion: Mental health and well-being in the modern era require integrated, culturally responsive, and equity-oriented approaches that combine clinical care with community support, digital governance, workforce development, social protection, primary care integration, and policy reform. Future research should prioritize longitudinal evidence, implementation evaluation, low-resource settings, marginalized populations, and regulation of emerging digital and AI-supported mental health tools
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References
1. World Health Organization. World mental health report: transforming mental health for all. Geneva: World Health Organization; 2022.
2. GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9(2):137-150. doi:10.1016/S2215-0366(21)00395-3.
3. Santomauro DF, Mantilla Herrera AM, Shadid J, Zheng P, Ashbaugh C, Pigott DM, et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398(10312):1700-1712. doi:10.1016/S0140-6736(21)02143-7.
4. Haidt J, Twenge JM. This is our moment to act on teen mental health. New York Times. 2021 Apr 7.
5. NHS Digital. Mental health of children and young people in England, 2022: wave 3 follow up to the 2017 survey. Leeds: NHS Digital; 2022.
6. American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, Children’s Hospital Association. Declaration of a national emergency in child and adolescent mental health. Itasca: American Academy of Pediatrics; 2021.
7. Poli A, Gemignani A, Soldani F, Miccoli M. A systematic review of a new generation of clinical assessment tools for problematic social media use in youth populations. Int J Environ Res Public Health. 2021;18(11):5690. doi:10.3390/ijerph18115690.
8. Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: systematic review of the current evidence. Brain Behav Immun. 2020;89:531-542. doi:10.1016/j.bbi.2020.05.048.
9. Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-907. doi:10.1016/j.bbi.2020.05.026.
10. Hickman C, Marks E, Pihkala P, Clayton S, Lewandowski RE, Mayall EE, et al. Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. Lancet Planet Health. 2021;5(12):e863-e873. doi:10.1016/S2542-5196(21)00278-3.
11. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19-32. doi:10.1080/1364557032000119616.
12. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews: checklist and explanation. Ann Intern Med. 2018;169(7):467-473. doi:10.7326/M18-0850.
13. World Health Organization. Comprehensive mental health action plan 2013–2030. Geneva: World Health Organization; 2021.
14. Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, et al. The Lancet Commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553-1598. doi:10.1016/S0140-6736(18)31612-X.
15. Kola L, Kohrt BA, Hanlon C, Naslund JA, Sikander S, Balaji M, et al. COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. Lancet Psychiatry. 2021;8(6):535-550. doi:10.1016/S2215-0366(21)00025-0.
16. Tomlinson M, Rudan I, Saxena S, Swartz L, Tsai AC, Patel V. Setting priorities for global mental health research. Bull World Health Organ. 2009;87(6):438-446. doi:10.2471/BLT.08.054353.
17. Chibanda D, Weiss HA, Verhey R, Simms V, Munjoma R, Rusakaniko S, et al. Effect of a primary care-based psychological intervention on symptoms of common mental disorders in Zimbabwe: a randomised clinical trial. JAMA. 2016;316(24):2618-2626. doi:10.1001/jama.2016.19102.
18. Firth J, Torous J, Nicholas J, Carney R, Pratap A, Rosenbaum S, Sarris J. The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomised controlled trials. World Psychiatry. 2017;16(3):287-298. doi:10.1002/wps.20472.
19. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed, text rev. Washington: American Psychiatric Association Publishing; 2022.
20. World Health Organization. International statistical classification of diseases and related health problems. 11th ed. Geneva: World Health Organization; 2019.
21. Kroenke K, Unützer J. Closing the false divide: sustainable approaches to integrating mental health services into primary care. J Gen Intern Med. 2017;32(4):404-410. doi:10.1007/s11606-016-3967-8.
22. Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med. 2010;71(12):2150-2161. doi:10.1016/j.socscimed.2010.09.030.
23. Evans-Lacko S, Henderson C, Thornicroft G. Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009–2012. Br J Psychiatry. 2013;202(Suppl 55):s51-s57. doi:10.1192/bjp.bp.112.114553.
24. United Nations High Commissioner for Refugees. Global trends: forced displacement in 2022. Geneva: UNHCR; 2023.
25. Carhart-Harris R, Giribaldi B, Watts R, Baker-Jones M, Murphy-Beiner A, Murphy R, et al. Trial of psilocybin versus escitalopram for depression. N Engl J Med. 2021;384(15):1402-1411. doi:10.1056/NEJMoa2032994.
26. Veesar GY, Akhlaq A, Siddiqi AQ. Global prevalence of quackery practices: a scoping review of definitions, regulations and allied healthcare. J Pak Med Assoc. 2024;74(6):1144-1152. doi:10.47391/JPMA.10230.
27. Sujatha V. Of informal practitioners of biomedicine: the interplay of medicine, economy and society in India. Soc Sci Med. 2023;317:115564. doi:10.1016/j.socscimed.2022.115564.
28. Skrbo A, Masic I. The role and characteristics of collections of folk recipes in the folk and traditional medicine of Bosnia and Herzegovina. Mater Sociomed. 2017;29(3):219-227. doi:10.5455/msm.2017.29.219-227.
29. Clayton S, Karazsia BT. Development and validation of a measure of climate change anxiety. J Environ Psychol. 2020;69:101434. doi:10.1016/j.jenvp.2020.101434.
30. Khan R, Mustufa MA, Hussain S. Factors contributing to the public proneness towards quacks in Sindh. Pan Afr Med J. 2020;37:174. doi:10.11604/pamj.2020.37.174.23411.
31. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69. doi:10.1186/1748-5908-5-69.
32. Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic review or scoping review approach. BMC Med Res Methodol. 2018;18:143. doi:10.1186/s12874-018-0611-x.
33. Maj M, Stein DJ, Parker G, Zimmerman M, Fiorillo A, De Hert M, et al. The clinical characterization of the adult patient with depression aimed at personalization of management. World Psychiatry. 2020;19(3):269-293. doi:10.1002/wps.20771.
34. Cuijpers P, van Straten A, Warmerdam L, Andersson G. Psychological treatment of depression: a meta-analytic database of randomized studies. BMC Psychiatry. 2008;8:36. doi:10.1186/1471-244X-8-36.
35. Firth J, Torous J. Smartphone apps for schizophrenia: a systematic review. JMIR Mhealth Uhealth. 2015;3(4):e102. doi:10.2196/mhealth.4930.
36. Thornicroft G, Sunkel C, Aliev AA, Baker S, Brohan E, El Chammay R, et al. The Lancet Commission on ending stigma and discrimination in mental health. Lancet. 2022;400(10361):1438-1480. doi:10.1016/S0140-6736(22)01470-2.
37. Saxena S, Thornicroft G, Knapp M, Whiteford H. Resources for mental health: scarcity, inequity, and inefficiency. Lancet. 2007;370(9590):878-889. doi:10.1016/S0140-6736(07)61239-2.
38. Naslund JA, Aschbrenner KA, Araya R, Marsch LA, Unützer J, Patel V, Bartels SJ. Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature. Lancet Psychiatry. 2017;4(6):486-500. doi:10.1016/S2215-0366(17)30096-2.
39. Twenge JM, Haidt J, Joiner TE, Campbell WK. Underestimating digital media harm. Nat Hum Behav. 2020;4(4):346-348. doi:10.1038/s41562-020-0839-4.
40. Thornicroft G, Chatterji S, Evans-Lacko S, Gruber M, Sampson N, Aguilar-Gaxiola S, et al. Undertreatment of people with major depressive disorder in 21 countries. Br J Psychiatry. 2017;210(2):119-124. doi:10.1192/bjp.bp.116.188078.
41. Cuijpers P, Cristea IA, Karyotaki E, Reijnders M, Huibers MJH. How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry. 2016;15(3):245-258. doi:10.1002/wps.20346.
42. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013;382(9904):1575-1586. doi:10.1016/S0140-6736(13)61611-6.
43. Torous J, Myrick KJ, Rauseo-Ricupero N, Firth J. Digital mental health and COVID-19: using technology today to accelerate the curve on access and quality tomorrow. JMIR Ment Health. 2020;7(3):e18848. doi:10.2196/18848.
44. Cuijpers P, Noma H, Karyotaki E, Vinkers CH, Cipriani A, Furukawa TA. A network meta-analysis of the effects of psychotherapies, pharmacotherapies, and their combination in the treatment of adult depression. World Psychiatry. 2020;19(1):92-107. doi:10.1002/wps.20701.
45. Krishnamoorthy S, Bhola P. Scope of digital mental health in low and middle income countries: challenges, opportunities and ways forward. Asian J Psychiatr. 2022;72:103085. doi:10.1016/j.ajp.2022.103085.
46. Bhugra D, Bhui KS, Wong SYS, Gilman SE, editors. Oxford textbook of public mental health. Oxford: Oxford University Press; 2018. doi:10.1093/med/9780198725183.001.0001.
47. Lund C, Stansfeld S, De Silva M. Social determinants of mental health. In: Patel V, Minas H, Cohen A, Prince M, editors. Global mental health: principles and practice. Oxford: Oxford University Press; 2014. p. 116-136.
48. Andrade LH, Alonso J, Mneimneh Z, Wells JE, Al-Hamzawi A, Borges G, et al. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychol Med. 2014;44(6):1303-1317. doi:10.1017/S0033291713001943.
49. Slade M, Amering M, Farkas M, Hamilton B, O’Hagan M, Panther G, et al. Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems. World Psychiatry. 2014;13(1):12-20. doi:10.1002/wps.20084.
50. Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry. 2016;3(2):171-178. doi:10.1016/S2215-0366(15)00505-2.
51. Uzair M, et al. Mental health services accessibility in Pakistan: gaps, barriers, and policy implications — a qualitative analysis. J Health Wellness Community Res. 2025;3(2).
52. Muzammil MH, et al. Barriers to universal health coverage in Pakistan: a health system perspective. J Health Wellness Community Res. 2025;3(2).