This report aims to improve the assessment of mental health needs in the Americas by providing an updated and nuanced picture of: (a) the disability resulting from mental, substance use, and specific neurological disorders, plus self-harm, alone and in combination with premature mortality; (b) the imbalance between mental health spending and its related disease burden; and (c) the inadequate allocation of the meager mental health spending by countries of the Region. Consistent with global trends, the epidemiologic transition in the Americas has resulted in a shift from communicable diseases, nutritional deficiencies, and maternal and child health conditions being the major causes of ill health and death, to noncommunicable diseases, which are responsible for increasingly higher levels of disability and premature mortality. A substantial proportion of the health problems in the Americas also arise from mental, neurological, and substance use disorders.