ABSTRACT:
Backgrounds: Mental health has historically received limited attention within public health policy frameworks, resulting in persistent treatment gaps, systemic exclusion, inequities in access to care, and inadequate prevention strategies. Mental health remains insufficiently integrated into broader public health systems, limiting the effectiveness of population-level responses. Effective policy frameworks must focus on social determinants, prevention strategies, resource allocation, and equitable access to care. In this context, the study applies urban hierarchy and location theories to examine how spatial organization and positionality within urban systems shape mental health policies and how the public health system can mitigate the adverse effects. The study builds standardized indexes of access, service quality, health expenditures, socioeconomic deprivation, and inequality and operationalizes each index to capture structural and contextual dimensions of mental health provision and explores how differential access to resources, services, and opportunities produces uneven mental health risks, disorders and mortality.

METHODS:
The study draws on multi-source administrative surveys and spatial data. Estimation is performed using dynamic panel techniques to address endogeneity, autocorrelation, enabling consistent identification of short- and long-run relationships between the indicators and mental health outcomes.

RESULTS:
Better valued public health institutions exhibit lower risk and reduced prevalence of mental disorders. Besides, mental disorder outcomes are not randomly distributed but are systematically produced by spatial inequalities embedded in urban systems, calling for place-sensitive and equity-oriented mental health policies, emphasizing prevention and equity as fundamental strategies to reduce the burden of mental illness in vulnerable populations.

CONCLUSIONS:
Embedding mental health policy within public health infrastructure can significantly improve mental health outcomes. Policymakers should prioritize sustainable financing, workforce development, and community engagement to close treatment gaps and address social determinants of mental health. Patterns identified in this study offer pathways to strengthen global mental health policy integration into public health systems to improve equity and inclusion.