Mental health is central to the concept of well-being. The social determinants that affect population mental health are often the same as those that inform physical health, and the need to integrate mental health with primary care services is a priority in the Caribbean region. However, mental health disorders remain underreported and underdiagnosed, with gaps in access and availability of services mostly due to stigma and discrimination. This chapter gives an overview of the mental health issues facing Caribbean countries. Depression contributes substantially to years lived with disability and strongly associated with suicidal behavior. Factors such as poverty, alcohol misuse, domestic violence, and family problems are identified drivers of high suicide rates. Psychotic disorders impose a significant public health burden due to associated costs and the link to homelessness. Cannabis use is a notable risk factor for psychosis in the region. Violence remains a critical public health issue, encompassing family and community violence, and necessitating targeted interventions to address its multifaceted nature. Strategic action for governments in the region would include increased funding for mental health services and research, development of integrated primary and mental health services, and community programs to enhance wellness and well-being.