The map shows which countries have the best mental health and which have the most distress.

This week, the largest survey of global mental health, with data from 34 countries, was released.

On average, English-speaking countries had some of the worst mental health scores.

Higher education and employment were linked to better mental health scores, especially in countries that value performance and individualism.

Sapien Labs, the non-profit research organisation behind the Mental Health Million Project, a global effort to track mental wellbeing, released the results of the largest survey of global mental health this week.

In 2019, the project began in eight English-speaking countries and has since grown to reach 223,000 people in 34 countries.

The second annual Mental State of the World Report, based on responses to a 15-minute anonymous survey available online in English, Spanish, French, and Arabic, provides a snapshot of wellbeing around the world in 2021.

Sapien Labs created the Mental Health Quotient (MHQ) survey to look at six aspects of overall happiness: mood and outlook, social self, motivation, cognition, adaptability and resilience, and the mind-body connection.

MHQ scores range from -100 to 200, with positive scores indicating "normal" functioning and negative scores indicating the possibility of clinical mental illness.

The report's average national scores ranged from 46 in South Africa, which was deemed to have "enduring" mental health, to 91 in Venezuela, which was deemed to be on the cusp of "managing" and "succeeding" according to the MHQ scale.

The English-speaking world had the lowest average mental health scores.

Eight of the ten countries with the lowest average MHQ scores were from the Core Anglosphere, according to the report. South Africa, the United Kingdom, Australia, Ireland, India, New Zealand, Canada, and the United States are among the countries with the worst reported mental health.

The story goes on.

Latin America, Spain, and a few French-speaking countries in Europe and Africa, on the other hand, had the highest average mental health scores.

To the researchers' surprise, national economic indicators of prosperity, such as high GDP per capita, were found to be linked to lower average mental health scores for the surveyed populations.

"This contradicts the widely held belief that increased national economic prosperity leads to increased social wellbeing, where these correlations should be positive and not significantly negative," the report states.

The authors also looked at how cultural values differ from country to country. In surveys for the separate GLOBE Project, populations who prioritised work performance and individualism tended to score lower on the mental health quotient, indicating some distress.

Access to the internet, education, and employment may have all played a role in mental health scores.

The ability to access the internet was required in order to complete the open, online survey. With that in mind, the data only reflects the experiences of people who have access to the Internet.

According to Patricia Escobar, a consulting manager for culturally responsive and inclusive care at Kaiser Permanente, people of colour are less likely to use the internet to access health services than their white counterparts.

In the early stages of the COVID-19 pandemic, research found that Black and Hispanic patients in the United States, particularly those over the age of 65, used telemedicine at significantly lower rates than white patients. When this trend is combined with cultural biases against mental illness, Escobar believes that people will be less likely to complete an online survey about mental health.

"From my family's experience, you do downplay and use more 'benign' words," said Escobar, who immigrated to the United States as a young girl from Bolivia. "We tend to be more resilient as immigrants and people of colour because we've faced so many other challenges that our neighbours may not have."

Higher education and employment were linked to better mental health scores in all countries. In Western, English-speaking countries, the link between employment and income was strongest.