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This review provides insight into the contemporary challenges and initiatives in mental health care across Egypt, the Middle East, and North Africa (MENA) region. It examines the structural barriers, including fragmented public health systems and inadequate resource allocation, which hinder access to mental health services. The COVID-19 pandemic exacerbated these challenges, prompting innovative approaches like telepsychiatry and the establishment of specialized psychiatric hospitals. Despite advancements in psychiatric education and research, disparities persist, particularly in rural mental health care. Limited funding, workforce shortages, and barriers to accessing medications and post-hospitalization support further compound the issue. International and local efforts aim to address these challenges, with a focus on enhancing child and adolescent mental health services and supporting populations affected by the refugee crisis. Policy reforms, increased financial allocation, and workforce development are essential for overcoming these obstacles and ensuring equitable access to quality mental health care throughout the MENA region. This review underscores the urgent need for collaborative action to improve mental health outcomes and reduce disparities in the region.