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Going abroad for —

Mental Health Privacy

Confidentiality and discretion standards for mental health treatment

A fuller editorial guide to mental health privacy is coming soon. For now, the ranking below compares every country we have assessed on it — open a country's report for the cited detail behind its score.

The country comparison

Which countries are best for mental health privacy

The destinations ranked high→low under this lens — each with the reasoning behind its score, the cited evidence one click down, and its full report. The verdict is free; the report is the depth.

19 / 19 Countries ranked

Researched and assessed by the Epidaurus editorial pipeline against our published scale. A country below the rule is not yet assessed enough — never ranked last.

  1. 1 Germany DE 4.5/5 Good Germany operates one of Europe's most rigorous mental health privacy frameworks, combining GDPR Article 9, BDSG §46(3), StGB §203 criminal penalties, and specialized psychotherapy legislation. Criminal liability for u... Full report
    The evidence behind this score 10 cited points
    • StGB §203 criminalizes unauthorized disclosure of mental health information with up to 1 year imprisonment; Schweigepflicht obligation applies to all treating staff including physicians, psychotherapists, nurses, and social workers
    • GDPR Article 9 classifies mental health data as special-category sensitive data requiring explicit consent; BDSG §46(3) adds national-level specificity with heightened organizational and technical security requirements
    • ePA 3.0 (from Jan 2025) uses end-to-end encryption via gematik TI 2.0, logs all access for 3 years, requires explicit patient notification before sensitive data storage, and legally bars health insurers from accessing mental health records
    • 17 independent data protection authorities (BfDI + 16 state-level Landesdatenschutzbehörden) enforce GDPR and national law; Germany's cumulative GDPR fine total exceeds €160 million since 2018 with hospital-specific enforcement (€105,000 fine for patient data mix-up)
    • International patients receive identical GDPR protections as German citizens regardless of nationality; September 2025 German guidelines require Transfer Impact Assessments and Standard Contractual Clauses for cross-border mental health data transfers
    • Facility-level protections: therapy diagnoses excluded from standard sick notes; statutory health insurance pre-approval uses anonymized external review (clinical data not transmitted to insurer); private self-pay option available entirely off-record
    • General Equal Treatment Act (AGG, 2006) prohibits employment discrimination based on disability; employers cannot request mental health diagnoses; courts affirm robust employer firewall for psychiatric treatment information
    • Red flag: ePA defaults to opt-out rather than opt-in for sensitive mental health data; advocacy groups including QueerMed Deutschland report lack of per-document granular consent controls (access control is institutional, not document-level)
    • Red flag: security researchers identified over 20 vulnerabilities in ePA before launch; theoretical access to 70 million patient records demonstrated in prior TI infrastructure phase; residual risk acknowledged despite gematik remediation
    • Red flag: 16 state-level PsychKG laws vary in scope and procedural protections for acute psychiatric admissions; federal GDPR/BDSG framework applies uniformly but state law details create geographic inconsistency

    Read the full Germany report →

  2. 2 Singapore SG 4.5/5 Good Singapore demonstrates a comprehensive multi-statute legal framework for mental health privacy, with PDPA treating mental health as sensitive personal data, the Health Information Act (2027) introducing a double-login... Full report
    The evidence behind this score 6 cited points
    • PDPA 2012 explicitly classifies mental health conditions as 'sensitive personal data' requiring heightened protection obligations compared to standard personal data
    • Health Information Act (effective 2027) creates a 'Sensitive Health Information' category for mental disorders with 'double login' authentication and documented access justification, representing one of Asia's most rigorous access control approaches
    • Workplace Fairness Act 2025 makes mental health condition a standalone protected characteristic with civil penalties up to SGD 250,000 for employment discrimination
    • PDPC enforces PDPA with penalties up to 10% of annual Singapore turnover for large organizations, with recent enforcement actions including SGD 102,000 in fines (May 2024)
    • Mandatory itemized billing policy creates documentation trail exposing mental health services despite legal prohibition on employer access without consent
    • Research shows persistent stigma with 44.5% of youth associating mental illness with derogatory terms and 46.2% reporting embarrassment at mental health diagnosis, creating practical chilling effect

    Read the full Singapore report →

  3. 3 United Kingdom GB 4.5/5 Good The United Kingdom maintains an exceptionally robust mental health privacy framework anchored by UK GDPR (classifying mental health as special category data), the Mental Health Act 2025 (introducing world-leading adva... Full report
    The evidence behind this score 5 cited points
    • UK GDPR classifies mental health data as special category data subject to presumptively prohibited processing except under narrow statutory conditions, with ICO enforcement authority up to £17.5 million or 4% global turnover
    • Mental Health Act 2025 introduced advance choice documents allowing patients to specify information-sharing preferences with statutory force, and replaced nearest relative role with patient-nominated person to strengthen privacy autonomy
    • NHS DSP Toolkit mandatory compliance with role-based access controls; Caldicott Guardian required in every NHS organisation; CQC inspection regime explicitly covers privacy and dignity; mental health records retain 20-year retention (vs. 8 years general)
    • CQC's 2023/24 Mental Health Act monitoring report identified physical privacy gaps in some NHS inpatient facilities due to ageing estates and poor ward design, which medical tourists using NHS-funded care may encounter
    • Private facilities (Priory Group, Harbor London) market discretion and enhanced confidentiality to international patients with private entrances and soundproofed rooms, but no standardised medical tourism mental health privacy protocol exists; patients must proactively request consent restrictions for cross-border data transfers

    Read the full United Kingdom report →

  4. 4 United Arab Emirates AE 4.0/5 Good The UAE demonstrates strong national mental health privacy legislation (Federal Law No. 10 of 2023) with specific protections and meaningful penalties (AED 50,000–200,000), combined with enhanced electronic health rec... Full report
    The evidence behind this score 5 cited points
    • Federal Law No. 10 of 2023 establishes comprehensive mental health privacy legislation with confidentiality as a legal right, employer secrecy obligations, and workplace anti-discrimination protections with fines of AED 50,000–200,000 per violation
    • Malaffi HIE implements 'Privacy Seal' mechanism restricting mental health records to highest-level clinical authorization with ISO 27001:2022 certification; NABIDH provides role-based access controls and patient opt-out rights
    • Multiple accredited private facilities (Al Amal JCI-certified hospital, Aspris, Maudsley Health, NMC Healthcare) document discrete services, confidential care, and specialized privacy measures
    • Data localization law (Federal Law No. 2 of 2019) prohibits unauthorized international transfer of health data; insurance-purpose transfers with explicit patient consent are permitted, protecting medical tourists' records
    • Emirate-level monitoring committees and facility-level Patient Rights Committees established by law provide accessible complaint mechanisms; however, implementing regulations for enforcement procedures remain pending as of mid-2025

    Read the full United Arab Emirates report →

  5. 5 Colombia CO 4.0/5 Good Colombia has a comprehensive multi-layered legal framework specifically protecting mental health confidentiality, including Article 6(15) of Law 1616 (2013) guaranteeing the right to confidentiality of psychiatric car... Full report
    The evidence behind this score 4 cited points
    • Article 6(15) of Ley 1616 de 2013 explicitly grants mental health patients the right to confidentiality of care-related information; Law 1581 of 2012 classifies health data as sensitive data with heightened processing restrictions; Constitution Article 74 declares professional secrecy inviolable
    • SIC (Superintendencia de Industria y Comercio) sanctioned SOS EPS for unauthorized disclosure of a patient's clinical history including psychiatric diagnosis; Constitutional Court T-402-24 affirmed that privacy violations trigger fundamental rights protection; Colpsic tribunals can suspend psychologists up to three years for confidentiality breaches
    • Mental health records are not legally segregated from general medical records despite Law 2015 (2020) establishing an interoperable EHR system; lack of standardized facility privacy measures (discrete entrances, soundproofing) across public and private providers
    • No documented medical tourism-specific mental health privacy protocols; Colombia's adequacy list for cross-border data transfers excludes most EU countries; cultural stigma persists despite legal protections, with reports indicating people with psychiatric diagnoses experience employment exclusion and public service discrimination

    Read the full Colombia report →

  6. 6 Spain ES 4.0/5 Good Spain provides strong mental health privacy protections through GDPR and LOPDGDD (which imposes stricter-than-baseline standards), with robust criminal deterrence (up to 7 years imprisonment for commercial disclosure)... Full report
    The evidence behind this score 6 cited points
    • GDPR Article 9 and Spain's LOPDGDD Organic Law 3/2018 classify mental health data as special category with consent-insufficient processing prohibition (stricter than GDPR baseline)
    • Penal Code Article 199 criminalizes unauthorized disclosure with 1-4 years imprisonment; 4-7 years for commercial disclosure of health data
    • AEPD imposed €40+ million in fines in 2025 with healthcare as second-most breach-affected sector; among Europe's top enforcement bodies
    • Premium private facilities (Sea Recovery, Bonaire Recovery, Oasis Premium Recovery) maintain undisclosed locations, NDAs, secure communications, and staff confidentiality training for international clients
    • GDPR cross-border restrictions prevent lawful transfer of psychiatric records to non-EU countries without explicit patient consent
    • Lack of dedicated national mental health privacy law; proposed legislation stalled in Congress with no formal psychiatric record segregation requirements

    Read the full Spain report →

  7. 7 Thailand TH 4.0/5 Good Thailand has comprehensive national legislation specifically protecting mental health information (Mental Health Act B.E. 2551 and PDPA classifying health as sensitive personal data) with meaningful penalties (THB 500... Full report
    The evidence behind this score 5 cited points
    • Mental Health Act B.E. 2551 (2008) with 2019 amendment explicitly protects patient confidentiality and regulates defamatory disclosure
    • Personal Data Protection Act B.E. 2562 (2019) classifies health data as sensitive personal data requiring explicit consent, with penalties of THB 500,000-5 million plus criminal penalties up to 1 year imprisonment
    • PDPC issued THB 21.5 million in administrative fines across 5 cases (2024-2025) and established 'PDPC Eagle Eye' complaint center with active enforcement approach
    • 62 JCI-accredited organizations in Thailand with privacy and data access control standards; major hospitals voluntarily adopted HIPAA-aligned practices for international patients
    • No specific anti-discrimination legislation protecting employment rights for individuals with mental health conditions; cultural stigma remains significant practical barrier despite legal protections

    Read the full Thailand report →

  8. 8 United States US 4.0/5 Good The United States maintains comprehensive mental health privacy legislation with HIPAA's enhanced psychotherapy note protections and 42 CFR Part 2's even stricter substance use disorder safeguards, combined with stron... Full report
    The evidence behind this score 5 cited points
    • HIPAA Privacy Rule provides enhanced protections for psychotherapy notes requiring patient authorization for disclosure; 42 CFR Part 2 provides even stricter protections for substance use disorder treatment records updated February 2024
    • All 50 states have mental health privacy statutes that can supersede federal standards when more protective; OCR enforces compliance with 31,000+ resolved cases and $144 million in total penalties
    • Criminal penalties reach $250,000 and 10 years imprisonment for violations involving malicious intent; multiple oversight bodies (OCR, DOJ, EEOC) provide accessible complaint mechanisms
    • Only 39% of medical tourism companies describe specific medical records security policies; HIPAA protections cease when records leave U.S. covered entities, creating cross-border data transfer vulnerability for international patients
    • 63% of mental health clinicians express low willingness to record confidential information in EHRs, and 83% prefer EHR systems limit routine access to psychiatric records, indicating implementation gaps despite legal requirements

    Read the full United States report →

  9. 9 India IN 3.5/5 Moderate India has established progressive, specialized mental health legislation (MHCA 2017) with explicit confidentiality rights and meaningful penalties, supported by constitutional protection of privacy and multiple oversi... Full report
    The evidence behind this score 5 cited points
    • Mental Healthcare Act 2017 Section 23 establishes explicit right to confidentiality with penalties of 6 months/10,000 rupees for first offense and 2 years/50,000+ rupees for subsequent violations
    • Government hospital psychiatric units operate as open wards with 6-20 bed halls where family members stay in shared accommodations, providing minimal individual privacy
    • State Mental Health Authorities not constituted in most states despite establishment in May 2018; Mental Health Review Boards lack sufficient judicial officers to function effectively
    • 75% of employees in India fear stigma and job loss when disclosing mental health issues; no Indian labor law requires accommodation for mental illness or provides relief from dismissal based on diagnosis
    • Specific mental health privacy protocols for medical tourists are underdeveloped; Aadhaar-health data linkage creates privacy risks in centralized biometric storage systems

    Read the full India report →

  10. 10 Poland PL 3.5/5 Moderate Poland has specific psychiatric secrecy legislation (Articles 50–52) and robust GDPR enforcement through UODO (€3.3M in fines in 2024), with multiple independent oversight bodies and accessible complaint mechanisms. H... Full report
    The evidence behind this score 5 cited points
    • Articles 50–52 of the 1994 Act on the Protection of Mental Health establish psychiatric secrecy binding all activity performers, broader than general medical confidentiality, but a 2024 Psychiatria Polska study concludes this is 'an institution of illusory nature' due to numerous statutory exceptions allowing data circulation without meaningful patient control
    • UODO imposed PLN 13.9 million (€3.3M) in fines across 22 cases in 2024 with healthcare a priority enforcement sector, and PLN 64M in 2025, demonstrating active GDPR enforcement; however, a 2022 ransomware breach of 30,000 patient records at a public hospital was fined only €9,300, illustrating limited deterrence
    • Mental health records are not segregated in the P1/IKP digital system; psychiatric data from public providers appears alongside routine medical information without enhanced access controls, creating visibility concerns for patients
    • Public psychiatric hospitals are characterized as underfunded and lacking basic physical privacy, while private providers offer better conditions; psychotherapy profession is largely unregulated, leaving confidentiality dependent on voluntary professional standards rather than enforceable law
    • Patient Rights Ombudsman handles nearly 100,000 notifications annually with 1,800+ violations confirmed in 2023, and UODO provides parallel GDPR complaint channel; however, enforcement is reactive (complaint-driven) rather than proactive via systematic mental health privacy audits

    Read the full Poland report →

  11. 11 Brazil BR 3.5/5 Moderate Brazil has a solid legal foundation with the LGPD classifying mental health data as sensitive personal data and Lei 10.216/2001 explicitly guaranteeing psychiatric confidentiality, supported by professional ethics cod... Full report
    The evidence behind this score 5 cited points
    • LGPD (Law 13.709/2018) classifies mental health data as sensitive personal data requiring patient consent for processing; Lei 10.216/2001 explicitly guarantees psychiatric patients' right to confidentiality
    • Mental health records are NOT legally segregated from general medical records in the RNDS national health system; role-based access controls not uniformly enforced
    • Public CAPS facilities documented to have inadequate physical privacy environments and informal information flows; private JCI-accredited hospitals operate to higher standards; no sector-wide discrete-entrance requirement
    • ANPD sanctions Ministry of Health (warning only) in 2024 for 2022 data breach notification failure; healthcare data enforcement is listed as a future priority not yet operationalized
    • Mental health stigma well-documented with cases of patients losing employment after treatment disclosure; enforcement of anti-discrimination laws is litigation-based rather than proactive; no mental-health-specific complaint portal

    Read the full Brazil report →

  12. 12 Turkey TR 3.5/5 Moderate Turkey's KVKK personal data protection law and e-Nabız electronic health system provide a robust general framework covering mental health as special category data with meaningful enforcement (4-5 year penalties). Medi... Full report
    The evidence behind this score 6 cited points
    • KVKK Law 6698 (2016) with 2024 amendments classifies health data as special category requiring enhanced protection with criminal penalties of 4-5 years imprisonment for unlawful recording
    • e-Nabız national personal health record system provides patient-controlled granular access authorization with secure e-government integration
    • Turkey lacks comprehensive mental health law despite decades of advocacy, with draft legislation remaining at proposal stage and not enacted
    • Cultural stigma toward mental illness in Turkish society is substantial and persistent, with inadequate legal protections against employment discrimination based on mental health conditions
    • Turkish Data Protection Authority enforces with administrative fines (TRY 68,083 to 13,620,402) and 72-hour breach notification requirements mirroring GDPR standards
    • International Health Tourism (IHT) certificate system explicitly protects international patient privacy rights with facility liability for breaches, covering over 750 hospitals including 40 JCI-accredited facilities

    Read the full Turkey report →

  13. 13 Israel IL 3.5/5 Moderate Israel's mental health privacy framework combines strong recent legal developments (Amendment 13's 2025 classification of mental health as 'Information of Special Sensitivity', mandatory ISO 27001/27799 security certi... Full report
    The evidence behind this score 5 cited points
    • Amendment 13 (effective August 2025) classifies mental health data as 'Information of Special Sensitivity' with mandatory Data Protection Officers for health institutions and penalties up to ILS 640,000 for violations
    • All MOH-licensed healthcare facilities required to hold ISO 27001/27799 certification since April 2022, with AES-256 encryption and RBAC access controls for psychiatric records
    • National psychiatric case register established since 1950 mandatorily records all psychiatric hospital admissions and shares data with Israeli Defence Forces, creating structural privacy concern for inpatient international patients
    • PPA 2024 supervisory audit of digital health sector found approximately 30% of entities only partially compliant with data protection requirements
    • Multiple accessible complaint mechanisms exist (ombudsman, State Comptroller, PPA, civil litigation), but 52% of Israelis report they would not hire someone with psychiatric diagnosis, indicating cultural stigma despite legal protections

    Read the full Israel report →

  14. 14 Japan JP 3.5/5 Moderate Japan's 2022 APPI amendments establish genuinely specialized mental health protections with explicit opt-in consent requirements, criminal penalties for physician breach, and mandatory breach notification—advancing be... Full report
    The evidence behind this score 5 cited points
    • APPI 2022 amendments classify mental health data as 'special care-required personal information' requiring explicit opt-in consent; organizations face fines up to ¥100 million for breaches
    • No legal mandate for segregation of mental health records from general medical records; 2017 policy direction pushes integration into comprehensive regional care systems with no enhanced access controls for psychiatric data
    • Criminal penalties under Penal Code Article 134 for physician confidentiality breach; PPC enforcement authority exists but with no substantial published history of enforcement actions specifically targeting mental health data misuse
    • Physical privacy measures inconsistent: Japanese hospitals lack discrete entrances for psychiatric patients, and fewer than one-third of ICU facilities have private rooms or partitions
    • Cultural stigma remains significant: approximately two-thirds of people with mental health conditions in Japan never seek professional help; Matsuzawa Hospital acknowledges Mental Health Act protections 'proved to be of little value' for foreign patients unable to communicate in Japanese

    Read the full Japan report →

  15. 15 South Korea KR 3.5/5 Moderate South Korea has an excellent legal framework for mental health privacy (PIPA, Medical Services Act, Mental Health and Welfare Act) with strict penalties and strong enforcement mechanisms through the PIPC. However, sig... Full report
    The evidence behind this score 5 cited points
    • PIPA is one of the strictest data compliance laws worldwide, classifying health information as sensitive requiring enhanced protections and special consent, with penalties up to 50 million won and 5 years imprisonment
    • PIPC became a central administrative agency with cabinet-level status (2020 amendment), with power to impose penalties up to 100 million won and imprisonment up to 10 years; courts can award punitive damages up to 5 times actual damages
    • Medical Services Act prohibits storing electronic medical records outside Korea and requires comprehensive EMR security including backup storage, network security, physical access prevention, real-time inspection, and CCTV surveillance
    • Despite legal protections, 88.7% of respondents believe mental health treatment records could hinder job prospects; discrimination persists due to lack of enforcement; many patients pay cash to avoid stigma on insurance records
    • Specific mental health privacy protocols for medical tourism patients are not extensively documented in available sources, creating uncertainty for international patients

    Read the full South Korea report →

  16. 16 Malaysia MY 3.0/5 Moderate Malaysia's mental health privacy framework rests on general medical privacy laws (PDPA 2010 with 2024 amendments) that cover mental health as sensitive personal data requiring explicit consent, but lacks comprehensive... Full report
    The evidence behind this score 7 cited points
    • PDPA does not apply to federal or state government agencies, meaning the majority of Malaysia's psychiatric hospitals (including Hospital Bahagia) fall outside statutory data protection
    • No standalone mental health privacy legislation or legal requirement to segregate psychiatric records from general medical records
    • No anti-discrimination law protecting individuals from employment or social discrimination based on mental health treatment history
    • 2024 PDPA amendments increased enforcement penalties to RM1 million and require Data Protection Officers for private data controllers
    • Cross-border data transfer rules enacted in 2025 require explicit written consent for transferring mental health data internationally
    • No facility-level mandates for discrete entrances, separate waiting areas, or soundproofed consultation rooms
    • Widespread cultural stigma documented in peer-reviewed research as a significant barrier to help-seeking

    Read the full Malaysia report →

  17. 17 Hungary HU 3.0/5 Moderate Hungary achieves a moderate standard in mental health privacy through strong technical safeguards (EESZT's default psychiatric-specialist-only access, GDPR compliance) and active enforcement by the NAIH. However, the ... Full report
    The evidence behind this score 5 cited points
    • Act XLVII of 1997 explicitly restricts psychiatric, addiction, and STD records to treating specialists, the strongest mental-health-specific legal protection in Hungarian law
    • EESZT enforces security level 5 with psychiatric records defaulting to treating-specialist-only access and patient-controlled consent tiers with full access logging
    • Hungary's mental health stigma is measurably higher than Germany, Portugal, and Ireland; 40-50% of Hungarian psychiatrists reluctant to seek treatment themselves or would not disclose to colleagues
    • No dedicated mental health act exists; only 12 articles in Act CLIV address psychiatry, described as widely criticized and insufficient
    • NAIH actively enforces (€20M maximum fines, growing caseload); no Hungary-specific cross-border data transfer protocol for medical tourists

    Read the full Hungary report →

  18. 18 Jordan JO 2.5/5 Moderate Jordan's mental health privacy framework is characterized by significant structural gaps despite recent legal development. While the Personal Data Protection Law No. 24 of 2023 classifies mental health data as sensiti... Full report
    The evidence behind this score 5 cited points
    • Hakeem EHR system has documented critical security vulnerability: psychiatric data 'openly accessed in most cases, even for non-psychiatrists' with no enforced record segregation or audit trails [Psychiatric electronic health records privacy in Jordan - PMC - 2020]
    • No dedicated mental health law exists despite 2023 National Center for Human Rights recommendation to enact one; psychiatric care governed only by Public Health Law No. 47 of 2008 with no specific confidentiality provisions [Freedom Denied - ARIJ - 2023; Psychiatry in Jordan - PMC - 2019]
    • Personal Data Protection Law No. 24 of 2023 classifies mental health as sensitive data with JOD 1,000–10,000 criminal penalties, but the Personal Data Protection Council and enforcement unit were not fully operational as of 2025 [Jordan issues first personal data protection law - Clyde & Co - 2023]
    • No specific mental health privacy protocols documented for Jordan's 250,000+ annual medical tourists; 10 JCI-accredited hospitals provide baseline standards but lack specialized psychiatric patient accommodations [Jordan Medical Tourism - MedicalTourism.com - 2024; Better by MTA Jordan - 2024]
    • Severe cultural stigma with only 305 per 100,000 Jordanians seeking mental health care; healthcare professionals exhibit significant stigmatizing attitudes; no legal protection against employment discrimination based on mental health treatment [Mental Health in Jordan - The Borgen Project - 2022; Social cognitive elements of mental illness stigma - PMC - 2023; Employee Rights in Jordan - Rivermate - 2024]

    Read the full Jordan report →

  19. 19 Mexico MX 2.0/5 Poor Mexico lacks specialized mental health privacy legislation, treating psychiatric information under general data protection laws without enhanced protections. The report documents severe practical failures including hu... Full report
    The evidence behind this score 5 cited points
    • Documented human rights violations in psychiatric institutions including total lack of privacy, physical and chemical restraints, physical and sexual abuse, and unhygienic conditions [Conditions of People with Mental Illness and Psychosocial Disabilities in Mexico - CeMeCA Regional Expert Series - 2017]
    • INAI dissolved March 21, 2025 and authority transferred to less specialized Ministry of Anti-Corruption, raising concerns about loss of specialized expertise and future enforcement [Data Protection Laws and Regulations Report 2025-2026 Mexico - ICLG - 2025]
    • No mental health-specific privacy legislation; psychiatric information receives same treatment as general medical records without enhanced protections [Mexico provides moderate mental health privacy protections through general legal framework]
    • Strong cultural stigma with healthcare personnel identified as second most important source of stigma after family members, and insufficient legal protections against employment discrimination [Mental Health Service Users' Perceptions of Stigma in Mexico - Community Mental Health Journal - PMC - May 2020]
    • Some facilities in Mexico do not maintain formal medical record privacy or security policies as standard practice, and HIPAA protections cease once records reach foreign providers [Medical Tourism - CDC Yellow Book - 2024]

    Read the full Mexico report →

See the full ranking, the 1–5 rubric and the reports →