This paper sets out the OECD’s assessment of the provision of community-based mental health care in Lithuania. It provides an overview of the burden of mental ill health in Lithuania, highlights strengths and challenges of the mental health care system and care delivery, reports on the quality and outcomes of care, and sets out a number of preliminary recommendations for reform. There are four key findings. Firstly, the burden of mental ill-health in Lithuania is significant, and considerable stigma around mental ill-health persists. Secondly, while considerable efforts have been made to strengthen community-based care, resource and capacity constraints limit the type of care that can be delivered in the community. Thirdly, the mental health system remains hospital-centric, and there is a need to clarify care pathways. Finally, greater efforts are required to monitor and ensure the quality of care.