The European Study of the Epidemiology of Mental Disorders (ESEMeD) project is the first cross-national European survey to collect data on prevalence, risk factors, health-related quality of life and use of services associated with common mental disorders. Representative samples of the non-institutionalized populations of Belgium, France, Germany, Italy, the Netherlands and Spain were interviewed using the CIDI 3.0, totaling 21,425 adult individuals. There was important variation across countries in prevalence estimates of the disorders studied, with Belgium and France in the highest proportions and Italy and Spain the lowest. Comorbidity of mood and anxiety disorders was frequent in all countries. Use of services due to mental health is low in all European countries, but especially low in Italy. Remarkably, only about one in five participants with a mental disorder had consulted the health services in the prior year. We discuss about the possible explanations of cross-national differences in prevalence estimates of mental disorders, and some of the limitations of the data on alcohol abuse and dependence gathered in the study. We conclude that despite the advances in knowledge about determinants and treatment methods, the care of the mentally ill is rather limited in Europe.