Half of the world’s population lives in countries with one psychiatrist to serve 200,000 people and in low and middle income countries (LAMICs), even most people with severe mental disorders remain untreated. As curative care is prioritized, public mental health is inundated with deep-seated problems, primarily due to the lack of funding. From an ethical perspective, such underlying issues in public mental health exist regardless of income levels; they are, however, further exacerbated by the lack of resources and awareness in LAMICs. Ironically, the ethics of public mental health have received much less attention than that of psychiatric research. We therefore use a public health ethics framework to broaden the ethical perspective in public mental health and examine it from a low-resource setting viewpoint. Next, we examine public mental health from a social justice perspective. Third, we examine issues critical to ensuring better access to mental health services in LAMICs.