Itapira, Brazil

With a population of just 56,586, Itapira is a sleepy backwater known as the "City of the Mad" - home to three major psychiatric hospitals, including one of the largest in the Americas. While the town has a quaint historical legacy, including the construction of a grand church by a wealthy coffee baron, the bureaucratic headaches of navigating its mental health industry would be a persistent challenge for most expats. And with the economy still dependent on declining agricultural sectors like coffee and sugar cane, Itapira offers little in the way of dynamic career opportunities. This is a place for those seeking a quiet, pastoral existence - but anyone looking to thrive in a modern, cosmopolitan environment should look elsewhere.