I think you are confusing several things here.
The 1500' is in respect of airfield elevation, not amsl. Hence this can be quite limiting in itself at high elevation airfields.
With no obstacles present, at for example EGLL, london Heathrow,, elevation about 80' amsl my company go straight ahead, tell ATC when we have time to do so, use a standard acceleration cleanup of 1580' qnh, clean up as required, and expect to turn towards an appropiate holding point and climb to 2300' qnh which is the local area msa. We don't expect any performance issues or need to go so far frfom the field we're in danger of hitting any fixed obstacles.
Have a look at north west departures from somewhere like geneva. These SIDS have minimum gradients and minimum altitudes to be attained at specific waypoints before you can continue, otherwise you have to tell ATC and climb in a holding pattern. If you follow the routing and the profile then you should keep out of trouble.
Other places have an engine out procedure which requires you to keep the speed back, V2+10, turn the aeroplane away from the obstacle and point it towards a clearer area to climb to acceleration altitude before it's safe to accelerate. Loads of examples, but runway 04R at Nice (LFMN?) is one that springs to mind, although I've not been there for a while. Good fun and spectular enough on 2 engines, the thought of struggling on one toward the mountains would concentrate the mind wonderfully. Addis Abbaba, Bole International on 25L can combine high elevation, high temperatures, huge difference between indicated and true airspeeds, with a dirty great hill (baby mountain?) at the far end.
Places like this it's important to have a very good idea of what you intend to do if it goes all exciting at an innopportune moment, and understand why the procedure is laid down as it is.
Hope this helps.