Only 5% of Lebanese children who screened positive had ever received care

In a nationally representative household survey of 1,517 Lebanese children and adolescents aged 5 to 17, 498 screened positive for a psychiatric disorder — and 25 of them, 5.0%, had ever received professional mental health care [s1].

That is the treatment gap stated as plainly as a number can state it: for every twenty young people in Lebanon whose screening indicated a probable disorder, nineteen had never been seen.

Where the number comes from

The figure is drawn from the Psychopathology in Children and Adolescents in Lebanon Study, which used a nationally representative household sample rather than a clinic sample [s1]. That design distinction matters more than it might appear. Studies recruited through clinics can only describe people who already reached a clinic; they are structurally incapable of measuring the people who never did. A household sample catches both.

Parents and adolescents completed self-report mental health questionnaires along with a demographic sheet, and the analysis examined which characteristics predicted help-seeking [s1].

Which children did reach services

Among those who screened positive, four factors were associated with having sought help after adjustment: male gender, receiving school accommodation, higher parent-reported hyperactivity, and higher parent-reported depression [s1].

Read together, that list describes a fairly specific filter. Hyperactivity is externalising — disruptive, visible, and difficult for a classroom to absorb. School accommodation implies an institution had already flagged the child. The male association is consistent with a long-standing pattern in child mental health referral, where boys' presentations are more often behavioural and more often escalated. The one internalising predictor in the list is depression, and it is parent-reported, meaning it had to be noticed by an adult before it counted.

The study reports these as correlates and does not claim a causal pathway. But the shape of the finding is that reaching services in this sample depended substantially on whether a child's distress inconvenienced someone else.

The barriers, ranked

For children who screened positive and had not sought help, parents were asked about five potential barriers: discomfort discussing mental health, stigmatisation, distrust in the effectiveness of mental health care, cost, and unavailability of nearby services [s1].

Cost was the most frequently endorsed major barrier at 22.3%, followed by unavailability of nearby services at 16.1% [s1].

The two structural barriers came out on top. That does not mean stigma is absent — the study measured it and it was among the endorsed options — but in this sample the barriers most often rated as major were the ones that money and geography, rather than attitude change, would address. The authors' own conclusion follows directly: they argue for incorporating mental health into public health policy and budget allocation across the Eastern Mediterranean Region [s1].

Why the framing matters for what gets funded

Anti-stigma campaigns are comparatively cheap, highly visible, and popular with funders. Building child and adolescent mental health capacity — training clinicians, staffing services outside major cities, subsidising care — is expensive and slow. A finding that the binding constraints in this sample were cost and availability is a finding about which of those two categories of intervention would move the number.

It is worth being careful about the strength of the claim. These are parent-endorsed barriers, self-reported, in a cross-sectional survey. People are generally more willing to name a financial obstacle than an attitudinal one, so the ranking may understate stigma relative to its true contribution. The study cannot rule that out.

The limits

This is a screening instrument, not a diagnostic assessment. "Screened positive for a psychiatric disorder" and "has a psychiatric disorder" are related but not identical, and screening instruments generally over-identify relative to clinical interview. The 5% figure is the proportion of screen-positive youth who received care, not the proportion of diagnosed youth.

The 25 young people who had received care is also a small absolute number, which limits how much can be said about what distinguished them.

And the study describes Lebanon at one point in time. The country's economic circumstances have shifted substantially in recent years in ways that would plausibly affect both the cost barrier and service availability; a cross-sectional survey cannot show whether the gap is widening or narrowing.

What to watch next

Whether comparable household-sample data emerges from other countries in the region. The Lebanese figure is striking on its own, but a treatment gap number only becomes actionable when it can be set against neighbours with different financing arrangements — which is the comparison that would show whether cost is the dominant barrier regionally or a Lebanon-specific one.

Sources

1. Youth mental health treatment gap in Lebanon: correlates of barriers to accessing child and adolescent mental health services (CAMHS) — Social Psychiatry and Psychiatric Epidemiology, 5 March 2026 (primary)