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Determinants of treatment of mental disorders in Lebanon: barriers to treatment and changing patterns of service use

Published online by Cambridge University Press:  13 August 2018

E. G. Karam ,
G. E. Karam ,
C. Farhat ,
L. Itani ,
J. Fayyad ,
A. N. Karam ,
Z. Mneimneh ,
R. Kessler  and
G. Thornicroft
E. G. Karam*
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon Department of Psychiatry and Clinical Psychology, Balamand University Faculty of Medicine, Beirut, Lebanon Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
G. E. Karam
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon Department of Psychiatry and Clinical Psychology, Balamand University Faculty of Medicine, Beirut, Lebanon Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
C. Farhat
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
L. Itani
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
J. Fayyad
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon Department of Psychiatry and Clinical Psychology, Balamand University Faculty of Medicine, Beirut, Lebanon Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
A. N. Karam
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon Department of Psychiatry and Clinical Psychology, Balamand University Faculty of Medicine, Beirut, Lebanon Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
Z. Mneimneh
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon Michigan Program in Survey Methodology, Survey Research Center, University of Michigan, Ann Arbor, Michigan, USA
R. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
G. Thornicroft
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College, HSPR, London, UK
*
Author for correspondence: Elie G. Karam, E-mail: [email protected]
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Abstract

Aims

To investigate for the first time the determinants and barriers of seeking help for mental disorders in the Arab world based on a national study: Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation (L.E.B.A.N.O.N).

Methods

A nationally representative (n = 2857) and multistage clustered area probability household sample of adults ≥18 years and older was assessed for lifetime and 12 months mental disorders using the Composite International Diagnostic Interview. In addition, detailed information was obtained on help- seeking behaviour and barriers to treatment.

Results

In total, 19.7% of the Lebanese with mental disorders sought any type of treatment: 91% of those who sought treatment did so within the health sector. Severity and perceived severity of disorders predicted seeking help, the highest being for panic disorder. The greatest barrier to seek help was low perceived need for treatment (73.9%). Stigma was reported to be a factor only in 5.9% of those who thought about seeking treatment. Eighty per cent of the Lebanese reported they would not be embarrassed if friends knew they were seeking help from a professional.

Conclusions

A small fraction of Lebanese seek help for their mental health problems: female gender, higher education and income are predictors of positive attitudes to help seeking. Severity and recognition of disorders, more than stigma, to get treatment seem to be the most important factors in determining help seeking. The findings underscore the importance of helping the public recognise mental health disorders.

Keywords

Barriersmental disorderspublic healthstigmatreatment
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 6 , December 2019 , pp. 655 - 661
Copyright
Copyright © Cambridge University Press 2018 

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