Bridging the mental health gap in Chad: a call to action.

Mental health remains one of the most neglected areas of healthcare in Chad, despite a high and growing burden of psychological distress driven by conflict, forced displacement, poverty and climate-related stressors. Access to modern mental health services is virtually non-existent outside the capital, N'Djamena, and the country has no functioning mental health legislation or operational national strategy. Human resource shortages are severe, with only two psychiatrists and a handful of trained professionals for a population exceeding 18 million. Cultural stigma and reliance on traditional healing approaches, while deeply rooted and often adaptive, further shape help-seeking behaviours, frequently delaying or substituting formal care. This perspective article highlights the structural, legal and sociocultural barriers to mental healthcare in Chad and presents a phased, context-specific roadmap for reform. Recommendations are categorised into short-, medium- and long-term priorities, including task-sharing to primary healthcare workers, legal reforms to protect patient rights and decriminalise suicide attempts, decentralisation of services, inclusion of essential psychotropic medications in public supply chains, and engagement with traditional and community actors to combat stigma. Drawing on WHO guidance and regional best practices, this article underscores the urgent need for political leadership and sustained investment to institutionalise mental health as a national priority. Closing Chad's mental health gap is not only a public health imperative but also essential for social resilience, development and human rights.