Breaking down barriers to mental health care in Lebanon – Lebanon


Hiyam Al Hujairi wears sunglasses to hide her tears as she listens to her daughter Rawan, 18, share her experience of battling mental health issues. Rawan’s voice trembles as she recounts how she suffered at home due to troubled family relationships. She admits that she is still terrified of her father. Rawan describes how she became introverted, fearing any contact with people, and how the care she now receives has helped her cope with these fears.

“At first, I vehemently refused to seek mental health care,” Rawan says. “But as I became more and more frustrated and sad about the changing attitudes of people around me, which I felt was alienating me, I decided to ask for help.”

Like her daughter, Hiyam, a 50-year-old Lebanese mother who dedicated her life to her children, decided to seek mental health care when she realized how her marital issues were affecting her relationship with her children, as well. than their sanity.

“The only thing I regret now is delaying seeking mental health care. I tried to find solutions on my own, but I was clearly unable to do it, ”says Hiyam. “As a result, my desire to be alone increased, while my ability to tolerate my children and communicate well with them decreased. I was full of energy, but now I’m always tired, nervous and crying all the time.

The care Hiyam received was crucial to his relationships.

“I have changed a lot and I am so happy that such treatment is available here in Arsal,” says Hiyam. “I feel a lot more energetic and I’m no longer afraid to leave my comfort zone. Little by little, I regained my self-esteem.

In Lebanon, Médecins Sans Frontières (MSF) provides mental health services in southern Beirut, the Bekaa Valley and northern Lebanon. Our teams offer psychotherapies, drug therapies by public health doctors trained under the supervision of psychiatrists, and referrals of more complex cases after examination to other organizations.

The daily struggle

Every day in our clinics, our teams see how mental health has a significant impact on adults and children in Lebanon. We see people whose marital problems affect their relationships, their professional and social lives. We see refugees suffering in silence. We see people suffering from bullying and other social pressures. We see people who have fallen into deep depression from the loss of loved ones.

When it comes to mental health, you rarely hear the stories of men. Antar Daoud, a 50-year-old Syrian refugee living in Hermel, began his battle with mental health after falling into a coma following an accident. When he woke up, he had lost his memory and regularly had epileptic seizures and other health problems.

“I had epileptic seizures so severe that I even reached a state where I was not able to recognize my children,” says Antar. “I didn’t know what I was doing and I became a completely different person. My wife and kids just didn’t recognize me anymore.

“Six years ago, following one of my seizures, I unconsciously bit my little girl,” says Antar. “She’s still scared of me today. It is very painful and difficult to accept. The last thing you want as a parent is to hurt your children.

Besides his health problems, Antar is also under great pressure due to the difficult living conditions of the refugees and because he has lost the ability to work. Unemployment and the rapid deterioration of his family’s standard of living made him think about committing suicide.

“When I reached this point, I decided to ask for help for the sake of my family,” says Antar. “I can’t control the economic and social situation, but I can get help with my mental health. “

Mental health issues are unfortunately too often overlooked and left untreated … There is a common misconception that mental illness cannot be cured. However, the treatment is very effective.

Stigma, misconceptions and the economic crisis

The economic crisis in Lebanon is also affecting the health sector. If the state of health services is bad today, mental health services are even worse. There are many barriers to accessing mental health care. Since most mental health services in Lebanon are privatized, the most vulnerable communities, such as the poor and refugees, struggle to access treatment because they simply cannot afford it.

In addition, the shortage of experienced and qualified medical personnel in the public health sector has worsened due to the massive brain drain of medical personnel over the past two years. Many medical staff have left the troubled country for a better life abroad. Add to this the lack of funds available to ensure that mental health care falls under basic (and free) health services.

All of these barriers mean that access to mental health care is virtually impossible, especially for vulnerable communities and people living in remote areas.

“Mental health issues are unfortunately too often overlooked and left untreated,” says Rima Makki, MSF’s mental health program manager. “Along with all of the economic challenges facing mental health care in the country, comes the stigma associated with mental health, which makes people very reluctant to seek professional care. “

“There is a very common misconception that mental illness cannot be cured,” says Makki. “However, the treatment is very effective. People must also be treated in order to avoid other health consequences, such as chronic illnesses and an impact on their daily life in terms of performance, isolation and social relationships. “

Awareness, training and progress

Since 2017, MSF has supported the Lebanese Ministry of Public Health in the implementation of the “Mental Health Gap Program”, launched by the World Health Organization. The program aims to include mental health services in general health services as a direct recognition of the importance of mental health care and the right to access these services for all, without any discrimination on the basis of social status. or nationality.

Our teams participate by training nurses in public health centers in psychological support under the supervision of psychologists and doctors. The aim is to provide a rapid and integrated response to patients with mental health problems.

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