BEIRUT: The head of the U.N. refugee agency in Lebanon has advocated for greater access to mental health care within the country’s primary health care services, saying that such measures would not discourage refugees from returning to Syria.
Speaking at a roundtable held Friday on the subject of mental health, Mireille Girard dismissed the notion that access to health care is keeping refugees in Lebanon.
“Health care is not an incentive either for refugees to remain in Lebanon or for them to return earlier to their country. Other considerations prevail for such decisions.”
At the discussion, organized by the Institute for Development, Research, Advocacy and Applied Care, an NGO dedicated to mental health in Lebanon, Girard noted that health care in Syria is subsidized. “So why would people not be attracted to go back? It’s cheaper there and they don’t have a rent to pay.”
The official told The Daily Star after the discussion that improved and more affordable access to mental health care for both Syrian refugees and the local Lebanese population could be achieved by integrating mental health care services into the country’s wide network of primary health care centers.
Girard said specialist mental health care centers can be difficult to locate and access, and carry a degree of stigma. “When people go to the primary health care centers, there’s no stigmatization,” she said. “These primary health care centers are subsidized, [and] they will be more available to people, closer to their homes and therefore [there is] more chance that people will access them.”
Girard also advocated for greater support for mental health issues within communities. “A number of mental health issues you can address at a community level. When it gets to acute issues, you need to consult a specialist,” she said. “If you can prevent or tackle it from the beginning before it escalates and deteriorates, then you save a lot of health costs.”
Richard Mollica, director of the Harvard Program in Refugee Trauma, echoed this belief, stressing that the majority of mental health issues could be treated on a community level with initiatives raising awareness around health care and general well-being. “When you look at the majority of the population, 60 to 70 percent of the population doesn’t need counseling,” he told The Daily Star. “You’ve got a small percentage of people with moderate mental health problems that need counseling.”
Girard addressed other push-and-pull factors for Syrian refugees considering returning home. She said 88 percent of Syrian refugees residing in Lebanon want to return to their homeland, but suggested that the main reasons preventing this were issues such as security concerns and have nothing to do with the question of political settlement in Syria.
The need to rebuild homes is also not preventing returns, although the ownership question could be, she said. “They are asking: Will I have to fight if I go back? Do I recuperate my home? Is my house still my house? Will I be punished for being a refugee? Will I recover my documents?” Girard said. “These are exactly the things that we are working on with the authorities in Syria.”
Girard said three-quarters of the Syrian refugee population in Lebanon lives under the poverty line ($4 per day), and more than a half of the refugee population is living under the extreme poverty line of less than $3 dollars per day statistics seemingly taken from the UNHCR’s 2017 Vulnerability Assessment of Syrian Refugees report.
“However, they still have hope in the future, and 88 percent of the Syrian refugees want to go back home. Our role is to try to make this intent possible,” she said.
According to Girard, refugees in Lebanon pay an average of $200 per month for rent. “If a Syrian refugee is lucky to work, he would work two weeks a month [and] earn around $170 a month, which is not even enough for the rent.”