Commentary

The mental health situation in Lebanon

Children wear face masks as they head to school in Sidon, Nov. 30, 2020. (The Daily Star/Mohammed Zaatari)

Given the array of crises Lebanon is facing today, it is vital to highlight its effect on the mental health of the Lebanese people and children, considering the social and emotional impact it can leave on their coping abilities and their everyday life. Studies show that political mistrust, insecurity, fear of losing a job, fear of the COVID-19 pandemic and the policies to control it are all sources of anxiety and stress.

In Lebanon, the situation is dire. Over 50% of the population is now living below the poverty line, as per the United Nations Economic and Social Commission for West Asia. The high rates of inflation, currency devaluation, salaries reductions and layoffs have led to a big decline in income and in the purchasing power. Alongside, the World Bank reported that unemployment has risen to nearly 40% late last year from 28% in February 2020. According to the United Nations Children’s Fund (UNICEF), 1.6 million people of which 541,000 children are confronting multiple deprivations. With the rapid increase in price of food by 300% in one year, people have reduced their food consumption, increasing the rate of malnutrition among kids. People, especially the disabled and the most vulnerable are at risk of lacking access to basic needs such as water, sanitation, health care and education. The World Bank’s Lebanon Economic Monitor says Lebanon’s financial and economic crisis could be considered as one of the world’s three most severe since the 19th century.

The COVID-19 pandemic has worsened the situation. In fact, in addition to increasing the mortality rate, the pandemic and the policies to contain it seem to impact the global mental health. A recent systematic review of the impact of COVID-19 pandemic on mental health, published in the journal of Affective Disorders, shows relatively high rates of anxiety (6.33% to 50.9%), depression (14.6% to 48.3%), post-traumatic stress disorder (7% to 53.8%) and stress (8.1% to 81.9%) during the pandemic. Factors related to such increase can be fear of infection or mortality, job insecurity due to lockdown measures and decreased political trust due to perceived inefficacy in controlling the pandemic.

For younger generations, studies have revealed that other than the fear of the virus, the sudden shift to online learning platforms have produced anxiety and depression symptoms among children due to the stressful load of work required. In Lebanon, students additionally struggle from the recurrent online interruptions due to weak internet connections and continuous electricity cuts, but statistics remains less known on the impact on their mental health.

Then comes the massive explosion that shook Beirut’s Port on Aug. 4, 2020. With more than 200 individuals killed, 6,500 injured, 47,000 apartments damaged, and at least 163 public and private schools serving 85,000 students, the blast has heightened the current vulnerabilities and yielded psychological trauma. It has marked mental wounds even for those physically uninjured. “There is a low mood bordering on clinical depression for the majority of the population” said the psychologist Mia Atwi, president of EMBRACE, an organization working on mental health awareness and support, in an interview with Associated Press on Feb. 1, 2021. According to their latest report issue No.9 on “Post Beirut’s Blast Update”, Embrace reported that two months after the explosion, their national hotline for emotional support and suicide prevention got more than 2,239 calls, 67% of which were from callers expressing emotional distress and 28% presenting suicidal tendencies.

Zooming into the children’s status, the UNICEF reported that around 1,000 children were injured and 100,000 saw their homes damaged or destroyed. These children who were traumatized at many levels, from witnessing the horror of the moment, to possible loss of members of family, to injury, to their home or school’s destruction to the drastic change in their social and living conditions, have endured distressing psychological responses, which might have an impact on their mental health at the short- and long-term levels. They have faced an exceptional reality that is affecting their social stability and their personal development. Some have developed symptoms of post-traumatic stress disorder, such as fear of loud voices (like thunder), nightmares, flashbacks, involuntary urination and social isolation symptoms among young. Prolonged distress has also ignited aggressive behavior in some of them.

Although not all kids dispose significant mental problems, and many show resilience, they generally are considered among the people who are often at high risk of distress. Some have even got professional support after the explosion, and many more are still enduring direct and long-term psychological and social suffering.

People in Lebanon, nationals and refugees, adults and children, are living in prolonged stress that may have a deleterious effect on their emotional, social and functional status. Providing adequate mental health support should be a priority in parallel with their physical health. Although interests in increasing the mental health and psychosocial support services have risen among local and international organizations and government facilities, following the explosion, mental health services are still in their development phases in Lebanon and are majorly run by civil society organizations like EMBRACE and IDRAAC. Priority now should be tailored to make psychosocial support services more accessible with a more consolidated sustainable approach to the mental health sector in Lebanon.

Dima El Hassan is a consultant at the Hariri Foundation for Human Development.

 

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