Read our blog 'Co-producing culturally responsive informed consent: what happens when communities and researchers coproduce consent approaches together' by GOAL researchers Emily Oliver, Sandy Char and Imad Abou Khalil.

 

The GOAL project has been busy hosting a number of training workshops for staff and partners. These include ones on: principles of co-production; gender and mental health research; mental health policy reform and law in Lebanon; and qualitative research methods. We will also be holding a workshop on health economics at the beginning of October.

Take a look at some ways in which LSHTM researchers are aiming to improve mental health in humanitarian settings. This short clip focusses on the aims of the GOAL, CHANGE and STRENGTHS projects.

As COVID-19 lockdown measures ease in Lebanon, mental health needs of displaced Syrians are on the rise

Around 1.5 million forcibly displaced Syrians currently reside in Lebanon, dispersed between Informal Tented Settlements or within communities across the country. The displaced Syrian population’s particularly vulnerable situation is characterized by general insecurity and poverty, discrimination, as well as the experience of forced displacement and the exposure to war and destruction in Syria. As a result, mental health needs are high among the displaced Syrians, and they face several barriers and challenges in accessing care for those needs. With the COVID-19 pandemic, these pre-existing determinants of mental health have been further exacerbated, including the barriers to access to mental health care, and are compounded by the mental health needs directly caused by the pandemic itself. These issues are explored further in this blog.

Prior to the COVID-19 pandemic, the specific mental health needs of displaced Syrians encompassed daily stressors of living in insecurity such as poverty, the inability to meet basic needs, stigma and discrimination, and protection concerns arising from their vulnerable status including exposure to violence and exploitation. In addition, the displaced Syrian population showed high prevalence of mental health disorders including depression, anxiety, and stress disorders that either resulted from the exposure to war and violence in Syria, or from the refugee situation itself, or from a combination of both.

The onset of the pandemic, which coincided with the rapidly deteriorating economic situation and currency devaluation in Lebanon, only exacerbated the pre-existing determinants of mental health among displaced Syrians. Insecurity about basic needs and employment, which are considered key causes of distress and poor mental health within the displaced Syrian population, were only aggravated by the lockdown measures and the worsening economic crisis. The resulting threat of food insecurity, the re-direction of aid and relief programs towards the COVID-19 response, and the inability to access healthcare services during lockdown, have also fueled insecurity and greatly aggravated previously-existing determinants of poor mental health.

In parallel to worsening socioeconomic difficulties, lockdown measures resulting from the pandemic response have undermined displaced Syrians’ access to mental health services. Pre-existing barriers to access such as means and cost of transportation were compounded by both social distancing measures and the financial crisis. Restrictions specifically targeting displaced Syrians have also undermined access to care, as municipalities imposed curfews and prohibited mobile health units from entering refugee settlements.

With mental health determinants critically affected by the consequences of the double burden of the COVID-19 pandemic and the rapid economic collapse in Lebanon, the mental health burden is increasingly heavier on the already-vulnerable displaced Syrian population. The response to these mental health needs is already underway: in many areas, NGOs providing mental health services as part of the Lebanese Ministry of Public Health’s Mental Health and Psychosocial Support (MHPSS) Taskforce are using teletherapy to remedy the gap in service provision resulting from lockdown measures. However, although remote phone-based teletherapy may help address previously existing barriers such as physical accessibility or transportation expenses, a re-adjustment of the current service provision model may be needed in order to fully address the gap in access that has been widened by the pandemic as well as the deteriorating socioeconomic conditions.

With the easing of lockdown measures, access to care is slowly improving, and an opportunity arises to apply lessons learned from using teletherapy services in preparation for any future quarantine measures. However, the mental health response must brace itself in order to address the rapidly rising mental health burden that is likely result from worsening living conditions caused by pandemic response measures and the deteriorating socioeconomic context.

Thurayya Zreik, National Mental Health Programme, Lebanon.

July 2020

GOAL PI, Bayard Roberts and Lebanon Lead, Rabih El Chammay have coauthored a paper on the national-level mental health responses to COVID-19 in Lebanon noting how COVID-19 represents a window of opportunity to help strengthen the mental health system in Lebanon.

The full article can be found here

On 24 and 25 February 2020 members from all the collaborating organisations came together to officially launch the GOAL project at a meeting hosted by St Joseph's University in Beirut. As well as being a chance for the team to get to know each other better,

this two day meeting provided an opportunity to further develop research plans and define outputs for this exciting three year project.

We are delighted to announce that the GOAL project has been awarded funding by the United Kingdom Research Initiative through the Global Challenges Research Fund / Economic and Social Research Council.