Providing specialized mental health services and community-based psychosocial support to 800 vulnerable Lebanese, migrants and refugees in Beirut, Mount Lebanon, North Lebanon and Akkar governorates. In emergencies, people are affected in different ways and require different kinds of supports. A key to organizing Mental Health and Psychosocial Support (MHPSS) is to develop a layered system of complementary supports that meets the needs of different groups. This is illustrated by the Inter-Agency Standing Committee (IASC) MHPSS Intervention pyramid for mental health and psychosocial support which entails four main layers of interventions: 1) Basic services and security, 2) Community and family supports, 3) Focused non-specialized support, and 4) Specialized services. All layers of the pyramid are important and should ideally be implemented concurrently. 

The top layer of the pyramid (Layer 4) represents the additional support required for the small percentage of the population whose suffering, despite the supports provided under Layers two and three, is intolerable and who may have significant difficulties in basic daily functioning. This assistance should include psychological or psychiatric supports for people with severe mental disorders whenever their needs exceed the capacities of existing primary/general health services. Although specialized services are needed only for a small percentage of the population, in most large emergencies this group amounts to thousands of individuals. 

The third layer (i.e., Focused non-specialized support) represents the supports necessary for the still smaller number of people who additionally require more focused individual, family or group interventions by trained and supervised workers. 

In particular, according to the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings, the percentage of people with a severe mental disorder (e.g., psychosis and severely disabling presentations of mood and anxiety disorders) increases by one per cent over and above an estimated baseline of 2–3 per cent. In addition, the percentage of people with mild or moderate mental disorders, including most presentations of mood and anxiety disorders (such as post-traumatic stress disorder, or PTSD), may increase by 5–10 per cent above an estimated baseline of 10 per cent.

The 12-months’ proposed project will address the third and fourth (top) layers of the IASC MHPSS pyramid of interventions. In particular, this project will support and contribute to improving the mental health of 600 vulnerable Lebanese, migrants and refugees with moderate and severe mental disorders (including persons with disabilities) through specialized mental health services in the most disadvantageous areas in Beirut, Mount Lebanon, North Lebanon and Akkar governorates, where specialized mental health services are not available through the MoPH Primary Healthcare Centers network. This target group is considered as high risk (complex severe cases with comorbidities) and is not supported by any other agency in the targeted regions. Likewise, the project was designed to allow for the provision of specialized mental health services to children with disabilities (i.e., speech therapy, psychomotor therapy, special education) that are not available at the level of PHCCs or community mental health centers. 

Furthermore, this project will support 200 people with significant distress among the Lebanese, refugee and migrant populations through non-specialized community-based psychosocial support. 

Under both components, priority will be given to hard-to-reach vulnerable populations, including families with children (children at risk of child labor, children with disabilities, children with protection risk) female Headed households and caregivers for children under 24 months pregnant and lactating women PWSNs and elderlies. 

The proposed project will be implemented by Restart Center (RESTART) as main applicant and First Step Together Association (FISTA) as sub-implementing partner. FISTA will be particularly supporting persons with disabilities in North Lebanon.