Psychiatry in Lebanon
Authors: S M Yasir Arafat, Sheikh Shoib, Sujita Kumar Kar, Samer El Hayek
Journal: The Lancet Psychiatry (2020)

Lebanon has a population of approximately 6·8 million people. The country has also been accommodating around 250 000 refugees from Palestine since the 1950s and 1·5 million refugees from Syria since 2010. Despite the prevalence of psychiatric disorders at 17% and a treatment gap of 89·1%,1Karam EG Mneimneh ZN Karam AN et al.Prevalence and treatment of mental disorders in Lebanon: a national epidemiological survey.Lancet. 2006; 367: 1000-1006Summary Full Text Full Text PDF PubMed Scopus (231) Google Scholar Lebanon's mental health services remain underfunded and are usually limited to urban centres.2Khoury B El-Khoury J Ammar J Psychological needs and response during the COVID-19 pandemic in Lebanon.Psychol Trauma. 2020; 12: 497-498Crossref Scopus (9) Google Scholar Mental health care in Lebanon faces many challenges, some of which include the absence of a mental health act, high stigma surrounding mental health, restricted government funding, a low general health budget, elevated costs of mental health care with inadequate insurance coverage, few inpatient psychiatric units, and a shortage of mental health professionals including psychiatrists, psychiatry nurses, and social care workers. These challenges have been aggravated by the COVID-19 pandemic, a major explosion in the port of Beirut on Aug 4, 2020,3World VisionLebanon: Beirut explosion facts and how to help.https://www.worldvision.org/disaster-relief-news-stories/lebanon-beirut-explosion-facts-how-helpDate: 2020Date accessed: August 23, 2020Google Scholar and political unrest occurring in the country since October, 2019. To improve mental health care in a timely manner, the Lebanese Government and international organisations should focus on allocating appropriate funding for mental health services, treatment, and training for health-care workers; scaling up community services, promoting mental health through awareness campaigns, and providing appropriate psychological first aid. In 2020, the Ministry of Public Health in Lebanon, in association with WHO and UNICEF, started a comprehensive Mental Health and Psychosocial Support action plan4The National Mental Health ProgrammeNational action plan for the MHPSS response to COVID-19.https://www.moph.gov.lb/en/Pages/0/29465/action-plan-mentalhealth-covid19Date: 2020Date accessed: August 23, 2020Google Scholar to address the mental health issues caused by the COVID-19 pandemic. Additional problems caused by the Beirut explosion and political unrest highlight the compelling need for global organisations such as WHO, UNICEF, United Nations High Commissioner for Refugees, and the World Psychiatric Association to support the Middle East Psychological Association and local mental health institutions. This additional support would speed up the process of finding culturally appropriate, immediate, and effective measures to improve mental health care in Lebanon. Scientists, medical practitioners, and legislators need to formulate policies within the framework of existing mental health services to reduce the treatment gap and improve mental health of the Lebanese population. An immediate and dedicated crisis response team could be a primary initiative to deal with the current disastrous situation. We declare no competing interests. Characterising neuropsychiatric disorders in patients with COVID-19As a group of senior National Health Service critical care psychologists and consultants, we would like to respond to the Article by Aravinthan Varatharaj and colleagues1 published in The Lancet Psychiatry. We congratulate the authors on conducting the first UK study of neurological and psychiatric complications of COVID-19 in 153 patients. However, we are concerned about the interpretation of the data on altered mental status, found in 37 patients. The authors state that 21 of these patients had new psychiatric diagnoses, including ten with new-onset psychosis, six with a neurocognitive (dementia-like) syndrome, and four with an affective disorder. Full-Text PDF