Lebanon: A Veritable Lifeline

Since 2014, people suffering from emotional or mental distress have had recourse to 1564, an emergency phone number, known as the "lifeline," where four trained operators answer calls for emotional support and suicide prevention some 21 hours a day. About 140 volunteer operators work on a rotating basis.

Fatima has been working here for over two years. At 24 years old, she is a psychiatric nurse: "I've always been passionate about mental health. But I always wondered how I could help. And when a friend told me about Embrace, I didn't hesitate."
But what do you say on the phone to someone who is at the end of their tether? "Most people don't talk to us to get us to tell them something," said Fatima. “They talk because they are about to explode and they need to be listened to. We need to listen and think about their situation and emotions, give them time and space to express themselves without judging them. And if necessary, we explore with them the possibility of referring them to a mental health specialist. We also have a team that can go into the field. We can hospitalize them if necessary. ”

Years of political and economic instability came to a head with the twin explosions that rocked Beirut on August 4, 2020. The crisis caused a new category to be added, for people whose situation no longer allows them to face daily difficulties.

“Most of them tell us they need medication but can't find it, or they can’t afford therapy,” explained Fatima. “There are also people who call us because they can't feed themselves anymore.” As a result of the crisis, the number of calls has risen from 6,000 for all of last year, to 7,500 for the 10 months ending in October 2021. The lifeline has withstood the pressure and made a difference: 1564’s operators have reported no suicides since its creation. "The Lebanese need to be embraced now more than ever," said Fatima.

Yara Chamoun, a psychiatrist, has been working for a year at a mental health clinic, created thanks to support from Embrace. Here, free care is provided by a multidisciplinary team that includes psychiatrists, psychologists, nurses and social workers. Plans for the clinic were already in place, but the Beirut disaster accelerated everything. 

“The founder of Embrace called us the day after the explosion to come and work some volunteer hours," recalled Yara Chamoun. We didn't have anything here yet, just two chairs and that was it. In less than two months, this clinic was up and running. ”

While the clinic was created to meet the immediate needs after the explosion, Yara's team saw that the Lebanese people were in deep trouble due to the multiple crises affecting the country: "There is a collective trauma that results in anxiety, insomnia, depression, substance abuse and alcoholism. All of this is to cope with or escape reality. ”

After a year of care, Yara Chamoun drew her first conclusions: "What has changed is the willingness of the Lebanese to come to us for counseling. People are less hesitant. Before, it was a taboo. The collective aspect of trauma means that as a whole, people are more willing to accept the idea that they are experiencing mental distress. ”

QUESTION & ANSWER SESSION WITH YARA CHAMOUN: 

The multi-faceted crisis, medicinal shortages and a wide range of difficulties forces the Embrace team to be highly flexible and able to improvise.

What do you prescribe to patients when most medications are out of stock?

"We ask the patient if they have family or friends overseas who could potentially send them the medication. ”

What about power outages?

"I had to see a patient in the dark. We had to use our cell phones for light. At one point we were forced to close the clinic because there was no electricity, until we received a donation to get our own generator. Sometimes the slots had to be reduced to 20 minutes to accommodate all the patients for the day during the hours when electricity was available. ”

How do you provide for the financial needs of patients, since insurance does not cover mental health care?

"It costs a lot of money and few people can afford it, not even the wealthy who no longer have access to their money in the bank. When someone needs to be hospitalized immediately, we cover the hospitalization costs. ”

In one year, Embrace has saved more than 20 people who were planning on committing suicide, while covering their hospitalization costs. 

“When we tell them not to worry about it and we cover their medication costs, hospitalization costs, and see how it relieves them... It's a wonderful feeling. ”