Background
The Lebanese setting
Rationale
Methods
Research design
Study setting
Study population, sampling and recruitment
Targeted participant group | Data collection modality | Beirut | Beqaa |
---|---|---|---|
Lebanese community | GMB workshops (N = 2) | 16 Total 9 Females 7 Males | 12 Total 9 Females 3 Males |
Semi structured interviews (N = 18) | 9 Total 5 Females 4 Males | 9 Total 6 Females 3 Males | |
Syrian Refugees | GMB workshops (N = 2) | 16 Total 10 Females 6 Males | 9 Total 2 Females 7 Males |
Semi structured interviews (N = 18) | 9 Total 5 Females 4 Males | 9 Total 5 Females 4 Males |
Semi-structured interviews: data collection and analysis
- Definitions of mental health and the causes contributing to mental health issues
- Society’s perception of those affected by mental health problems
- Help seeking behaviors and factors shaping these routes
- Perceptions of treatment-seeking from the health system and its barriers
Group model building: data collection and analysis
Reporting
Ethics
Results
Perceptions of mental Health problems
“In today’s society, if someone is struggling with mental health, people point fingers and say he is crazy.” A Lebanese man living in Beirut.
“They don’t view them positively. They would consider them crazy and as if they are less than human.” A Syrian woman residing in Beirut.
“There is no awareness. Some people think it’s because a person is not religious. They don’t take it like it’s a disease that needs treatment.” A Lebanese woman living in Beqaa.
“It used to be a taboo issue and an embarrassing one. Now, people deal with it and accept it.” A Syrian woman residing in Beirut.
Causes of mental Health issues (refer to Fig. 1)
Long term effects of exposure to war and violence (blue zone in Fig. 1)
“When someone dear dies, this could also lead to mental illness.” A Lebanese woman from Beirut.
“Yes, people developed fear. If something explodes, they get afraid. They have psychological issues.” A Syrian woman from Beqaa.
The political and social effects of war (Orange zone in Fig. 1)
“We are in a country where there is no stability. We don’t feel if our future is here or no. I have 2 kids; I always worry about whether I should leave this country or stay. Over 10 years, the situation has worsened. I never used to think of leaving the country, but now I feel that I have to if I want my kids to grow up in good conditions.” A Lebanese man from Beirut.
Socioeconomic constraints (Green zone in Fig. 1)
“If you go looking for a job, they barely pay you 200 or 250 ($). You work so hard, and you barely earn anything. You feel your efforts are in vain. All this affects how you feel. Yet, I hope we remain healthy and capable of working.” A Syrian man living in Beirut.
Gendered expectations driving onset of mental health issues (yellow zone in Fig. 1)
“There are many causes. I feel men worry more about financial matters, if he is unable to make his family happy. Men feel that money is the most important thing that they can offer to make their family happy. Mothers worry about taking care of their children, if they are not in a good mental state, if they have marital problems, or if they can’t meet their children’s demands. This causes stress. Children need to be well educated.” A Syrian woman living in Beirut.
“First, poverty can lead to a mental illness. When someone has no money and is unable to make ends meet or provide for his children, this greatly affects a person’s mental state. Just imagine not being able to secure the needs of your children, such as education, food, cloths. This has a major effect on parents’ mental state. This also affects children who would have nothing.” A Lebanese man living in Beqaa.
Health seeking behaviors and practices to maintain wellbeing (refer to Fig. 2)
Determinants of health seeking (green pathways of Fig. 2)
"I: What are the obstacles that stand in the way of people going to a therapist?“They would think that they’d seem crazy.” A Syrian man living in Beqaa.“Our society views you as crazy if you see a therapist. So, society stands in your way when you want to seek therapy even if it is the only thing that would help you”. A Syrian man living in Beirut.
Barriers to health seeking (variables highlighted in pink of Fig. 2)
“Some people get scared. They tell you they don’t want to go because their condition might worsen. They want to solve their problems alone. If society is not helping, he can go to the doctor, but he does not want anyone to intervene.” A Syrian woman living in Beqaa.
"Why wouldn’t some people accept that?“Some people don’t trust in therapy. They don’t think it is effective.” A Lebanese man living in Beqaa.
“Another factor is the area of residence, for example if I want to be treated by a good doctor but I live far from his clinic and I cannot always go to him. These are also minor obstacles.” A Lebanese woman living in Beqaa.“ Sometimes these services would not be available at a center nearby or if no one is supporting the person with a mental illness and encouraging him to get treatment.” A Lebanese man living in Beqaa.
“Sometimes it is expensive, so the cost stands in the way. Not everyone can afford it.” A Lebanese woman living in Beqaa.“Mostly Financial obstacles. Unless there is social security or insurance” A Lebanese man living in Beqaa.