EAP & Mental Health Services in Lebanon and Jordan: Status Report
KEY POINTS
In Lebanon and Jordan, stigma and limited access to care make mental health support difficult to reach.
Employee Assistance Programs (EAPs) provide confidential, culturally sensitive counseling and early intervention.
In recent years, there has been an increase in awareness of the value of mental health services and employee assistance in the workplace, in the Middle East region generally. However, it is critical to examine the state of employee assistance programs and mental health services in countries like Jordan and Lebanon where getting access to mental health treatments might be challenging. The main obstacles to effective mental health services in Lebanon and Jordan are stigma and a lack of access to mental health facilities and to qualified clinicians who can offer solutions that respect and integrate patients' cultural norms. In addition to many other obstacles that will be discussed in this article, such as lack of resources allocated to meet the high needs for mental health support. In this article, we will explore the benefits of Employee Assistance Programs (EAPs) as a solution to bridging the gap in mental health services in Lebanon and Jordan. We will also delve into the challenges faced and the key considerations for implementing EAPs in these countries.
Mental health burden in Lebanon and Jordan
Lebanon and Jordan are countries that have experienced significant challenges due to limited natural resources and recent crises. Lebanon's economy severely collapsed in 2020, according to the World Bank, the economic crisis in Lebanon is listed to be as one of the three worst worldwide since the middle of the nineteenth century. In addition, COVID19 pandemic pressures and a massive refugee crisis since the Syrian war started in 2011. All of these were exacerbated by the Beirut explosion on August 4, which was discovered by the United States Geological Survey that it has a seismic event of magnitude 3.3 and is considered one of the most powerful artificial non-nuclear explosions. Even though Lebanese people have been used to dealing with continuous crisis and ongoing civil unrest followed the end of civil war in 1991, nerveless, the recent events has added to the burden of mental disorders in Lebanon. As an overview to the mental health burden in Lebanon, according to the most recent prevalence research in Lebanon, which dates to 2006, roughly one in every four people in Lebanon suffers from at least one mental disorder at some point in their lives, with anxiety and depression being the most common. The suicide mortality rate in Lebanon is predicted to be 2.8 per 100,000 people (as of 2019). In Lebanon, one person commits suicide every 2.1 days, and one person attempts suicide every 6 hours. However, due to underreporting caused by an inadequate surveillance system, these data do not represent the true number of suicide cases due to stigma.
Jordan on the other hand is one of the safest and most stable countries in the Middle east region. However, the country has its own set of different serious challenges that have had a profound impact on the mental well-being of its populations. Jordan is considered one of the countries most affected by environmental changes, especially those caused by the climate crisis and the resulting in drought, desertification and loss of arable lands, the large influx of multiple refugee population form neighbouring countries has impacted the country economy and depleted its limited resources, and all of this has exacerbated by the covid-19 pandemic and its impact on the local population economic status and wellbeing. It is estimated that following the Covid 19 lockdown, the national GDP is estimated to have fallen by 23 percent, employment losses to over 20 percent which increased the burden of mental health issues, level of stress and inability for people to afford basic services including mental health support. According to the World Health Organization (WHO), Jordan’s mental health system requires considerable reorganization, with more than 25% of Jordanians experiencing mental health symptoms. According to the World Health Organization (WHO), only 305 Jordanians out of 100,000 seek care for mental health concerns, a problem that must be addressed.
Mental Health Services challenges in Lebanon and Jordan
Despite the burden of mental health impact in both countries, several factors contribute to the challenges in accessing mental health services in Lebanon and Jordan. First and foremost is the stigmasurrounding mental health. Many individuals in these countries hesitate to seek help due to fear of being judged or marginalized. This stigma hinders progress in addressing mental health issues and perpetuates the existing gap in services. The most significant barriers to mental health care in both Lebanon and Jordan are a lack of mental health literacy and persisting stigma. Poor mental health knowledge and poor attitudes toward persons suffering from mental illness significantly restrict help-seeking behaviour. Negative interactions with healthcare providers and mental health services can also be a deterrent to continuing treatment. Moreover, the fear of harm or criminalization for people suffering from addiction, suicide, or minorities such as LGBTIQ people in need of mental health care. In April 2022, Jordan criminalised suicide, threatening prison time and fines for those who attempt self-harm in public. While in Lebanon, drug consumption is criminalized and persons who suffers from drug addiction are detained with the convictions of drug abuse leading them to be the victim additional social stigma.
Both Lebanon and Jordan have low tolerance to the LGBTI community which make it very difficult for those form the community to access support safely and with dignity.
Additionally, access to service and the geographical distribution of mental health facilitiesand professionals is uneven, with urban areas having more resources compared to rural areas. This disparity in access further exacerbates the challenge of reaching individuals in need.
In Lebanon, the many compounded crises have had a significant negative impact on the country's healthcare sector. The healthcare sector has suffered because of the currency devaluation in 2020. Due to the government's inability to pay private and public hospitals the money it owes them and the ensuing inability to pay personnel and buy necessary equipment, hospitals have been straining to provide service users with lifesaving surgery and urgent medical care. Furthermore, due to currency restrictions, basic and lifesaving pharmaceuticals have been in short supply, severely limiting the importation of necessary medication and medical items. Given the substantial inflation and currency depreciation in Lebanon, the cost of medical services including mental health and pharmaceuticals has risen significantly.
In Jordan, the country mental health public service is based on psychiatric services mainly in few hospitals, however it is limited in capacity and quality of service. Public mental health services are not available in more remote sites and in less populated governates which leads to making access challenging for those not residing in big cities. Based on the latest statistics of the ministry of public health in Jordan, there are only a few mental health institutions. Jordan has just three adult mental health hospitals, one specialist psychiatric hospital for children, and 64 outpatient facilities. In Jordan, there are just two psychiatrists, 0.27 psychologists, and 0.04 nurses for every 100,000 people.
In addition to the challenges related to accessibility of mental health services in Lebanon and Jordan. There is a shortage of qualified mental health professionals, and the existing services often lack the capacity to meet the growing demand, leaving many individuals without the support they desperately need. In Lebanon, the World Health Organization (WHO) reports that about 40% of qualified medical professionals and 30% of registered nurses have already left the nation, either permanently or temporarily. The flight of human capital will not only restrict society’s access to the services offered by these professions, but it will also increase the economy’s downfall and hinder its recovery.
Actions taken towards mitigating challenges presented in the mental health sector in Lebanon and Jordan
Despite the tremendous burden of mental illnesses in both countries, Lebanon and Jordan lack a comprehensive mental health policies and poorly financed mental health services. Moreover, the COVID-19 pandemic has further highlighted the need for prioritizing mental health. Which played an important factor leading both ministries of public health in Lebanon and Jordan to increase collaboration and efforts with the World health organization (WHO) and create The National Mental health strategy for Lebanon (2023-2030) and The National Mental Health and Substance Use Action plan (2022-2026) for Jordan. Both National plans focus on different major points, such as:
- Updating the national health policy to be in line with international standards and human rights instruments.
- Strengthening the role of the existing bodies and the ministry of public health in leading the response to mental health crisis.
- Enhancing the management of mental health and psychosocial human resources to meet with the needs.
Therefore, both Lebanon and Jordan allocated more funding into the public mental health sector, using support in collaborate projects with local and international nongovernmental organization (NGOs). Both countries are putting significant effort into eliminating stigma about mental health and create clear policies in different layers of the health and educational system. More effort is being put into public and private education institutions to support majors related to mental health, making it more attractive to increase the number of specialised well-trained counsellors to respond to the high demand. In addition to that, the licencing process of mental health providers has been established in both Lebanon and Jordan, it is being supervised by both ministries of public health, the Lebanese Psychology Association for Lebanese psychologists, and the Jordanian Psychological Association to ensure a standardized form of service provided with easy access and no harm.
Employee Assistance Programs in Lebanon and Jordan
Employee Assistance Programs (EAPs) have emerged as a promising solution to bridge the gap in mental health services in Lebanon and Jordan. These programs offer free and confidential counseling, crisis intervention, and referral services to employees and their families. Following the Beirut explosion in August 2020, CCSprovided support to a good number of Lebanese located in Lebanon and in other countries which they have found great benefit to help with their mental health issues while the public and private health sector was overwhelmed with the response to crisis. CCS has also been serving good number of Jordanian through the EAP supplying high level of professional Arabic speaking counsellors responding Arabic speaking hotline. EAPs in Lebanon and Jordan has been serving as a valuable resource for individuals who are hesitant to seek help outside of the workplace due to stigma. By integrating mental health support within the workplace, EAPs reduce barriers and make it easier for employees to access the care they need. Moreover, EAPs provide a holistic approach to employee well-being, addressing both personal and work-related challenges that may contribute to mental health issues.
Bridging the Gap: Enhancing Mental Health Services through Employee Assistance Programs in Lebanon and Jordan
Mental health services play a crucial role in supporting the well-being of individuals and
communities. In countries like Lebanon and Jordan, where limited natural resources and recent crises have posed significant challenges, the need for effective mental health services is more pressing than ever. Employee Assistance Programs bridge the gap in mental health services in Lebanon and Jordan by providing accessible and confidential support to employees. Through EAPs, individuals can access professional counseling services without the fear of stigma or financial burden. EAPs also offer flexibility in terms of scheduling appointments, making it easier for employees to seek help without disrupting their work responsibilities.
Moreover, EAPs promote early intervention and prevention by offering proactive services such as stress management workshops, mental health awareness campaigns, and resilience training. These initiatives help individuals build coping skills and resilience, reducing the likelihood of developing more severe mental health issues.
Key considerations for implementing EAPs in Lebanon and Jordan
While implementing Employee Assistance Programs in Lebanon and Jordan, there are several key considerations to keep in mind:
Cultural Sensitivity:In a multicultural region, tailoring EAP to be culturally sensitive and respectful of the local customs and traditions is essential, to enhance its effectiveness and acceptance.
Language Accessibility:Ensure that EAP services are available in multiple languages (Arabic, English and French) to accommodate the diverse workforce in Lebanon and Jordan.
Partnerships and Collaborations: Establish partnerships with local mental health organizations and local professionals to maximize the impact and reach of the EAP.
Affordability and Accessibility:Explore options to make the EAP services affordable and accessible to all employees, regardless of their financial situation or location.
Conclusion: The future of EAPs in improving Mental Health Services
Employee Assistance Programs have the potential to play a transformative role in enhancing mental health services in Lebanon and Jordan. By addressing the challenges in accessing care and providing support within the workplace, EAPs can bridge the gap and improve the well-being of individuals and communities. As these programs continue to evolve and expand, it is crucial for employers, policymakers, and mental health professionals to collaborate and invest in creating a supportive and inclusive environment that prioritizes mental health. Through such collective efforts, Lebanon and Jordan can pave the way for a brighter future in mental health care.
References
- World Health Organization N/A About WHO / Frequently asked questions / History https://www.who.int/
- Cambridge Dictionary N/A Stigma https://dictionary.cambridge.org/dictionary/english/stigma
- Civil Society Organizations in Jordan 2021 Jordanian Psychological Association http://www.civilsociety-jo.net/en/organization/312/jordanian-psychological-association