The fragile state of children's mental health in Lebanon
Over the last two years, childrenâs lives around the world. But for Lebanonâs children, in particular, the pandemic, and its related anxieties, has been only one hardship in an overflowing basket of woe facing the country.
Doctors and psychologists have been reporting an alarming increase clinically in the number of children and teenagers requiring mental health services, in parallel to the countryâs deteriorating living conditions.
Since the end of 2019, when a popular revolution ground the country to a halt, Lebanon has been undergoing . It has been regarded as the gravest threat to stability , while three-quarters of the population have fallen into poverty.
"Any respite from the economyâs downturn, now entering its third year, is yet to emerge. As the cost-of-living surges amid sky high inflation, many households have been forced to reprioritise needs, laying aside mental health treatment"
For the often-overlooked youngest generation, the fragile state of living has been derailing childhoods up and down the country, .
âThis year has been definitely one of the busiest... we have more than 100 children on the waiting list at this point, waiting to be seen,â Dr Fadi Maalouf, an associate professor of child and adolescent psychiatry at the American University of Beirut, told °źÂț”ș.
âThis may be due to several factors. , but this may also be due to the fact that we donât have professionals, some of them have emigrated.â
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Globally, one out of seven children aged between 10 and 19 are estimated to live with a diagnosed mental disorder, according to UNICEF. However, in Lebanon, the ratio is higher, with around one in five aged between 15-24 reporting feeling depressed.
Last autumn, children returned to school 24 months after they were sent home in October 2019, .
The disruption brought on by the revolution movement morphed into the pandemic and meant children were taught remotely for two yearsÌęâÌęand this has had a lasting impact, according to Maalouf.
âWe're seeing mainly in preteens, and teenagers, a lot of what we call âschool refusalâ; which is refusing to go to school, also known as maybe school phobia,â he explained.
Maalouf said the issue stems .
But in a particular case in Lebanon, Maalouf noticed incidences of school phobia cropping up among children in families who have recently emigrated.
Over 77,000 people are estimated to have left Lebanon over the last 12 months in search of a more stable existence, according to a report from Information International, a Beirut-based consultancy firm.
Despite moving to a hoped-for safer environment, children have actually struggled to acclimatise, Maalouf said. â.â
But the problem remains on return to school in Lebanon, trapping children in a cycle of difficulty. âThey've already developed the school phobia,â Maalouf added.
"Pandemic-induced lockdowns and related stresses, like domestic violence, have harmed childrenâs wellbeing and caused cases among the paediatric population to rise"
The mass migration of citizens, the third in Lebanonâs modern history, has not only drained the country of talent, but has left emotional voids too.
In another unique-to-Lebanon case, Maalouf has met youngsters who are mourning departed friends. âBecause of the exodus that has taken place, the kids who stayed here lost many friends who left the country, so now they're having to manage...theyâre dealing with the physical loss of a social network for them.â
One breaking point for residents' mental health in Lebanon was the , when hundreds of tonnes of poorly stored ammonium nitrate detonated, killing 218 people, wounding thousands, and ripping apart the capital city.
In just seconds, tens of thousands of homes and their inhabitants were ransacked. As windows, walls, and doors were destroyed, so too was the sense of safety that a home embodies.
âAfter the Beirut explosion I had several children [come in] for different disabilities; like they cannot talk, they become violent â these [problems] were during the pandemic also,â Dr Anita Toutikian, a psychotherapist, said to °źÂț”ș.
âSome children or adolescents start to develop self-harm, [or] start to be aggressive.â She explained that once a child âtriggered by a single incident or multiple factors âÌęthey can behave out of character, and interactions can become negative.
Toutikian specialises in art therapy to treat children in her private rooms in Beirut, which she opened over a decade ago. âPlay is the language for children,â she said, sitting in her therapy room that resembles a nursery; boxes of toys line the table and cupboards are filled with paints and crayons.
For Toutikianâs patients, the return to school was positive. âThe children that I saw, it accelerated the therapy,â she said, referring to younger children while conceding that among teenagers it can be more complicated.
But Toutikianâs practice has not been totally immune to the crumbling state around her. âTo tell you the truth, many people stopped coming to therapy,â she admitted. âMany children, the parents could not afford the therapy, so I didnât see them again.â
, now entering its third year, is yet to emerge. As the cost-of-living surges amid sky-high inflation, many households have been forced to reprioritise needs, laying aside mental health treatment.
âAnd those who [still] come to therapy, are more or less, well off,â Toutikian said.
Yet, the emptying of one therapy room has only caused another to fill up. Primary health care centres, which offer low fee consultations, have witnessed an uptick in patients, among them children, seeking psychological support.
St Antione Community Center based near Jdeideh, in the northern suburbs of Beirut, is one. Before the crisis, the centre would refer two or three people a month for mental health services, Dr Nancy Abi Assaf, a general practitioner, told °źÂț”ș. But today, it has swelled dramatically to two or three cases a day.
âPeople could afford private care services, so they were not visible to us,â she explained. Pandemic-induced lockdowns and related stresses, like domestic violence, have harmed childrenâs wellbeing and caused cases among the paediatric population to rise, she said.
âOh my god," Assaf exclaims,Ìęholding her head in her hands, on the countryâs children,Ìę"itâs really sad."
Rosabel Crean is a freelance journalist based in Beirut, Lebanon.
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