Lebanon’s suicide hotline Embrace is facing a surge in calls as political and economic turmoil exacerbates mental health problems in the country.
Embrace co-founder Mia Atoui told The Daily Star that calls to the suicide prevention hotline had increased from around 300 to 400 a month to over 600.
There have been several high-profile suicides in Lebanon in recent months, with the media drawing a direct link between the economic crisis and the deaths.
Two widely reported suicides on July 3 included a man identified as Ali al-Haq, who died in Hamra. Haq left a note that read, “I’m not a heretic but hunger is heresy.”
Hashtags pertaining to Haq’s death trended on Twitter while some media outlets published headlines attributing his death to poverty. One such headline, featured by MTV, read, “Photos: Man commits suicide in Hamra due to hunger,” with a picture attached below of the man dead on the floor.
Embrace, however, advises against attaching pictures of suicides as they can be a trigger for others in a vulnerable position.
Furthermore, according to Atoui, it is over-simplistic and unhelpful to say a man killed himself due to hunger, as the full circumstances that lead to someone being the victim of suicide are complicated and the media can’t know the full picture, especially when reporting on suicides on the day they occur. Atoui said that globally 90 percent of suicide victims have pre-existing mental health conditions.
Speculation and over-simplification of suicide cases are not just problematic in terms of accuracy but also because of the knock-on effect such reporting can have.
In December a number of suicides received extensive media coverage, with many attributing the deaths to economic malaise in the country. Embrace’s hotline received over 150 calls a day for two weeks in December, compared to the usual 300 to 400 calls a month. A volunteer at Embrace who preferred to be referred to by her initials KM said they had also seen a spike in calls on July 3.
Atoui is worried that simple economic explanations for suicides can lead to copycat suicides among those in similarly desperate financial situations. Six suicides were recorded in one week in December compared to an average of one suicide every three days in recent years.
That is not to say that economic factors are not relevant to discussions around suicide and mental health in Lebanon.
In June, the head of the Beirut Traders Association Nicolas Chammas said 25 percent of businesses in Beirut had closed since January, and this could rise to half of all businesses in the city by the end of the year.
Loss of incomes across the country has led many previously independent people to rely on their families, friends and charities. Atoui said that mental health problems and risk of suicide could be exacerbated by individuals feeling like a burden on others.
“Accumulating social pressures, people may perceive that they have become a burden to those around them,” she said, adding, “One factor is employment.”
KM said she had dealt with many calls from people who were distressed because they were unable to support their families.
For example, “fathers call because they don’t know how to feed their children,” she said.
For Atoui, conversations around suicide and mental health are a fine balancing act whereby financial distress has harmed mental well-being across the country, but this factor shouldn’t be speculated upon as the sole reason in individual cases.
Elie Karam, founder and head of the Institute for Development, Research, Advocacy and Applied Care, researches mental health in addition to working on mental health education and treatment in Lebanon and the surrounding countries.
Speaking to The Daily Star over the phone, Karam was despondent, saying that even for someone from a relatively wealthy background, a fall in living standards and having to cancel career, study and retirement plans could be damaging. “You’re still not poor but your whole structure is lost, and that can destabilize you,” he said.
According to Karam, one in four Lebanese people have or have had a mental health illness and that these people were especially at risk now, in particular those who were already poor before the economic crisis.
Consequently, Karam said he saw “clouds that are getting darker and darker on the horizon.”
IDRAAC, which has been conducting mental health research in Lebanon since 1982, has already seen an increase in people reaching out to them, many of whom are unable to afford counseling or medication.
Karam added that besides the financial losses and coronavirus, the political instability ignites fears, particularly for older generations, of a return to periods of violent instability that have gripped Lebanon in the past.
The overlapping economic, political and coronavirus stresses are creating what Karam referred to as a triple trauma.
IDRAAC is bracing for a mental health crisis it must face with limited funding. A meeting Monday discussed different plans to boost its support capacity at a lower cost, including hiring less specialized staff and holding group counseling sessions.
Meanwhile, Embrace, which has been surviving on donations from international and local donors, is facing a shortage of funding at a time when it is needed desperately. Atoui said local donations had already shrunk over the past two years and international funding was now also in short supply amid the global economic downturn.
And while Embrace had been hoping to make its hotline available to callers 24 hours a day, Atoui said the organization could potentially shut down in the next six months.
For KM, who started volunteering for Embrace over two years ago hoping to make a difference in people’s lives, the closure would be a tragedy.
She said she felt the organization made a difference. “They call in distress, sometimes crying,” but by the time they hang up some callers end up “laughing and saying they feel much better,” she explained.
Karam was downbeat regarding a shift in donations, saying Lebanon’s crisis had also been a fall from grace reputation-wise, meaning that foreign donations were unlikely.
“Who’s going to give money to Lebanon to help with mental health if Lebanon is considered corrupt and mismanaged?” he lamented.