Once the dust settles on Beirut, its citizens’ mental health will still be in tatters

When I first saw footage of the Beirut explosion on Twitter, I couldn’t believe what I was witnessing. 

The news sent me into a trance-like state.

As soon as I snapped out of my daze, I instantly contacted my parents in Lebanon on WhatsApp (thank God for modern technology) to make sure they were okay, and fortunately, both were physically unharmed.

Psychologically they, like so many others, were in shock and are still coming to terms with the enormity of the catastrophe.

As a psychiatrist and as someone who was born in Belfast and raised in the Lebanese city of Sidon, I know only too well the negative impact that trauma can have on our minds.

In 2006, I woke up to headlines that my home country had been bombed by Israeli jets and hundreds of people had been killed overnight. At the time, I was a medical student, living in Manchester. I had left my family behind in Lebanon and moved to the UK aged 17, wanting to serve society as a doctor.

In the months that followed, my world was turned upside down, I became severely depressed and developed suicidal ideation.

My dream had always been to become a heart surgeon, but the war – and my reaction to it – made me realise how utterly beholden we are to the power and mercy of our minds. This, along with the life-saving treatment I received from an NHS psychiatrist, led me down a different path.

Let there be no mistake, the psychological effects of the explosion in Beirut will not end once the dust settles.

Cliché though it may be, the scars that cannot be seen are the deepest. It is absolutely vital that the mental health of those affected by the blast is not overlooked.

Without crucial support and treatment, people with mental disorders experience impaired functioning, their productivity plummets, their quality of life worsens and they have increased morbidity and mortality and reduced life expectancy. 

Some of the initial reactions to traumatic events include confusion, sadness, agitation, numbness, dissociation and survivor’s guilt to name but a few. Many people, including myself, are already experiencing these symptoms as well as acute stress reaction, a mental disorder that is commonly triggered by trauma.

But the remnants of this trauma may continue for years to come; data derived from studies on previous explosions show that there is a risk of longer term mental health conditions, including post-traumatic stress disorder, anxiety, depression and addictions.

For example, research on the mental health consequences of the Enschede fireworks explosion in Holland in 2000 revealed that 13% of participants met the diagnostic criteria for PTSD three months after the disaster.

Unfortunately, Lebanese people may not get the help they so urgently need.

At the time of the blast, Lebanon was already crippled by an economic implosion due to decades of political and financial mismanagement. The coronavirus pandemic didn’t help, with estimates placing unemployment rates around 25% and almost a third of the population living below the poverty line.

Poverty and unemployment are both social determinants of mental ill health and suicidal behaviour. Moreover, 300,000 residents in Beirut have been rendered homeless, there is widespread destruction to infrastructure and extensive damage to the environment – all of which adversely affect psychological wellbeing. 

There will henceforth undoubtedly be a surge in the demand for mental health services, however due to the pervasive treatment gap that exists in Lebanon many, if not most, will not receive the support they so urgently need. 

This explosion will never be forgotten, and will remain indelibly etched on our collective consciousness for generations to come.

Health experts and policy makers in Lebanon must therefore formulate a longer-term strategy to manage the proliferation of chronic mental health conditions that will ineluctably ensue.

In the words of John Steinbeck, what happened in Lebanon is ‘a sorrow that weeping cannot symbolise’.

What gives me solace, however, is the spirit and resilience of the Lebanese people.

Throughout our history we have endured wave after wave of crises, however our resolve and fortitude have always prevailed. 

Much like the phoenix, we will rise from the ashes – but we cannot do so by ourselves.

We need support from the international community and we need your support, too.

Those who want to help the people affected by the blast can donate to the Amel association, which is providing health and psychological care, including mental health first aid, in Lebanon.

Do you have a story you’d like to share? Get in touch by emailing jess.austin@metro.co.uk.

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