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WHO-AIMS Report on Mental Health System in Lebanon

WHO and Ministry of Health, Lebanon Country Resources WHO-AIMS Country Reports Lebanon 31 December 2010 Report

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WHO-AIMS Report on Mental Health System in Lebanon

The World Health Organization Assessment Instrument for Mental Health Systems (WHOAIMS) was used to collect information on the Mental Health System in Lebanon.

the goal of collecting this information is to improve the Mental Health System and to provide a baseline for monitoring change. This will enable Lebanon to develop information-based Mental health Plans with clear baseline information and targets. It will also be useful to monitor progress in implementing reform policies, providing community services, and involving users, families and other stakeholders in Mental Health promotion, prevention, care and rehabilitation. Lebanon is a small Eastern Mediterranean country with a geographical area of 10452 sq/ km and a population around 4,350,000, including 500,000 refugees from different nationalities, most being Palestinians. The country belongs to the upper-middle income group with a diversity of 18 religions.

The mental health system benefits from different acts and legislations in different areas of mental health, namely:
1) Lebanese Act no 72-9/9/1983 Welfare Act and Protection and Treatment of Mentally Ill Patients.
2) Lebanese Act no 673-16/3/1998 Narcotic Drugs and Psychotropic Substances and Precursors.
3) Lebanese Act no 220-29/5/2000 Rights of Mentally Handicapped in Lebanon
4) Lebanese Act no 574-11/2/2004 Patients Rights and Informed Consent.

Despite the presence of the above Acts, Lebanon is still not capable of enforcing and implementing human rights and protective laws for the mentally ill. The budget for Mental Health constitutes 5% of the general health budget, mainly devoted to cover long stay inpatient cost in private mental hospitals whereas outpatient community based services are the responsibility of the private sector with no budget except for those providing certain psychotropic medicines for free. However, expenditures on mental health are still far below the needs.

In terms of availability of mental health facilities, the system still suffers from an imbalance with a crucial lack of community-based services such as residential or day treatment facilities. The mental health services should be organized in terms of catchment/ service areas because the MOH should be responsible for the provision of care to the population of every region in the country. The essential list of psychotropic drugs is regularly updated and includes anti psychotics, antidepressants, anxiolytics, mood stabilizers and antiepileptics. Only doctors are allowed to prescribe without restrictions. There is no interaction with traditional healers/ practitioners who are not legally recognized. The country also suffers from a shortage of mental health professionals (psychiatric nurses and psychiatrists).

Little research is carried out by personal initiative, therefore the need for national technical committee for mental health providing advice to the government on mental health policy legislation and service planning is necessary.

Mental Health action plan. Critical next steps in reforming the mental health system include:
• Prevention and promotion of mental health (Mental Health Awareness campaign)
• Creating a Mental Health department within the MOH general healthcare system
• Development of mental health national policy
• Developing a mental health information system
• Strengthening community-based facilities mainly public mental health outpatient facilities to provide availability of services in the 6 Lebanese districts
• Integration of mental health in community-based primary healthcare settings in order to move from Mental hospitals to community-based services.
• Mental health training for pre/post-graduate healthcare providers on emotional & psychosocial health in different health & educational institutions.
• Implementation of mental health activities in prisons (psychosocial rehabilitation programs for detainees)
• Creation of public substance abuse disorder (SUD)s treatment centers in/outpatient (detoxification, OST)
• Mapping primary health care center for referral and networking
• Behavioral Science rotation in medical schools should be mandatory and not elective
• Updating The Mental Health Act
• Creation of a national intelligence multidisciplinary committee with key people and experts in the fields of mental health, public relations, marketing, advertising, media, management, journalism, research etc. to study the needs, prioritize action steps, using logistics and setting a plan of execution while spreading awareness and educating etc..


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