Lebanon’s Ministry of Public Health is working with researchers to redesign how the country’s health system delivers mental health care to over one million Syrian refugees and the Lebanese communities hosting them. Effective treatments for depression, post-traumatic stress, and other mental disorders exist, but refugees rarely receive them. Lebanon’s health system was already strained before the Syrian crisis, and the influx of international aid has sometimes weakened, rather than strengthened, the government’s own response. The project—called GOAL—asks how the health system should be governed and financed to close that gap. It treats gender as a cross-cutting issue, since men and women face different barriers to care. If successful, the research will produce a practical blueprint for Lebanon’s National Mental Health Programme, showing how to integrate mental health services into the public health system rather than leaving them to short-term humanitarian projects. The team is also creating animations and augmented-reality materials, co-produced with people who have lived experience of mental illness, to help advocates and policymakers communicate why participation matters. The findings could inform other countries facing protracted displacement, such as Jordan or Turkey.
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GOAL focuses on the challenge of supporting health systems providing for the mental health needs of people affected by protracted displacement, focusing on Lebanon. Poor mental health causes long-term suffering and disability, is a barrier to realising full potential of individuals and society, and impedes progress in achieving the SDGs. Poor mental health is often more common among protracted refugee populations than non-crisis affected populations. Effective mental health services exist, but there are major gaps in access to them, especially among refugee populations. The challenge is how to best deliver such services, including the design of health systems required to support this delivery. This is particularly challenging in protracted displacement settings which can place substantial additional pressure on already strained health systems and where an influx of international aid and actors can risk weakening national government-led responses. GOAL is a partnership between universities, the National Mental Health Programme at the Ministry of Public Health and civil society organisations in Lebanon. It addresses the following questions in the UKRI-GCRF Protracted Displacement call: (i) what should governments at every level do in order to anticipate and efficiently manage protracted stays, reduce refugees' dependence on humanitarian aid and implement systems that facilitate refugee /IDP integration, inclusion and social wellbeing? (ii) How can health care systems for the displaced be expanded to cover areas that are usually neglected in refugee/IDP settings such as (though not limited to) treatment of chronic illnesses, disability and mental health? (iii) How does gendered access to services, economic and cultural opportunities and levels of power influence differently the experiences, opportunities and limitations of men and women? The overall aim of GOAL to support government and partners in strengthening the ability of health systems to meet the mental health needs of refugee and host communities affected by protracted displacement, focusing on Lebanon as it is home to over one million Syrian refugees. It addresses two health system topics, governance and financing, identified as priority areas by key stakeholders in Lebanon and by external independent experts. GOAL's research is framed by the use of Transition Theory and gender is addressed as a cross-cutting issue informing all aspects of the project research. It follow a co-production approach, working closely with key stakeholders - particularly mental health service users. Quantitative and qualitative methods will be used and interdisciplinarity fostered. We also work with mental health service users to produce innovative materials (e.g. animations and augmented reality digital images) communicating the benefits of participation from people with lived experience of mental disorders in research and policy-making processes, and for advocacy and teaching. GOAL has capacity strengthening activities to provide technical training to project partners and key stakeholders, and to support institutional capacity and individual career progression. The main immediate beneficiary will be the National Mental Health Programme at the Ministry of Public Health in Lebanon. Other beneficiaries will include key stakeholders including mental health service users, NGOs, and UN agencies, both in Lebanon and other countries responding to protracted displacement situations. The proposal responds to SDG 3 (good health and well-being) and DFID's strategic objectives of strengthening resilience and response to crises, and tackling extreme poverty and helping the world's most vulnerable.
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