Embrace: The first suicide prevention hotline in Lebanon

BEIRUT: Aiming to ignite the light at the end of the tunnel, Embrace is the first suicide hotline in Lebanon. It works on bringing mental health out of its overlooked shell into the open, in the hope of spreading awareness and saving the lives of those whose journey is far from being over.

Embrace is a non-governmental organization, which was founded in ‪2013 by Dr. Ziad Nahas, the chairperson of the Psychiatry Department at the American University of Beirut Medical Center (AUBMC).

It was initiated as an affiliation with AUBMC at first, until August 2017, when it became an independent NGO. “Embrace started because we heard in the in-patient care that we lost many of our patients to suicide; and we heard about suicide among patients outside AUBMC.” Zeina El Jordi, Embrace board member and clinical instructor, told Annahar.

When the NGO first started, one of the biggest obstacles faced by Embrace team was the vague statistics about suicide in Lebanon. “When we first started, the statistics showed very low numbers, but we know that our rates can’t possibly be that much lower than other countries’ rates,” El Jordi told Annahar. “So it was not possible that we had only 20 cases per year,” she added. In Lebanon, one commits suicide every three days according to the NGO’s data.

One level Embrace works on is raising awareness in the community through sessions held at universities and municipalities. These sessions educate the audience on what mental illness is, and what are the signs of suicidal tendencies.

The NGO hopes to collaborate with media outlets soon to raise awareness on how the media can have a negative impact. “We should not focus on the method. Mentioning the method to a suicidal person can give them an idea.” El Jordi told Annahar.

“We need to raise awareness on what we post on the media, we should report on suicide but not turn it into a gossip topic,” she added.

Another problem the sessions discuss is dealing with suicidal people when we come across them. “When a mentally-ill person is spotted trying to jump off somewhere to end their life, anyone who takes videos is encouraging the victim to commit suicide,” El Jordi explained.

The most effective part of Embrace’s job is Embrace Lifeline, the first suicide prevention hotline in Lebanon. Every day ‪from 12:00 p.m. until 2:00 a.m. Anyone who has suicidal thoughts can call the lifeline on 1564 and will get the help needed. Calls are confidential and sharing names is optional.

Phone operators are volunteers; they go through training to prove they are emotionally stable enough to operate the lifeline’s phones. “There is training, and they do mock calls to see their reactions and observe whether they’re emotionally stable for it.” El Jordi said, adding that the training covers every step from the picking up the phone until hanging up.

Embrace hopes to become a ‪24/7 lifeline, but more funds and resources are needed.

Embrace Lifeline is a part of the strategy set by the Ministry of Public Health. The National Mental Health Programme (NMHP) at the Ministry of Public Health has launched the first national strategy for mental health: the "Mental Health and Substance Use-Prevention, Promotion and Treatment-Strategy for Lebanon 2015-2020." The Strategy was launched in May 2015 and is under implementation since.

The implementation is based on a collaborative model of work as the NMHP has partnerships, collaborations or coordination with all stakeholders, including many ministries, like the Ministry of Education, Ministry of Social Affairs, Ministry of Interior and Municipalities, Ministry of Justice, UN agencies, local and internal NGOs, universities, etc.

The strategy was developed through a highly participatory process, with numerous phases of consultation/consensus meetings to guarantee that it tends to every single national need distinguished by the principle on-screen characters in the field.

The domains of action that were integrated into this strategy were in line with the World Health Organization Global Action Plan for Mental health. The strategy is divided into five main domains.

The first domain concerns the leadership and governance for mental health. The second domain focuses on the service organization and scale-up, through increasing the availability and accessibility to mental health and social care services in strictly community-based settings, near where people live, in line with the latest evidence and high-quality standards.

The third domain’s goal is to develop and implement key promotion and prevention strategies for mental health and substance use. This includes, among other key actions, the development of a suicide prevention framework, in which the Embrace Lifeline is one of the components implemented.

The fourth domain is centered on information, evidence, and research. The last domain concerns vulnerable groups, in which the improvement of access to equitable evidence-based mental health services for all vulnerable groups is the goal.

The biggest challenge facing this program is the absence of stable funding for full implementation of the national mental health strategy, which currently heavily relies on humanitarian aid, until the program transitions into a department with dedicated government funding. The rooted stigma that faces mental health and substance use is a key challenge in Lebanon, which is being addressed.

Nour El Kik, the Policy and Advocacy Coordinator in the National Mental Health Programme, told Annahar, “The program was established in the Ministry of Public Health in 2014 to lead the mental health reform in the country and address the gaps in the mental health system to cater for the high needs. There is no health without mental health."

In case of any distress or suicidal ideations, call Embrace Hotline on 1564.

This photo shows the Embrace team. (Photo Courtesy of Embrace's Facebook page)