Geopsychiatry in Policy Making: Implications for War and Peace

​On Tuesday, April 23, 2024, the Women, Peace, and Security Regional Hub at IFI hosted a presentation and panel discussion on “Geopsychiatry in Policy Making: Implications for War and Peace.” The presentation was given by Dr. Joseph El-Khoury, assistant professor of psychiatry and president of the Lebanese Psychiatric Society, followed by a panel discussion with Dr. Lina Kreidie, expert in political psychology and gender studies; Mia Atoui, clinical psychologist and co-founder of Embrace; Dr. Samah Jabr, psychiatrist and head of the Mental Health Unit in the Palestinian Ministry of Health; and Dr. Audrey McMahon, child and adolescent psychiatrist and World Health Organization global mental health consultant.

In his presentation, Dr. El Khoury highlighted a significant gap in understanding mental health. He introduced “geopolitical psychiatry” to address this gap, examining how global factors like globalization, climate change, and conflict impact mental health. Unlike psychogeography, which focuses on local environments, geopolitical psychiatry takes a broader view, emphasizing the inadequacy of traditional mental health treatments. It calls for comprehensive approaches that consider the complex relationship between global events and mental well-being. Dr. El-Khoury also noted a North-South research divide, urging for better-informed policies to address the realities of the developing world. He highlighted the “well-being agenda” promoted by some countries, linking geopolitical stability with mental health. El-Khoury argued that mental health should be recognized as a political issue, advocating for its integration into policy decisions and foreign aid efforts to prioritize global mental well-being.

Following the presentation, Dr. Lina Kreidie further elucidated the complex challenges faced by the region. Dr. Kreidie emphasized that achieving good mental health and social support requires a nuanced understanding of various background factors. Using Lebanon as an example, she highlighted the substantial burdens faced by both the host population and a record number of Palestinian and Syrian refugees. Dr. Kreidie pointed out that refugees and war survivors are particularly vulnerable due to pre- and post-migration trauma, often exacerbated by a loss of dignity, leading to conditions such as depression, stress disorders, and feelings of hopelessness. Despite these challenges, accessing mental health services in Lebanon remains daunting due to several factors, including high costs, limited availability, pervasive stigma, mistrust, and a lack of awareness.

Dr. Kreidie then proposed promising solutions for sustainable peacebuilding. She emphasized the importance of empowering women through early interventions before their involvement in peace processes. Dr. Kreidie also recommended drama therapy programs as a culturally sensitive approach. These non-stigmatizing, community-based programs, often run by trusted NGOs within refugee camps and disadvantaged areas, utilize body, voice, and movement to promote catharsis, positive self-narratives, resilience, and empowerment.
In addition to Dr. Kreidie’s insights, Mia Atoui shed light on the harsh realities of mental healthcare in Lebanon. Despite efforts to prioritize access to mental health services, political and economic instability in the country continues to impact citizens’ mental well-being negatively. Atoui emphasized the concept of geopsychiatry, where social and economic factors play a significant role in mental health outcomes. She also discussed the challenges faced by Embrace as an NGO advocating for policy changes, particularly during times of conflict, leaving them focused on providing direct support.

Atoui further delved into Embrace’s experience managing the region’s first 24/7 mental health hotline, highlighting unique challenges such as infrastructure issues and a shrinking volunteer pool due to emigration. Despite these obstacles, a new project involving mobile clinics and interventions aims to bridge gaps in the existing healthcare system and address the population’s immediate needs.

On the other hand, Dr. Samah Jabr shed light on the Palestinian context, emphasizing the critical need for mental health support in Gaza. She highlighted the overdiagnosis of mental illness due to a failure to differentiate between social suffering and pathology. Jabr also stressed the severe shortage of mental health professionals to meet the overwhelming demand, compounded by the collapse of the healthcare system. She urged policymakers to consider Gaza’s unique geographical and historical context when developing public health initiatives, with a strong emphasis on mental health services.
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Finally, Dr. Audrey McMahon echoed the importance of on-the-ground experience in understanding mental health needs, drawing from her work in low-income regions of Canada and the Global South. She emphasized the often-overlooked struggles of indigenous populations facing historical traumas and poverty. Dr. McMahon argued that an area’s social determinants significantly shape people’s lives and mental well-being, underscoring the need for firsthand observation in the field to grasp these nuances fully, also drawing examples from Palestine.