Almost ten years ago, I rented an Airbnb in Beirut from a young American lawyer named Samantha, who had recently moved there from D.C. She mostly stayed at her boyfriend’s apartment, leaving me alone in her tiny place in Achrafieh, but she made me feel welcome, inviting me along on evenings with her friends.
I had come to Beirut for the final stretch of a reporting trip for Science on mental health in Syrian refugee communities. I’d spent three months visiting refugee camps in Greece, Germany and Sweden, talking to people who’d fled the war in Syria and the researchers and clinicians trying to alleviate their suffering. By the time I reached Lebanon, I was exhausted and sad. Most evenings, I found myself revisiting the fear, loss and grief I’d encountered—and trying to ignore the guilt I felt each time I returned to my hotel room, safe.
A few evenings with Samantha, without my recorder or notebook, were a huge relief. She took me to an underground bookstore where her friends—a group of burly, bearded locals—were playing Munchkin. Another night, she invited me to an acroyoga class in a cavernous warehouse, where her instructor bent her body into gravity-defying L shapes, dangling from a loop of red silk.
After a few embarrassing attempts to hoist my own body up on the silks, I gave up and watched another group using the warehouse. Dozens of children tumbled across the padded floors, doing flips and cartwheels. They were mostly refugees from Syria, the instructors told me, participating in a volunteer-led program. Earlier that day, I’d seen other children their age — also mostly refugees from Syria — teetering on the medians between lanes of traffic, approaching cars to sell roses or wash windshields.
Watching those kids brought up the same question that had come up in different ways throughout my trip: What can mental health care— and particularly the kinds of short-term programs that only last as long as humanitarian aid does — provide for people whose lives are so precarious? I never wrote about the time I spent in Lebanon for Science, but I still think about a conversation I had with the architect of its then-new national mental health program, a bespectacled psychiatrist named Rabih El Chammay. We met in the leafy, sunlit courtyard of a shopping mall near the hospital in downtown Beirut. As he described his vision for mental health care in Lebanon, speaking softly but deliberately, the bustle around us seemed to fade.
El Chammay spoke directly to the question that had been bothering me. I’d heard versions of it throughout my trip, often from people at some distance from the work: What is the value of addressing mental health in a war zone or refugee camp if people’s basic needs aren’t met? He challenged the premise: mental health and physical well-being aren’t separate things, he said, and treating them that way creates a false choice.
It might not seem visionary, in 2026, to say that poverty, physical illness and psychological suffering are intertwined. But recognizing that they’re connected is different from organizing care around them. Governments, aid organizations and funders still tend to treat mental health as an add-on, especially when funding dries up. El Chammay, who fled his own home with his parents at age six during Lebanon’s civil war, wanted to change both how mental health services were delivered and how the institutions providing them understood their responsibilities. He built an international coalition to pull that off, creating a program that many in the field admired at the time — Inka Weissbecker, then a global mental health and psychosocial adviser at International Medical Corps, described it to me as “the most promising” example of mental health reform in the Middle East.
Since my visit in 2017, Lebanon has endured economic collapse, COVID-19, the Beirut port explosion — which destroyed much of the Achrafieh neighborhood, where I stayed — and successive waves of war. El Chammay is still working toward the same goal of making mental health care accessible to everyone in Lebanon through one crisis after another.
Earlier this year, I listened to him speak at a panel on the future of humanitarian aid. The intervals between emergencies in Lebanon are now so short that there is no time to catch your breath before the next, he said. Resources are dwindling just as the need for mental health care explodes. He also surprised me by arguing that these crises have helped make some of Lebanon’s mental health reforms possible. Each emergency offers an opening to bring mental health more deeply into conversations about public health, humanitarian assistance and government responsibility. The challenge is turning those temporary surges of interest into support for institutions that endure, he said.
One reason I didn’t write about Lebanon’s program for Science was that it was still so new. It hadn’t yet generated the sorts of rigorous, measurable results that a scientific audience would find compelling—or at least that’s what my editors and I decided at the time. In hindsight, listening to El Chammay, and seeing how the entire field of global mental health has converged around the approach he’s taking, I think we might have been asking the wrong questions.
“We still think that a crisis is, like, six months to one year,” El Chammay said on the panel. “Crises are 10 to 15 years.” That is longer than most research grants, and far longer than most reporting assignments. A decade has passed since my conversation with El Chammay in that courtyard, and I have left journalism, at least for now. But he is still building that program.
I would love to ask El Chammay now about the program’s accomplishments, its shortcomings and its future. Maybe a sharp-eyed editor will assign a different reporter to call him and write about it. If they do, I hope they’ll ask deeper questions than I did: How to measure progress when the crises never stop? And how do you keep going?
