Modelling Target Workforce Estimates For Community-Based Mental Health Services In Lebanon

Abstract Background: Mental health services in Lebanon are weakly integrated in the health system due to a huge political unrest, cultural and societal stigma, and more importantly, due to the inappropriate planning of human resources. A shift of the mental health services in Lebanon from hospital-based care into community-based care and efficient planning of human resources became a priority given the increasing burden of mental health disorders as a consequence of socio-political and economic crises: the bordering Syrian war, the massive influx of refugees, the huge inflation rate and above all the Beirut explosion. Methods: The WHO-ATLAS was conducted in 2019 as well as the WHO-AIMS in 2015 to map mental health services in Lebanon. Data from those two reports was plugged into the service needs calculator; an economic tool including epidemiology of eight priority mental health packages and target population, outpatient service use/needs and inpatient service use/needs. Total full-time equivalents (FTE) were calculated for psychiatrists, nurses and psychosocial care providers. All formulas were extracted from the WHO “Planning and Budgeting to deliver mental health services” module of the Mental Health Policy and Service Guidance Package. Results: For an effective community-based mental health system in Lebanon, there is additional need for 182 (+16%) psychiatrists, 762 (+68%) nurses and 184 (+16%) psychosocial care providers; a total increase of 1,128 mental health workforce. Conclusions: A proper workforce skill mix for an optimal utilization of the existing staff is recommended. New models will need to account for task shifting to attempt to close the gap between what is needed and what is available.