Unseen and unspoken,
the stress you need to address

by MainGate Staff
Fall 2020/Spring 2021

“We wake up and check the numbers: the lire rate, the number of COVID cases, our body temperatures,” says Ali, a student who discovered the benefits of mental health counseling before this “roller coaster year.”
He continues, “I have personally handled this period even better than my first year at AUB because of the counseling I received when I got here before all the crises started. This is not because there’s less stress,
it’s about the help I received from the Psychiatry Department and the Counseling Center. The stress will never disappear, but what can change is how we handle it. I’m now working two part-time jobs while pursing my engineering studies. Seeking help and asking for help was a life-changing experience for me.”

Perhaps no one appreciates the benefits of mental healthcare better than the founding co-chairs of AUB’s new Mental Health Council (MHC), Dean of Student Affairs Talal Nezameddin and Department of Psychiatry Chair Fadi Maalouf. At the launch of the MHC on October 9, 2020—the eve of World Mental Health Day—they described the Council’s mission and introduced a roundtable moderated by the chief of the Division of Child and Adolescent Psychiatry and Psychology, Leyla Akoury Dirani. Representatives from different walks of university life—students, faculty, and staff—participated.

Dean Nezameddin discussed AUB’s groundbreaking mental health services for students, starting with the Counseling Center in 2002. “Mental health really does matter and AUB has been a leader in Lebanon and the Arab world for a long time,” said Nezameddin. “Our first challenge was to break the taboo of psychological support. Student suicides and other life threating incidents prompted the creation of a mental health emergency protocol and response team. This led to collaboration between the Counseling Center, the Student Affairs Office, the Psychiatry Department, the Protection Office, the HIV Office, and Family Medicine. President John Waterbury endorsed the initiative and many recommendations were introduced, including improving criteria for mental health patients.” Progress was slow until President Fadlo Khuri made mental health a top priority of his administration. At the launch of the MHC Khuri spoke of the stigma of mental illness: “Mental Health is one of the most challenging and intractable issues. It’s the disease that no one can talk about. If it’s ignored, it doesn’t go away, it gets worse. Like cancer, it’s a disease that needs to be treated.”

Interim FM Dean Razi Zatari reported that one in four people in Lebanon are affected by mental illness. Many symptoms start at around age 14 but go unnoticed and untreated. Nearly 90 percent of Lebanon’s mentally ill have no access to treatment. Chair of Psychiatry Fadi Maaloof warned that a mental health pandemic would follow the viral pandemic. “With multiple crises—the Beirut explosion, the pandemic, the economic crisis, and political and civil unrest, we are at quadruple risk,” he said.

On the agenda for the MHC are a number of initiatives: coordinating services between departments; expanding health insurance criteria to cover treatment costs; enhancing wellness and prevention measures; providing support for vulnerable groups, such as individuals with existing conditions, learning challenges, or other special needs; and broadening the patient base beyond students, faculty, and staff to the neighboring community. Among AUB’s new mental health services are the Employee Assistance Program, which offers counseling for faculty and staff that is free, confidential, and easily accessible; and psychiatric services at the Counseling Center, where students can now see a psychiatrist free of charge without needing to be referred to the Medical Center.

Thoughts from the roundtable . . .


“We want to make sure we are ‘caring for our caregivers’. In best-case scenarios, hospitals are stressful workplaces. In the context of a pandemic, where people are dealing with a new virus, anxiety and fear are even more palpable. When healthcare workers enter the hospital, they know they might be in contact with patients who have COVID. They are afraid that they might take the virus home to their loved ones. Through the Employee Assistance Program, we teamed up with Dr. Fadi Maalouf and the Psychiatry Department to provide mental health services to AUBMC healthcare workers. Since the services are delivered through Employee Health (outside of the psychiatry department) they are better received because unfortunately, mental health continues to be considered a taboo in our society.” Director of Employee Health, Carine Sakr

“Uncertainty is a major theme that we identified as leading to the building up of anxiety. There are many challenges impacting student mental health, including, but not limited to, learning new things, such as remote teaching, learning, and virtual services; tutoring or medical care that might not be accessible virtually; family and social services that might not be available; social interaction feeling disconnected; students feeling alone and not supported; and worries about the looming financial and economic situation. All of which are negatively affecting student success and wellbeing.” Director of the Counseling Center, Chant Kazandjian

“Over the past year we’ve been living through a series of disasters . . . With pandemics, when national or international systems fail, hospitals pay the price. When the Beirut blast happened, it disrupted our response to other disasters. Worse, it made everyone—faculty, staff, students, members of the community, lose their sense of security and safety.” Director of Operations, Emergency Department, Mazen El Sayed

“We’ve had to reexamine the way we live, the way we teach, and the way we provide our services. As educators having to move to a virtual teaching environment, we’re doing a lot of questioning—what are we teaching, and how can we do it the best way possible with the new tools at our disposal? We also have to think about our role mentoring and supporting our students—academically and personally. And we need to be attuned to the additional stresses for new young faculty members, mothers with kids at home during the lockdowns, and single parents. The work/life balance is in flux. Figuring it out is not a luxury; it’s a must if we are to sustain our high standards for what we do and how we do it.” Assistant Professor of Landscape Design and Associate Dean of Student Affairs, Nayla Al Akl

“As working mothers, we are stressed and worried. Starting with the street protests, we’ve had to worry about getting to work. Are the roads open or closed? With COVID, we had to move our offices and work from home, where we struggled with an Internet connection, trying to reach all of our students, and online teaching—which was new not just for the students but for the parents and teachers—all while taking care of our kids. With the economic crisis there was the additional worry of whether or not our salaries would cover our basic family expenses. Could we maintain?” Assistant to the MSFEA Dean, Magguie Chammas

“In terms of the services our team provides to employees, it’s an amazing team—a team that provides a safe space for our patients. I’m a clinical psychologist and we’re very big on boundaries—how much do you share with your patients, how much emotion do you show? This situation has pushed us to question things that we have taken for granted in our profession. We’ve talked with residents, students, and staff in individual sessions and in group sessions. We’re listening and we’re here to help people tailor our services to their own needs.”
Clinical Psychologist, Psychiatry Department, Dinah Ayna

“As a mental health epidemiologist, I am concerned with accurate measurement. Many of the thoughts and emotions we experience vary with internal and external pressures and can change frequently. For example, if I had collected data on July 30, five days later, following August 4, that data would likely have been obsolete. The silver lining this past year has been new collaborations—writing new grants with new stakeholders for evidence-based mental health action. I am working in a very supportive environment in my department and in my faculty. That kind of support encourages a researcher to try and continue with their mission even under duress.” Associate Professor, Department of Epidemiology and Population Health, Lilian Ghandour