"I Go up to the Edge of the Valley, and I Talk to God": Using Mixed Methods to Understand the Relationship between Gender-Based Violence and Mental Health among Lebanese and Syrian Refugee Women Engaged in Psychosocial Programming

Int J Environ Res Public Health. 2021 Apr 23;18(9):4500. doi: 10.3390/ijerph18094500.


Lebanon's intersecting economic and political crises exacerbate complex public health issues among both host and refugee populations. This mixed-methods study by a Lebanese service provider, in partnership with an international research institute, seeks to better understand how experiences of gender-based violence (GBV) and mental health intersect in the lives of Syrian and Lebanese women, and how to better meet these needs. It employs a randomized cross-sectional survey of 969 Abaad service users and focus groups with community members and service providers. There were significant associations between GBV and ill mental health; notably, respondents reporting transactional sex had 4 times the likelihood of severe distress (aOR 4.2; 95% CI 1.2-14.8; p ≤ 0.05). Focus groups emphasized less-visible forms of violence, such as emotional violence, and the importance of environmental factors in one's ability to cope, noting "it always came back to the economy". Recommendations include providing a more holistic and coordinated approach between GBV, mental health, livelihood, and basic assistance sectors; and sensitive, accessible, and higher-quality mental health services informed by GBV response actors' experience putting in place survivor-centered programming and made available to both host and refugee community members.

Keywords: LMICs; Lebanon; Syrian refugees; gender; gender-based violence; humanitarian; intimate partner violence; mental health.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Gender-Based Violence*
  • Humans
  • Mental Health
  • Refugees*
  • Syria