The hidden psychological toll of frontline work in Lebanon

In Lebanon, years of successive crises have placed immense pressure on those responsible for responding to emergencies. While their work is essential to protecting and supporting others, the psychological toll it takes on first responders often receives far less attention than the emergencies themselves. The country's economic instability, the COVID-19 pandemic, the Beirut port explosion and repeated periods of conflict have placed enormous pressure on emergency and humanitarian workers. For many, responding to one crisis has meant preparing for the next, sometimes without enough time to process what they have already experienced.

According to Peter Wanna, a clinical psychologist at Embrace, one of the greatest challenges facing frontline responders is the cumulative impact of prolonged stress. "Not everything is trauma," he emphasizes, explaining that responders may experience repeated stressful events without sufficient time or resources to recover before another crisis emerges. This continued exposure can affect people emotionally, physically and socially, contributing to exhaustion, irritability, difficulty sleeping, emotional numbness and feelings of helplessness. Importantly, Wanna explained that these reactions do not automatically indicate mental illness. Many are understandable responses to prolonged exposure to exceptionally stressful circumstances.

The pressure to remain strong

For first responders, the ability to remain composed under pressure is an essential part of their work. In an emergency, they are expected to make decisions, provide assistance and continue functioning regardless of the circumstances surrounding them. However, the expectation of strength can become a burden when it extends beyond the emergency itself. Wanna explains that frontline professionals may begin to associate resilience with emotional control, self-sufficiency and the ability to continue working without acknowledging their own distress.

Over time, this can create the belief that expressing fear is a sign of weakness, feeling overwhelmed indicates incompetence or asking for help means failing in their professional responsibilities. These expectations can sometimes be reinforced by workplace cultures in which vulnerability is viewed negatively. "The ability to function under pressure should not be confused with the absence of suffering," Wanna says. A person may continue performing their duties effectively while experiencing considerable emotional distress. The fact that someone can respond to an emergency does not necessarily mean they are unaffected by it. This distinction is particularly important in professions where responsibility for others can take priority over personal needs. Wanna argues that resilience should not be understood as the ability to endure everything alone. Recognizing personal limits, establishing boundaries and seeking support are equally important.

Responding to a crisis while living through it

Another challenge facing Lebanon's frontline workers is that they are not separate from the emergencies they respond to. A healthcare worker treating injured patients may simultaneously be worried about the safety of their family. A journalist documenting displacement may have experienced displacement themselves. A humanitarian worker supporting people who have lost their homes may be navigating similar uncertainty. Many Lebanese frontline professionals are responding to crises that also affect their own lives. Wanna points to this overlap between professional responsibility and personal vulnerability as a significant source of emotional strain. Responders may witness suffering while feeling responsible for helping, even when the circumstances are largely beyond their control. This can contribute to guilt, helplessness and moral distress. The psychological impact is therefore not limited to what happens during an emergency response. It can extend into relationships, sleep, daily routines and the way individuals understand themselves and their responsibilities.

Why mental health support matters

Mental health support for first responders is not only about responding to severe psychological difficulties. It can also provide an opportunity to recognize stress, understand emotional reactions and develop healthier ways of coping. One approach is peer support, which brings together people who may have different professional experiences but share some of the emotional pressures associated with caring for others. Wanna explains that group settings can help participants recognize feelings they previously believed were theirs alone.

Someone describing helplessness may help another participant recognize similar feelings. A conversation about anger may reveal underlying grief or fear that someone has struggled to identify. These exchanges can reduce feelings of isolation and make difficult emotional reactions easier to discuss. As Wanna explains, "Shared humanity does not require shared experiences." The value of these spaces lies partly in allowing people to be understood beyond their professional roles. Participants do not need to have witnessed identical events to recognize similar emotions in one another. Importantly, support should not depend on people being ready to disclose traumatic experiences. Confidentiality, personal choice and the freedom to participate without sharing more than one feels comfortable with are essential to creating a supportive environment.

Creating space for those who provide care

Recognizing this need, Embrace has introduced support groups for civilian frontline responders from different professional backgrounds. The initiative initially began with journalists who had been directly or indirectly exposed to conflict in Lebanon. Through that work, the organization identified similar challenges among healthcare workers, emergency responders, social workers and humanitarian personnel. According to Wanna, interest in the expanded initiative was immediate. Approximately 40 frontline responders applied within the first few days of its announcement, with the number reaching around 75 within three days. The response suggests an appetite for spaces where frontline workers can address their own emotional needs, although application numbers alone cannot establish the scale of unmet mental health needs across the sector.

The initiative consists of eight group sessions addressing experiences such as grief, anger, helplessness, uncertainty, emotional suppression and the effects of prolonged stress. Rather than following a fixed curriculum, the sessions are shaped partly by participants' experiences and may include guided reflection, grounding exercises, body awareness and emotional regulation strategies. The program is implemented by Embrace with support from the International Organization for Migration and funding from the European Union. Wanna is careful not to overstate the impact of the sessions. Although participants in earlier groups appeared increasingly comfortable identifying and expressing their emotions, he stresses that positive observations during sessions should not be mistaken for demonstrated long-term psychological outcomes.

Beyond the emergency

For Lebanon's first responders, psychological support cannot be treated as something reserved for those who have reached a breaking point. "When we talk about frontline responders, we often focus on what they do, how much they give, and how much they can endure," Wanna explains. "But behind these professional roles is a person with their own emotions, relationships, histories, vulnerabilities, and needs." He believes that when colleagues become more comfortable acknowledging their experiences and offering support to one another, the benefits may extend beyond the individual and into their workplaces.

However, the responsibility for psychological well-being cannot rest solely on individual workers or temporary initiatives. Organizations and institutions employing frontline personnel also have a role in making psychological care accessible and creating environments where seeking help is not interpreted as weakness. As Wanna puts it, "If we're asking people to continue showing up for others, we also need to make sure that someone is showing up for them." For first responders, being able to care for others should not come at the expense of their own well-being. Recognizing their psychological needs is an essential part of supporting the people who respond when their communities need them most.