More than a traumatic event: mental health, overlapping crises, and systemic safety deficits in Lebanon

Purpose The purpose of this study is to develop the systemic safety deficit framework (SSDF), a conceptual model for understanding mental health in Lebanon and contexts where economic, governance, infrastructure, healthcare, security and community systems fail to provide essential functions predictably and continuously. Design/methodology/approach The SSDF is developed through a critical narrative review of empirical studies, policy reports and other sources concerning Lebanon’s overlapping crises since 2019. Findings The SSDF proposes that prolonged and unpredictable system failures, inter-system spillover, reduced compensatory capacity and restricted intervals for societal systems to recover may contribute to psychological distress in the population and constrain mental health recovery. Research limitations/implications The SSDF is a theoretical framework that can advance research and practice in mental health. Future research can explore the SSDF in various contexts. Practical implications Although clinical mental health support is essential in Lebanon, mental health recovery also requires the restoration of foundational societal systems and institutional structures that provide predictability, protection, continuity and credible recourse for the population. Social implications Macro-level infrastructural and governance breakdowns, particularly in fragile and conflict-affected states, may produce and sustain mental distress, social exclusion, community suffering and chronic uncertainty. Originality/value The SSDF extends current understanding of mental health beyond discrete-event, polycrisis and social-determinants approaches by proposing that psychological distress and recovery are shaped by the predictability and duration of failures in essential societal systems, spillover between systems, compensatory capacity and intervals for system recovery.