“When the phone rings, I feel a sense of anticipation,” says psychologist Lusine Babayan. “Who will be calling? What kind of questions will he or she ask? What kind of problem might they share with me?”
Lusine is one of 10 operators supported by the WHO Country Office in Armenia to answer calls on the mental health and psychosocial support (MHPSS) hotline. To better support callers, in October 2023 she and her colleagues received specialized training from WHO MHPSS experts. They now work shifts, listening and providing referrals for callers who may be suffering from anxiety, depression or even suicidal thoughts.
Initially set up in 2020 to support health workers dealing with the COVID-19 pandemic, the hotline was repurposed to support people affected by the crisis in the Karabakh region. However, the mass movement of refugees to Armenia in September 2023, and the horrific explosion at a fuel depot that killed around 220 and severely burned 300 more, has left many in need of mental health support. Between September and December 2023, the hotline received 1108 calls, reflecting the cumulative impact of this series of crises. Today, the line is open to anyone who needs it. Currently, around half of the callers are recent refugees, and 60% are women.
Connecting people with the support they need
Psychologist Lilit Baghdasaryan, president of a nongovernmental organization called AMBRA Mental Well Being Center, also works on the hotline. “Sometimes people come to us and say they don't know where to start,” she says. “We tell them that by reaching out to a specialist, they have solved 60% of the problem.”
“In some cases, it is enough to talk to family and friends and that’s important in itself, but sometimes people need professional support,” agrees Marietta Khurshudyan, clinical psychologist and national consultant on MHPSS at the WHO Country Office in Armenia. “In case of real need, such as depression, high levels of stress, panic attacks or suicidal thoughts, people need some follow-up and support that can only be provided by a skilled psychologist.”
Callers who need more help can be referred to psychological services in specialist centres in the country’s capital, Yerevan. The hotline also functions alongside WHO Armenia’s other major MHPSS programmes: a multidisciplinary mobile mental health team that conducts visits to areas where psychological services are scarce, and the ongoing psychological support for the survivors of injuries, both physical and mental, from the explosion at the gas depot. Group therapy sessions are also planned, and will include the relatives of people who sustained lifelong burn injuries.
Extended psychological impact of the refugee crisis
“Initially, when people became displaced, they did not have the time to reflect upon the psychological aspect of the situation. The overwhelming feeling amongst them was simply relief that they were alive, that they had survived,” says Lusine.
In this first phase of the refugee crisis, many callers used the hotline to connect with social support, such as help with housing and food supplies. However, now that the critical phase of the emergency has passed, the psychological impact of what they have lived through is hitting home.
“The problems and the level of perception have changed,” Lusine continues. “Now, more existential problems have come to the surface regarding their future uncertainties.”
Many of the female refugees who call the hotline used to be socially and professionally active in Karabakh and now keenly feel the loss of their past lives. The team encourages women to access the hotline, both for psychological support and for practical referrals that could lead to work and social opportunities.
“In my opinion, there are many women all over the world who put their children, partner, family and elderly parents first, leaving themselves behind. But we shouldn’t neglect our own mental health. So please take care of yourselves, dear women, all of you. I tell myself the same thing every day – that I really need self-care. I really need to put myself first. It’s like what you’re told to do on an airplane – put your own oxygen mask on first before assisting your child. You need to be able to breathe, both mentally and physically. You really need to have this resource to be able to keep going.”
She stressed that seeking help is important not just for the individual, but for society as a whole: “If someone has no inner resources to recover, they cannot fully participate in the life of their society, they cannot create, they cannot work, they cannot be proactive.”
Dr Marthe Everard, Special Representative of the WHO Regional Director for Europe to Armenia, added: “Providing MHPSS as part of the humanitarian response pays dividends, not just in helping displaced people to survive extreme distress and hardship, but also in supporting a nation’s recovery.”
To support the hotline operators with emotionally and practically processing complex conversations, regular supervision sessions are provided to enable them to confidentially debrief and ensure continuous learning.
Helping to reduce the stigma around mental health