Generation Start-up: Lebanon's mental well-being initiative Siira creates spaces to talk

In Lebanon, where the dual crises of the Covid-19 pandemic and a financial meltdown are taking a toll on people's daily lives, mental well-being start-up Siira is looking to provide emotional support by organising group discussions led by experts.

Beirut-based Siira offers weekly online meetings, moderated by certified therapists or psychologists, on various themes including parenting, relationships, family dynamics and work. People are invited to discuss their problems in a “safe and private" setting.

The idea is to minimise stigma around mental health issues, alleviate isolation by bringing people facing shared struggles together and tackling problems at an early stage through a preventive approach, Siira founder Sandra Salame says.

“The idea is not to replace therapy but to increase awareness, educate yourself emotionally so that at least you can detect if you have an issue, change behaviour early on and maybe you realise you need therapy or realise you are not alone in going through this,” she says.

“By saying the problem out loud, you’ve already started your treatment … the sessions are very humbling to hear people speak up.”

The Covid-19 pandemic has cast a spotlight on mental health tech start-ups globally, as disruptions to daily life and work, coupled with lockdown measures, triggered and accentuated stress.

Global funding for mental health tech start-ups reached $5.5 billion in 2021, more than doubling from $2.3bn in 2020, the “State Of Digital Health 2021" report by market intelligence firm CB Insights showed. The majority of deals — 68 per cent — were in early-stage start-ups, indicating room for further growth in the sector.

The pandemic, a Beirut port blast in 2020 that devastated large parts of the capital, along with Lebanon's economic collapse, have led to frequent power cuts and inflation skyrocketing to 155 per cent in 2021, which pushed 80 per cent of the population to below the poverty line.

Unsurprisingly all of this has taken a heavy toll on people's mental health. Scant insurance coverage for psychiatric treatment as well as the lack of cheap and accessible support services has exacerbated the situation further for those in need of help.

“The exodus of doctors, the crisis of services and the medication shortages add to long-standing challenges such as stigma,” Joseph El Khoury, president of the Lebanese Psychiatric Society, said in a tweet last December.

There are fewer than 100 psychiatrists registered in Lebanon, a 2021 survey by the Lebanese Psychiatric Society showed. Among those practising and training in the country, the majority — 94 per cent — believe the state of mental health care in Lebanon is worse than before the pandemic, the survey found.

Many psychiatrists are leaving Lebanon because of instability, low income, few career opportunities or better clinical experiences abroad, according to the study.

Siira, which began operations in January 2022, has seen demand increase for its mental well-being services.

“People are thirsty for getting together and talking and knowing they’re not alone in their struggles,” Ms Salame says.

“It's an outlet for people to deal with these stressors that are affecting all aspects of life. The economic crisis will affect your mood, health, the way you function or live your life — there’s a lot of uncertainty and that comes up in the sessions.”

Ms Salame, a tech executive, was inspired to start the initiative after confronting her own “personal crisis” two years ago and seeking out therapy.

Expensive treatment, a scarcity of qualified therapists in the region and difficulty in verifying practitioners' credentials led her to start Siira.

“It was an eye-opening experience,” she says. “The shame and stigma are so high that you think you're alone in this but everybody struggles with life issues and not a lot of people talk about it — you're supposed to look like you have it together all the time.”

As part of the group sessions, Siira organises discussions and workshops on topics such as dealing with parental guilt, student problems, art therapy and support for teachers. It also provides educational content co-created and validated by mental health experts, Ms Salame says.

Target clients are Arabic-speakers aged between 18 and 50 who have access to social media and Zoom.

Electricity cuts and patchy internet connectivity can make it difficult for some to join the support meetings.

“It's heartbreaking when people cancel because the infrastructure is overstretched,” Ms Salame says. “We repeat sessions but we never record them and this makes people comfortable because it's private.”

Users can join Zoom meetings by audio, video or chat, with attendance capped at 15 people to create a sense of trust, she says.

Still in the pilot stage, Siira's business model will offer users subscription to the platform on a yearly, monthly or pay-per-event basis. It will also focus on the B2B market, where businesses can offer the service to their employees and customers, sponsor the workshops or pay for advertisements within the educational content.

The initiative is backed by social enterprise C3's Idea (Inclusion, Diversity, Equity and Access) accelerator through a programme that offers entrepreneurs advice from business experts, access to a network of investors and exposure at Expo 2020.

Session prices will be set as low as $5 per month so as to “democratise” access to mental health services, says Ms Salame. Corporate rates will differ depending on the negotiations.

“The pandemic, like all stressors, is an accelerator: if we feel bad, we feel worse. So, it has shed light on our need for connection. We’re becoming a very individualistic society, people are living in silos, with no time to connect and create this social fabric,” Ms Salame says. “This is a way to draw people together, even if they are strangers. You feel you're not alone and recreate this community concept.”

Ms Salame's next priority is to monetise the initiative and she is seeking investors, grants and funds to finance her plans, including the launch of a mobile app.

The start-up aims to serve at least 2,000 customers by the end of 2022 in markets within Lebanon, the UAE, Saudi Arabia and Egypt, she says.

“Siira”, loosely translated from Arabic, means “life journey” and aims to help people build healthier relationships and overcome personal crises, Ms Salame said.

“We're inviting people not to go on their life journey alone, let's be together in each of our life journeys and to go on a journey inward,” she adds.

Company Profile

Name: Siira

Founder: Sandra Salame

Founding date: January 2022

Based in: Lebanon

Sector: HealthTech

Size: 12 collaborators

Investment stage: Seeking investors

Investors: Self-funded

Q&A with Siira founder Sandra Salame:

1. What is your next big dream?

To make Siira the go-to platform for people who want to connect, learn and network with others and discuss their mental well-being, relationships and emotional life.

2. What new skills have you learnt in the process of launching your start-up?

The importance of building the right team who will make this dream a reality and a solid supporting ecosystem; accepting failure and seeing it as an opportunity to transform rather than an obstacle; and gearing up to ask the right questions and being open to divergent views.

3. How has the Covid-19 pandemic and Lebanon's economic crisis affected your business?

Both crises have affected internal and external aspects of our initiative. On the internal front, our resilience as a team increased in that we continue to offer our services despite all the hardships and instability. On the external front, we witnessed an increase in the demand for our services. During tough times, people seek connection, they want to share their struggles and look for guidance to navigate this crisis with the least damage possible. Just by having meaningful conversations or listening to others, people can start to heal.

4. How important are mental well-being services during the pandemic?

The pandemic, like all stressors, is an accelerator. It pushes us to question our choices and to reflect on our issues, wants and dreams. It can worsen our already precarious mental state or it can liberate us. In all cases, stressors instigate change and shove the fragility of life in our face. Having the right support system, awareness and taking care of our mental health becomes of essence during these stressful times.

5. Where do you see your business in five years?

A sustainable, impactful and continuously innovating business. Hopefully, Siira will keep reminding us to harness the power of the collective for a better quality of life.