Mental health in Palestine

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The mental health of Palestinians has been described as among the worst in the world Flag of Palestine.svg
The mental health of Palestinians has been described as among the worst in the world

The mental health of Palestinians has been described as among the worst in the world, [1] with over half of Palestinian adults meeting the diagnostic threshold for depression [2] and a significant portion of Palestinian children experiencing mental distress, particularly in Gaza. [3] This high prevalence of mental distress among the Palestinian population has been attributed to the intersection of a number of factors, including exposure to conflict, poor living conditions and restrictions on movement. [4]

Contents

Demographics

2022 Palestinians' Psychological Conditions Survey (PPCS)

In 2022, a study was conducted by the World Bank Group, in collaboration with the Palestinian Central Bureau of Statistics, International Security and Development Center, and Zentrum Überleben, which aimed to understand the intersection of various factors which contribute to poor mental health among Palestinians. This has been described as the first nationally representative survey on this topic. [4] The study was conducted on a representative sample of 5,876 Palestinian adults from Gaza and the West Bank, who were assessed using a number of questionnaires. [5]

Depression

58% of the participants met the diagnostic threshold for depression. Among participants from Gaza, 71% met the criteria for depression, while the prevalence was 50% for participants from the West Bank, [6] which is roughly 10 times higher than the global average. [7] The severity of depression symptoms did not differ significantly between men and women. The prevalence of depression was strongly associated with perceived poverty. [8]

A 2022 study conducted by Save the Children among children in Gaza found that 55% of the children in their study experienced suicidal ideation. Photos taken in Hai Al-Zaytoun on 25th January - 3235324924.jpg
A 2022 study conducted by Save the Children among children in Gaza found that 55% of the children in their study experienced suicidal ideation.

Post-traumatic stress disorder

7% of the participants met the diagnostic criteria for PTSD, with little difference in prevalence reported between participants from Gaza and the West Bank. [9] While this figure is lower than the prevalence obtained by previous studies, this has been attributed to previous studies conducting research in the immediate aftermath of a crisis.

2022 Save the Children report

In 2022, Save the Children released a report titled "Trapped", which involved interviewing 488 children and 160 parents and caregivers to assess the impact which the blockade of the Gaza Strip has had on the children's mental health. [3] 80% of the children reported experiencing emotional distress, 59% reported engaging in self-harm and 55% reported experiencing suicidal ideation. [3]

Israel–Hamas war

Weeks of continuous air strikes and explosions have contributed to the psychological destruction of children in Gaza. Following 16 days of bombardment, children developed severe trauma, with symptoms including convulsion, aggression, bed-wetting, and nervousness. 90% of children in pediatric hospitals in Gaza exhibited or reported symptoms of anxiety, the majority exhibited post-traumatic stress symptoms, and 82% reported fears of imminent death. [10] [11] On 6 November, UNICEF spokesman Toby Fricker warned of the psychological impacts and "massive stress" experienced by children in Gaza. [12] On 17 November, WHO chief Tedros Adhanom Ghebreyesus stated 20,000 people were in need of specialized mental health services. [13] On 9 January 2024, OCHA reported 485,000 people with mental health issues were experiencing care disruption. [14] In March 2024, a U.S. doctor stated it appeared the Israeli military "purposely bomb by night for the psychological effect on people". [15]

Mental health services

Building Palestinian Resilience project

In 2016, the World Health Organization (WHO), along with the Palestinian Ministry of Health, initiated the Building Palestinian Resilience project, which involved integrating mental health into primary and secondary care, and strengthening coordination and mental health emergency preparedness. [16] The project was funded by the European Union (EU). Almost 1,600 people were trained on the full range of mental health and psychosocial support services. [16] The project came to an end in 2019. [16]

Related Research Articles

A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is also characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior, often in a social context. Such disturbances may occur as single episodes, may be persistent, or may be relapsing–remitting. There are many different types of mental disorders, with signs and symptoms that vary widely between specific disorders. A mental disorder is one aspect of mental health.

Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Postpartum depression</span> Mood disorder experienced after childbirth

Postpartum depression (PPD), also called postnatal depression, is a mood disorder experienced after childbirth, which can affect men and women. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns. PPD can also negatively affect the newborn child.

<span class="mw-page-title-main">Hoarding disorder</span> Behavioral pattern

Hoarding disorder (HD) or Plyushkin's disorder, is a mental disorder characterised by persistent difficulty in parting with possessions and engaging in excessive acquisition of items that are not needed or for which no space is available. This results in severely cluttered living spaces, distress, and impairment in personal, family, social, educational, occupational, or other important areas of functioning. Excessive acquisition is characterized by repetitive urges or behaviours related to amassing or buying property. Difficulty discarding possessions is characterized by a perceived need to save items and distress associated with discarding them. Accumulation of possessions results in living spaces becoming cluttered to the point that their use or safety is compromised. It is recognised by the eleventh revision of the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

Psychopathology is the study of mental illness. It includes the signs and symptoms of all mental disorders. The field includes abnormal cognition, maladaptive behavior, and experiences which differ according to social norms. This discipline is an in-depth look into symptoms, behaviors, causes, course, development, categorization, treatments, strategies, and more.

Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. It must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se. Examples include violence, rape, or a terrorist attack.

<span class="mw-page-title-main">Depression (mood)</span> State of low mood and aversion to activity

Depression is a mental state of low mood and aversion to activity. It affects more than 280 million people of all ages. Depression affects a person's thoughts, behavior, feelings, and sense of well-being. Depressed people often experience loss of motivation or interest in, or reduced pleasure or joy from, experiences that would normally bring them pleasure or joy.

Adjustment disorder is a maladaptive response to a psychosocial stressor. It is classified as a mental disorder. The maladaptive response usually involves otherwise normal emotional and behavioral reactions that manifest more intensely than usual, causing marked distress, preoccupation with the stressor and its consequences, and functional impairment.

Dissociative disorders (DDs) are a range of conditions characterized by significant disruptions or fragmentation "in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior." Dissociative disorders involve involuntary dissociation as an unconscious defense mechanism, wherein the individual with a dissociative disorder experiences separation in these areas as a means to protect against traumatic stress. Some dissociative disorders are caused by major psychological trauma, though the onset of depersonalization-derealization disorder may be preceded by less severe stress, by the influence of psychoactive substances, or occur without any discernible trigger.

<span class="mw-page-title-main">Mental distress</span> Symptoms and experiences that are troubling, confusing, or unusual

Mental distress or psychological distress encompasses the symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. Mental distress can potentially lead to a change of behavior, affect a person's emotions in a negative way, and affect their relationships with the people around them.

<span class="mw-page-title-main">DSM-5</span> 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In 2022, a revised version (DSM-5-TR) was published. In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has practical importance. However, not all providers rely on the DSM-5 for planning treatment as the ICD's mental disorder diagnoses are used around the world and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions. The DSM-5 is the only DSM to use an Arabic numeral instead of a Roman numeral in its title, as well as the only living document version of a DSM.

Mixed anxiety–depressive disorder (MADD) is a diagnostic category that defines patients who have both anxiety and depressive symptoms of limited and equal intensity accompanied by at least some autonomic nervous system features. Autonomic features are involuntary physical symptoms usually caused by an overactive nervous system, such as panic attacks or intestinal distress. The World Health Organization's ICD-10 describes Mixed anxiety and depressive disorder: "...when symptoms of anxiety and depression are both present, but neither is clearly predominant, and neither type of symptom is present to the extent that justifies a diagnosis if considered separately. When both anxiety and depressive symptoms are present and severe enough to justify individual diagnoses, both diagnoses should be recorded and this category should not be used."

<span class="mw-page-title-main">Healthcare in the State of Palestine</span>

Healthcare in the State of Palestine refers to the governmental and private healthcare providers to which residents in the claimed territory have access. Since 1967, there have been improvements in the access to healthcare and the overall general health conditions for residents. Advances in training, increased access to state-of-the-art medical technology, and various governmental provisions have allowed per-capita funding to increase, and therefore the overall health of residents in the region to increase. Additionally, the enhanced access to and funding from international organizations like the World Health Organization, the United Nations, the Palestinian Ministry of Health, and the World Bank Education and Health Rehabilitation Project have contributed to the current state of affairs within the healthcare segment of the Palestinian territories.

Health in the State of Palestine should be addressed by the healthcare system in the State of Palestine. There are problems arising from difficulty of access, water scarcity while burden of non-communicable diseases in Palestine is high; the problems are compounded in Gaza.

Early childhood trauma refers to various types of adversity and traumatic events experienced during the early years of a person's life. This is deemed the most critical developmental period in human life by psychologists. A critical period refers to a sensitive time during the early years of childhood in which children may be more vulnerable to be affected by environmental stimulation. These traumatic events can include serious illness, natural disasters, family violence, sudden separation from a family member, being the victim of abuse, or suffering the loss of a loved one. Traumatic experiences in early childhood can result in severe consequences throughout adulthood, for instance developing post-traumatic stress disorder, depression, or anxiety. The effects of this trauma can be experienced very differently depending on factors such as how long the trauma was, how severe and even the age of the child when it occurred. Negative childhood experiences can have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. However, not all children who are exposed to negative stimuli in early childhood will be affected severely in later life; some children come out unscathed after being faced with traumatic events, which is known as resilience. Many factors can account for the invulnerability displayed by certain children in response to adverse social conditions: gender, vulnerability, social support systems, and innate character traits. Much of the research in this area has referred to the Adverse Childhood Experiences Study (ACE) study. The ACE study found several protective factors against developing mental health disorders, including mother-child relations, parental health, and community support. However, having adverse childhood experiences creates long-lasting impacts on psychosocial functioning, such as a heightened awareness of environmental threats, feelings of loneliness, and cognitive deficits. Individuals with ACEs are more prone to developing severe symptoms than individuals in the same diagnostic category.

<span class="mw-page-title-main">Children in emergencies and conflicts</span>

Conflicts and emergencies around the world pose detrimental risks to the health, safety, and well-being of children. There are many different kinds of conflicts and emergencies, for example, violence, armed conflicts, war, and natural disasters. Some 13 million children are displaced by armed conflicts and violence around the world. Where violent conflicts are the norm, the lives of young children are significantly disrupted and their families have great difficulty in offering the sensitive and consistent care that young children need for their healthy development. One impact is the high rates of PTSD seen in children living with natural disasters or chronic conflict.

<span class="mw-page-title-main">Mental health during the COVID-19 pandemic</span> Psychological aspect of viral outbreak

The COVID-19 pandemic has impacted the mental health of people across the globe. The pandemic has caused widespread anxiety, depression, and post-traumatic stress disorder symptoms. According to the UN health agency WHO, in the first year of the COVID-19 pandemic, prevalence of common mental health conditions, such as depression and anxiety, went up by more than 25 percent. The pandemic has damaged social relationships, trust in institutions and in other people, has caused changes in work and income, and has imposed a substantial burden of anxiety and worry on the population. Women and young people face the greatest risk of depression and anxiety. According to The Centers for Disease Control and Prevention study of Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic, "63 percent of young people reported experiencing substantial symptoms of anxiety and depression".

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on neurological, psychological and other mental health outcomes</span>

There is increasing evidence suggesting that COVID-19 causes both acute and chronic neurologicalor psychological symptoms. Caregivers of COVID-19 patients also show a higher than average prevalence of mental health concerns. These symptoms result from multiple different factors.

Kufungisisa is a culture bound syndrome prevalent in Zimbabwe similar to anxiety disorders and depression.

References

  1. Hoyle, Charlie (12 May 2017). "Mental health in Palestine among world's worst". The New Arab. Archived from the original on 15 May 2024. Retrieved 2 July 2023.
  2. World Bank 2022, p. 7.
  3. 1 2 3 4 "Trapped: The impact of 15 years of blockade on the mental health of Gaza's children". Save the Children. 15 June 2022. Archived from the original on 15 May 2024. Retrieved 2 July 2023.
  4. 1 2 Aghajanian, Alia; Finn, Arden; Mohammad, Nadir (14 June 2023). "The intersection of economic conditions, trauma and mental health in the West Bank and Gaza". World Bank Blogs. Archived from the original on 15 May 2024. Retrieved 2 July 2023.
  5. World Bank 2022, p. 1.
  6. World Bank 2022, p. 28.
  7. Hendricks, Kern (2024-07-03). "Young Palestinians Face a Steep Toll on Mental Health". Undark Magazine . Archived from the original on 2024-07-04. Retrieved 2024-07-04.
  8. World Bank 2022, p. 8.
  9. World Bank 2022, p. 29.
  10. "Bedwetting, nightmares and shaking. War in Gaza takes a mental health toll, especially on children". AP News . 18 July 2024. Archived from the original on 24 July 2024. Retrieved 19 July 2024.
  11. "Children in Gaza 'developing severe trauma' after 16 days of bombing". The Guardian . 15 October 2023. Archived from the original on 22 October 2023. Retrieved 10 November 2023.
  12. "'Massive stress' on Gaza children struggling to cope with attacks". Al Jazeera . Archived from the original on 15 December 2023. Retrieved 6 November 2023.
  13. "WHO Director-General's remarks at the Informal Plenary Meeting of the United Nations General Assembly – 17 November 2023". World Health Organization . Archived from the original on 17 November 2023. Retrieved 17 November 2023.
  14. "Hostilities in the Gaza Strip and Israel Flash Update #88". ReliefWeb . UNOCHA. 10 January 2024. Archived from the original on 1 March 2024. Retrieved 10 January 2024.
  15. "Israelis 'purposely bomb by night for psychological effect': Doctor". Al Jazeera . Archived from the original on 16 March 2024. Retrieved 16 March 2024.
  16. 1 2 3 "The closing ceremony of the mental health project in the occupied Palestinian territory". World Health Organization - Regional Office for the Eastern Mediterranean. Archived from the original on 2023-07-02. Retrieved 2023-07-02.

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