Mental health in Palestine

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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. [4] 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. [6] Among participants from the Gaza, 71% met the criteria for depression, while the prevalence was 50% for participants from the West Bank. [6] The severity of depression symptoms did not differ significantly between men and women. [7] The prevalence of depression was strongly associated with perceived poverty. [7]

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. [8] 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]

2023 Israel–Hamas war

Weeks of sustained 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. [9] On 6 November, UNICEF spokesman Toby Fricker warned of the psychological impacts and "massive stress" experienced by children in Gaza. [10]

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. [11] 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. [11] The project came to an end in 2019. [11]

Related Research Articles

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 type of mood disorder experienced after childbirth, which can affect both sexes. 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.

Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences, such as experiencing violence, rape, or a terrorist attack. The event 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.

<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. Depressed mood is a symptom of some mood disorders such as major depressive disorder and dysthymia; it is a normal temporary reaction to life events, such as the loss of a loved one; and it is also a symptom of some physical diseases and a side effect of some drugs and medical treatments. It may feature sadness, difficulty in thinking and concentration and a significant increase or decrease in appetite and time spent sleeping. People experiencing depression may have feelings of dejection or hopelessness and may experience suicidal thoughts. It can either be short term or long term.

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 (DD) are conditions that involve disruptions or breakdowns of memory, awareness, identity, or perception. People with dissociative disorders use dissociation as a defense mechanism, pathologically and involuntarily. The individual experiences these dissociations to protect themselves. Some dissociative disorders are triggered by psychological trauma, but depersonalization-derealization disorder may be preceded only by stress, psychoactive substances, or no identifiable trigger at all.

Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder. There are no marked gender differences in the diagnosis rates of disorders like schizophrenia and bipolar disorder. Men are at risk to suffer from post-traumatic stress disorder (PTSD) due to past violent experiences such as accidents, wars and witnessing death, and women are diagnosed with PTSD at higher rates due to experiences with sexual assault, rape and child sexual abuse. Nonbinary or genderqueer identification describes people who do not identify as either male or female. People who identify as nonbinary or gender queer show increased risk for depression, anxiety and post-traumatic stress disorder. People who identify as transgender demonstrate increased risk for depression, anxiety, and post-traumatic stress disorder.

<span class="mw-page-title-main">Military sexual trauma</span> U.S. legal term for sexual assault or harassment during military service

As defined by the United States Department of Veterans Affairs, military sexual trauma (MST) are experiences of sexual assault, or repeated threatening sexual harassment that occurred while a person was in the United States Armed Forces.

Incident stress is a condition caused by acute stress which overwhelms a staff person trained to deal with critical incidents such as within the line of duty for first responders, EMTs, and other similar personnel. If not recognized and treated at onset, incident stress can lead to more serious effects of posttraumatic stress disorder.

<span class="mw-page-title-main">Health in South Africa</span>

Health in South Africa touches on various aspects of health including the infectious diseases, Nutrition, Mental Health and Maternal care.

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. However, while many efforts at enhancing the state of health affairs within the Palestinian territories have shown improvement, there are still efforts to be made. Continued efforts to recognize and address the geopolitical barriers will be necessary in order to continue to have significant success in this field. Finally, addressing demographic trends within the region, like differing pregnancy rates and mortality rates, will be necessary to enhance the state of health affairs that the Palestinian territories face. This article addresses each of these issues in more explanatory detail, giving an overview of the major legal and ethical developments in healthcare within the Palestinian territories, and discussing further obstacles that the region faces due to infrastructural and political barriers.

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.

Culture defines how people view the world and certain phenomena. Culture also appears to influence the way people experience depression. An individual's experience with depression can vary from country to country. For example, a qualitative study revealed that some countries did not recognize post-natal depression as an illness; rather, it was viewed as a state of unhappiness that did not require any health interventions.

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 sickness, 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. 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.

Adverse childhood experiences (ACEs) include childhood emotional, physical, or sexual abuse and household dysfunction during childhood. The categories are verbal abuse, physical abuse, contact sexual abuse, a battered mother, household substance abuse, household mental illness, incarcerated household members, and parental separation or divorce. The experiences chosen were based upon prior research that has shown to them to have significant negative health or social implications, and for which substantial efforts are being made in the public and private sector to reduce their frequency of occurrence. Scientific evidence is mounting that such adverse childhood experiences (ACEs) have a profound long-term effect on health. Research shows that exposure to abuse and to serious forms of family dysfunction in the childhood family environment are likely to activate the stress response, thus potentially disrupting the developing nervous, immune, and metabolic systems of children. ACEs are associated with lifelong physical and mental health problems that emerge in adolescence and persist into adulthood, including cardiovascular disease, chronic obstructive pulmonary disease, autoimmune diseases, substance abuse, and depression.

<span class="mw-page-title-main">Trauma and first responders</span> Trauma experienced by first responders

Trauma in first responders refers to the psychological trauma experienced by first responders, such as police officers, firefighters, and paramedics, often as a result of events experienced in their line of work. The nature of a first responder's occupation continuously puts them in harm's way and regularly exposes them to traumatic situations, such as people who have been harmed, injured, or killed.

<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.

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

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.

Hispanic immigrants living in the United States have been found to have higher levels of exposure to trauma and lower mental health service utilization than the general population. Those who met the criteria for asylum and experience trauma before migrating are vulnerable to post-traumatic stress disorder (PTSD) symptoms. Higher levels of trauma-related symptoms are associated with increased post-migration living difficulties. Despite the need for mental health services for Hispanic immigrants living in the United States, cultural and structural barriers make accessing treatment challenging.

References

  1. Hoyle, Charlie (12 May 2017). "Mental health in Palestine among world's worst". The New Arab.
  2. "Mental Health in the West Bank and Gaza" (PDF). World Bank. 22 November 2022. p. 7.
  3. 1 2 3 "Trapped: The impact of 15 years of blockade on the mental health of Gaza's children". Save the Children. 15 June 2022.
  4. 1 2 3 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.
  5. "Mental Health in the West Bank and Gaza" (PDF). World Bank. 22 November 2022. p. 1.
  6. 1 2 "Mental Health in the West Bank and Gaza" (PDF). World Bank. 22 November 2022. p. 28.
  7. 1 2 "Mental Health in the West Bank and Gaza" (PDF). World Bank. 22 November 2022. p. 8.
  8. "Mental Health in the West Bank and Gaza" (PDF). World Bank. 22 November 2022. p. 29.
  9. "Children in Gaza 'developing severe trauma' after 16 days of bombing". The Guardian . 15 October 2023.
  10. "'Massive stress' on Gaza children struggling to cope with attacks". Al Jazeera . Retrieved 6 November 2023.
  11. 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. Retrieved 2023-07-02.