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Mental Health in Palestine: The Hidden Plague

Mental Health in Palestine
Palestinian refugees and citizens in the Occupied Territories are exposed to a great amount of violence and terror as a result of the Israeli occupation. This exposure has increased the prevalence of mental health disorders such as PTSD, insomnia and even schizophrenia. This article will provide some insight into the mental health issues that are prevalent among Palestinians, the healthcare system and the possible solutions to help facilitate a better mental health response.

The Conditions 

Palestinians in the Occupied Territories live in a very volatile and unstable region. Recently, there has been an increase in the awareness of the effects that living through decades of continuous political aggression and violence have on mental health. Mental health disorders amount to one of the largest – but the least acknowledged – health problems in Occupied Palestine. Almost a third of Palestinians are in dire need of mental health interventions. However, mental health services in Occupied Palestine are amidst the most under-resourced fields of healthcare provision.

Palestinians have experienced a series of traumatic events that range from imprisonment and torture to unemployment, house demolitions and land confiscation. All these experiences foster an environment of continuous instability, stress, uncertainty and anxiety, which can dangerously affect mental health. 

Mental health is a concern for both adults and children in the Occupied Territories. Adults who are exposed to house demolitions exhibit a higher level of anxiety, depression and paranoia. However, the psychological effects of the conditions in Occupied Palestine are especially traumatizing for children. Many injured children have developed severe psychological impairments. The prevalence of behavioral issues and psychopathic symptoms among children is incredibly high. About 32.7% of children in the Gaza Strip suffer from severe levels of PTSD, 49% of children suffer through moderate levels of PTSD and 16% of children suffer from low levels of PTSD.

The Healthcare System

As of now, mental health services in the West Bank and East Jerusalem are provided by both the government and the non-governmental sector. General services are provided by the Ministry of Health but the majority of the system is operated under and funded by humanitarian organizations like UNRWA. There are only 13 community mental health clinics in the West Bank, and one psychiatric hospital in Bethlehem. In 2013, the clinics with outpatient facilities treated over 2400 patients. Of the 2,400 patients, 24.2% were diagnosed with neurotic disorders (PTSD, generalized anxiety disorder and clinical depression) and 12.2 % were diagnosed with schizophrenia. 

Generally, mental health services in Gaza and the West Bank are difficult to come by and inconsistent in quality. There is no legislation that addresses mental health and no budget allocated by the Ministry of Health. The region does not have mental health policies or an overview plan to address ongoing care and services for the severely mentally ill and those directly affected by trauma and loss. 

What Needs to Be Done 

The healthcare system in Palestine relies heavily on humanitarian aid and assistance. However, this funding and aid could easily be subjected to budget cuts from countries like the United States. Currently, the Ministry of Health does not allocate any funds to mental health services.

To effectively address mental health in Palestine, the government must create a fund for mental health services. The government should also promote legislation that addresses mental health. This legislation could include the protection of employment rights for those mentally ill, the integration of mental illness within the education system as well as civil legislation to address the rights to vote or own property.

It is also important for the Ministry of Health and NGOs to work together to create a comprehensive plan that addresses mental health. In collaboration, these organizations can acquire more hospital beds and help hospitals accommodate a greater number of patients. If mental health is made a priority, it can be effectively addressed in the coming years.

– Nada Abuasi
Photo: Flickr

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Poverty and PTSD

Poverty and PTSDCommonly associated with combat veterans, Post-traumatic stress disorder (PTSD) impacts more of the global population than maybe expected. Recent studies have found a link between poverty and PTSD that reveals that socioeconomic status contributes to the majority of anxiety disorders.

How Poverty Contributes to PTSD

Mental disorders manifest in distinct ways for many people. However, the common underlying origin of Post-traumatic stress syndrome (PTSD) remains a terrifying or traumatic life event. Living in poverty often means surviving daily in vulnerable conditions, and with financial instability that limits access to necessities such as food, shelter and water. The inability to pay for expenses starts to become emotionally and mentally taxing. Poverty acts as a traumatic experience in many people’s lives and even after graduating in class status, difficulty persists to enjoy day to day life.

Symptoms of PTSD can appear within months of the traumatic event and include:

  • Avoiding: Detaching from the traumatic event by avoiding triggers such as places, situations or people.
  • Reliving: Flashbacks and nightmares due to memories that force reliving the traumatic experience.
  • Increased Arousal: An increased blood pressure or heart rate accompanied by outbursts of anger and difficulties sleeping

Some people with PTSD may exhibit all these symptoms, while others exhibit just a few. The severity of PTSD also varies from person to person. PTSD can be broken down into subtypes such as:

  • Delayed on-set PTSD: This variation refers to when symptoms of the disorder develop many years after the traumatic event.
  • Complex PTSD: This type of PTSD usually surfaces after ongoing childhood physical or sexual abuse.
  • Birth Trauma: This type occurs after traumatic childbirth.

Women with PTSD

Research estimates that 284 million people globally suffer from anxiety disorders such as PTSD. About 63 percent of people that suffer from anxiety disorders are women. In addition, women living in poverty tend to face PTSD at higher levels than any other group within the general population. The relationship between poverty and PTSD embodies that of the domino effect. Poor women’s PTSD symptoms often worsen due to the fact that living in impoverished neighborhoods risk ongoing exposure to triggers of the traumatic incident. A study undertaken by the Social Cognitive Theory also reveals that most of the women living in poverty with PTSD share a history of domestic violence and lack social support.

Treatments

It can feel nearly impossible to live a normal life with PTSD. Luckily, effective treatments exist that minimize the symptoms of the disorder. One of the best treatments for PTSD is Psychotherapy. Psychotherapy allows PTSD victims to talk about their cognitive behavioral process to a mental health professional to reduce and change reactions to triggers. Another important tool for managing PTSD is having a strong support system. The help of friends and family means everything during a mental health crisis. A support system of others that have suffered from PTSD also helps signify that a person is not alone in the experiences of the mental disorder. There are also organizations such as the PTSD Alliance, who work to educate and empower people with PTSD psychologically, economically and emotionally to thrive beyond environmental barriers. The organization currently has five international partners that provide programs to help improve the lives of those living in poverty with PTSD.

Overall, poverty and PTSD remain two prominent issues impacting people on a global scale. The connection between poverty and PTSD only further emphasizes that the more work that is done to reduce global poverty also diminishes the mental health crisis.

– Nia Coleman
Photo: Wikimedia