Search

The authors describe community mental health in Palestine from several vantage points: Palestine's historical and current context of military/political violence under Israeli occupation, its health care system and system of mental health care, and the status of its mental health staffing and training. Vignettes illustrate characteristic challenges and opportunities for Palestine within the domain of mental health. The roles of cognitive behavioral therapy and psychoanalytic thinking are discussed in terms of current practice, with an eye toward policy planning for a fully integrated model of health care delivery. The authors argue that the values of justice, freedom, and human rights are fundamental to well‐being, and that the theory and practice of community mental health must support active resistance to violation of these principles. [ABSTRACT FROM AUTHOR]

The current study aimed to test whether social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideation among Palestinians. The study sample consisted of 520 Palestinian adults selected using online tools. The findings of the study revealed that posttraumatic stress symptoms positively correlated with suicidal ideations (r = .32, p < .01), and negatively correlated with social support (r = −.34, p < .01), spirituality (r = −.16, p < .05) and mindfulness (r = −.72, p < .01), whereas suicidal ideations negatively correlated with social support (r = −.46, p < .01), spirituality(r = −.27, p < .01) and mindfulness (r = −.72, p < .01). Results of the path analysis showed that social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideations. Developing intervention programs to enhance social support, mindfulness and spirituality to mitigate the effect of ongoing traumatic experiences among Palestinians is crucial to reducing suicidal ideations. Further studies are also recommended to investigate the role of potentially protective factors that may reduce suicidal ideations and appropriate techniques to deal effectively with traumatic and stressful events. [ABSTRACT FROM AUTHOR]

This article examines the social and political determinants of the Israeli occupation in Palestine and how these create specific vulnerabilities for women. Although marginalized, women have always been active in the resistance to the Israeli occupation, despite being specifically targeted. Depoliticization processes by international organizations have further weakened their efforts for social change. To confront this marginalization, the article highlights the different ways that women resist structural discrimination and develop agency and resilience by defying gendered dimensions in regard to the occupation and structures of patriarchy. [ABSTRACT FROM AUTHOR]

This article reports on suicide and suicidal behaviour in Palestine and sets this in the context of political violence related to the Israeli occupation. Accurate data about suicide and attempted suicide are limited and as such a range of studies including those concerned with the wider Middle East and North Africa region are used here to describe the context for suicide. The article indicates some of the individual and societal risk factors associated with suicide in Palestine and reflects on the role of Islam and religious leaders in tackling the stigma associated with suicide. It describes current mental health services for those who may attempt to take their own life and then outlines the steps that the Ministry of Health is taking to develop a national plan in suicide prevention. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has laid bare the devastating and disproportionate effects of structures of violence that produce vulnerability in communities of color globally, including with respect to mental health-care provision. While coping and resilience are dominant mainstream frameworks to understand mental health in crisis--both in Palestine and elsewhere--the three contributors to this roundtable were asked to offer a rejoinder to that approach. They reflect on the pandemic as an opportunity to revisit how we understand and advocate for critical approaches to mental health in Palestine in the midst of prolonged crisis. [ABSTRACT FROM AUTHOR]

The authors report on episodes in which five professional mental health organizations—for the most part associations for psychoanalysis and psychoanalytically oriented psychotherapy—have covertly tried to silence members who bring attention to the issue of human rights abuses inflicted by the Israeli occupation of Palestine. These various vignettes illustrate how the leadership of these organizations systematically attempts to limit the activism of their members, even in their "free time," and to forbid the introduction of discussion of Israel/Palestine into their newsletters, meetings, chatrooms, and other organizational venues—despite the fact that these organizations profess their commitment to exploring themes of social justice and to the principle of open dialogue. Implications and recommendations are discussed, particularly the practical need for transparency on the part of our organizations and the intellectual need for a more complete theoretical understanding of the roles of history, ideology, and collective meaning within mental life. [ABSTRACT FROM AUTHOR]

Mental health is a key component of health, yet appropriate care is limited. Evidence concerning child and adolescent mental health has predominantly come from western countries, while the Middle East region, with a large youth population, has reported very little on it. This original, cross-sectional study of child and adolescent psychiatry in the Middle East provides an assessment of current postgraduate programs, services and what is needed to build workforce capacity. Academic psychiatrists from 16 Middle East countries were invited to form a Consortium to map current postgraduate training as one of the determinants of available child and adolescent psychiatry services, identify gaps in the distribution of child and adolescent psychiatrists, and propose potential steps to improve access to child and adolescent mental health care. The study collected data from 15 of the 16 countries invited (no data provided from Yemen). The study revealed underdeveloped child and adolescent psychiatry academic systems throughout the region. Despite recognition of the specialty in a majority of the countries (11/15), only six countries had established a designated child and adolescent psychiatry training program. The overall shortage of child and adolescent mental health specialists varied, yet all Consortium members reported a need for additional child and adolescent psychiatry specialists and allied professionals. Lack of child and adolescent psychiatry specialized programs in place throughout the region has evidently contributed to the shortage of qualified child and adolescent mental health workforce in the Middle East. [ABSTRACT FROM AUTHOR]

Samah Jabr, psychiatre psychothérapeute palestinienne, dirige l'unité ministérielle de santé mentale en Cisjordanie occupée. Cette contribution vise à mieux faire connaître ses travaux ainsi que la question de la santé mentale en Palestine au lectorat francophone intéressé par les liens entre psychiatrie, guerre et occupation coloniale. Cet article a été conçu à partir de la retranscription d'un entretien réalisé avec Samah Jabr en janvier 2018 au laboratoire UTRPP de l'Université Paris 13-Sorbonne Paris Cité. Travailler au sein d'une nation occupée amène à développer des politiques de santé mentale et des outils cliniques spécifiques. Après un aperçu de sa formation entre Jérusalem, Bethléem, Paris et Londres, cet entretien rend compte du travail institutionnel de S. Jabr qui consiste, d'une part, à développer des services de santé mentale dans les Territoires Occupés, et, d'autre part, à disséminer le soin et l'implanter dans la communauté. Les perspectives clinico-théoriques élaborées par S. Jabr y sont également dépliées : elles s'organisent autour d'une différenciation qualitative entre la démoralisation, c'est-à-dire la souffrance psychosociale et la psychopathologie. Cet entretien interroge la pratique clinique et politique de l'auteure, dont les travaux se situent dans la lignée du psychiatre Frantz Fanon. C'est à travers une approche holistique que seront discutées des prises en charges de jeunes adolescents post-détention, ou de patients manifestant une symptomatologie réactionnelle à la torture ; les effets de l'humiliation à motivation politique ; ou encore, les difficultés du contre-transfert face au mécanisme de l'identification à l'agresseur. L'article se clôt sur les ressources favorisant la résilience de la société palestinienne. Samah Jabr is a Palestinian psychiatrist and psychotherapist, and the current head of the ministerial Mental Health Unit in the occupied West Bank. This article aims to make her work and the question of mental health in Palestine better known to the French-speaking readership interested in the links between psychiatry, war and colonial occupation. The present article is based on the transcript of an interview with Samah Jabr, conducted in January 2018 at the Psychology Department in Paris 13-Sorbonne Paris-Cité University. Practicing within an occupied nation requires the development of specific mental health policies and clinical tools. After an overview of her training, from Jerusalem to Bethlehem, Paris and London, this interview explores S. Jabr's institutional work, which has two broad aims: on the one hand, the development of mental health services in the Occupied Territories, and on the other, the dissemination of mental healthcare and its implantation within the Palestinian community. Throughout this interview, S. Jabr's clinical and theoretical perspectives are unfolded, with emphasis on a qualitative differentiation between demoralization, i.e. psychosocial suffering, and psychopathology. This interview explores the clinical and political practice of the author, whose work is in line with the legacy of Fanon. Via a holistic approach, the article broaches the subject of the treatment of adolescents following imprisonment, or of patients with reactive symptoms subsequent to torture; it also reflects on the effects of politically motivated humiliation, as well as on the difficulties of counter-transference when dealing with mechanisms of identification with the aggressor. The article ends with reflections on factors promoting the resilience of Palestinian society. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression (PPD) affects women from different cultures around the world. No previous studies have investigated PPD among women in Palestine. Fertility rates in Palestine are among the highest in the world, hence even low rates of PPD could have considerable national impact. The aim of this study was to determine the prevalence of, and risk factors for, PPD among Palestinian mothers. Methods: 101 mothers were recruited during the registration of their child's birth (within 1 week) at the Bethlehem branch of the Ministry of Interior. Participants were assessed via a face to face interview, and were followed up 1 week, 2 weeks, 6 weeks, 3 months, and 6 months later by telephone interview. Interviews included the Arabic Edinburgh Postnatal Depression Scale (EPDS), with PPD indicated by depressive symptoms (EPDS score =11) at =2 follow-up time points. Pearson's correlation was calculated between repeated EPDS scores, and multivariable logistic regression was used to investigate risk factors for PPD. Results: The prevalence of depressive symptoms was fairly constant (14-19%) over the follow-up period. Most depressive symptoms developed within 1 month of delivery; mothers with depressive symptoms at 3 months postpartum were highly likely to still have symptoms at 6 months. 27.7% (28/101) of women met our criteria for PPD. High parity (odds ratio (OR) 4.52 (95% CI 0.90, 22.8) parity 3+ versus primiparous), unplanned pregnancy (OR 2. 44 (0.99, 6.01)) and sex of child not being the one desired (OR 5.07 (1.12, 22.9)) were associated with PPD, but these associations were attenuated in multivariable analysis. Conclusions: The prevalence of PPD in Palestine appears to be higher than in high income countries, but similar to the prevalence in other Middle Eastern countries. High parity and unplanned pregnancy were identified as risk factors for PPD, suggesting that fully meeting the need for family planning could reduce the incidence of PPD in the Palestinian population. [ABSTRACT FROM AUTHOR]