For the past several months we have observed the catastrophic situation in Palestine worsen day by day. The mental health implications of the ongoing bombardment, displacement and dire living conditions are stark. Evidence of the significant damage being done to people’s mental health is mounting and the impact will be lasting. Last year, the World Health Organisation stated that mental health is a universal human right. The conditions that the Palestinian people are being subjected to are putting their mental health under the greatest pressure.
In Gaza, the prevalence of conditions that foster poor mental health – bombing, violence, poverty, family separation, food and water scarcity, lack of education and lack of secure housing – continue to skyrocket. Palestinians have been living under conditions that Amnesty International and the International Court of Justice have called apartheid for decades, risking their mental health and their hope of recovery from the traumas already inflicted.
Over 39,000 people in Gaza have been killed since October, with thousands more believed to still be buried under rubble. During the current assault on Gaza, more children have been killed than in all conflicts around the world in the previous four years. It has also been the deadliest year on record for Palestinians living in the Israeli-occupied West Bank, where more than 500 Palestinians have been killed.
In a survey conducted in 2020, half of children in Gaza already had post-traumatic stress disorder (PTSD) as a result of traumatic events such as witnessing shelling, having their homes destroyed, or being physically injured. Given the shocking death toll and exposure to violence since October 2023, these figures are likely to be far higher now (Ahmed, 2021). UNICEF reports that at least 17,000 children in Gaza are unaccompanied or separated from their parents, and Save The Children report that more than ten children a day had lost a limb over the course of three months. Our research has highlighted the impact of adverse childhood events on the chances of having poor mental health, and this is a reality for every child in Gaza. UNICEF reports that nearly all children there require mental health support.
The toll that Israel’s actions have been taking on Palestinian adults is also immeasurable. A study conducted by the World Bank in November 2022 found that more than half of the adult Palestinian population screened positive for depression, including 71% of Palestinians in the Gaza Strip and 58% in the Israeli-occupied West Bank.
Medical workers in Palestine have been suffering significant psychological impacts in the current bombardment. Médecins Sans Frontieres (MSF) reports “anxiety, insomnia, depression, intrusive thoughts, emotional avoidance and nightmares, all of which can heighten the risk of mental health issues”. And Amparo Villasmil, an MSF psychologist who worked in Gaza in February and March said, “There isn’t even a safe place in people’s minds. They live in a state of constant alert. They can’t sleep, they think that at any moment they are going to die; that if they fall asleep, they won’t be able to react quickly and run away, or protect their family”.
A UN special rapporteur on the right to health warned of the risk of mental illnesses manifesting as a result of the war on Gaza saying, “acute mental distress that will then turn into anxiety and other kinds of mental illnesses later on in life is really, really important to start thinking intentionally about”.
(Inter)generational trauma is an important part of this picture. Brutal and widespread antisemitic persecution throughout history and the attacks on 7 October have deeply affected Jewish people, with significant mental health impacts. It’s vital that we never forget and never minimize the harm and hurt that these horrors have caused.
The traumatic events that Palestinians have experienced are also multi-generational: this is the latest and most deadly of multiple waves of displacement and killings; entire families have been wiped off the map forever. Holocaust survivor and trauma expert Gabor Maté has vocalised the semblance between his own experience as a child and that of Palestinian children: “Palestinians have been oppressed and suppressed and murdered and controlled and dispossessed for decades. That’s just the truth. There’s no post-traumatic stress disorder here, because the trauma is never post.”
We know that around the world, people are being subjected to traumatic violence and living in conditions that are toxic for mental health. Atrocities are happening in the Democratic Republic of Congo, in Sudan, in Tigray, in Haiti, this violence often stemming from the poverty and instability engendered by ongoing oppression and colonial exploitation. When confronted with these realities, we might be encouraged to look away, and ignore the international failures and global inequality fuelling this suffering.
However, we understand that hierarchies of global attention and care are, in fact, also products of this global inequality and we do not wish to uphold the status quo of these hierarchies through silence. During the current conflict we have witnessed Palestinians being relentlessly dehumanised by politicians and the media, with Islamophobic and Anti-Arab rhetoric used to justify the ongoing attacks, which may amount to genocide. Anti-racist activists and theorists taught us to see our struggles as connected; our freedom impossible to disentangle from someone else’s. We call for those of us in the field of mental health to apply this to our work. Through international solidarity, we turn the individualised view of mental (ill) health on its head. If our struggles are connected, so are our chances of having good mental health.
This is an essential moment to stand with people being subjected to colonial violence and racial apartheid and defend their right to mental health, their right to life.
