Counseling and Mental Health Care in Palestine

The Palestinian territories of the West Bank, the Gaza Strip, and East Jerusalem are formerly part of the British Mandate of Palestine and have been occupied by Israel since 1967 (Lindsay, 2007). These areas have experienced substantial political instability, military violence, and social unrest during the last half century. Mental health care services were primarily organized and operated by nongovernmental organizations (NGOs) until control of social programs was transferred to the Palestinian National Authority (Palestinian Counseling Center [PCC], 2010). Counseling and mental health care services have expanded over the years but major areas of growth exist in regulation, training, and professional development. * Palestine Palestine is located in the Middle East and is divided into the West Bank, which borders Israel and Jordan, and the Gaza Strip, which borders Israel, Egypt, and the Mediterranean Sea. East Jerusalem is the declared capital of Palestine but is occupied and under the full control of Israel. The Palestinian National Authority exercises limited control over the West Bank and the Gaza Strip. The West Bank has a population of 2.5 million, including approximately 300,000 Israeli settlers (Central Intelligence Agency [CIA], 2011b). Islam is practiced by 75% of West Bank residents, Judaism by 17%, and Christianity by 8% (CIA, 2011b). East Jerusalem has an estimated population of 389,298 Palestinians; 95% are Muslim and the remaining 5% are Christian (Palestinian Central Bureau of Statistics, 2007). The population of the Gaza strip is approximately 1.6 million (CIA, 2011a). Muslims comprise 99.3% of the Gazan population, and the remaining 0.7% is Christian (CIA, 2011a). Arabic is the language most spoken, although many Palestinians are also fluent in Hebrew and English (CIA, 2011 a, 2011b). Palestinians in the West Bank, Gaza, and East Jerusalem have limited to no mobility between the Palestinian territories. The demographics of Palestine as well as the various challenges faced by the population continue to change as the political situation changes. The economy in Palestine suffers as the political climate worsens. The unemployment rate in the West Bank is 16%, with 40% of individuals living below the poverty line; the Gaza strip currently has 40% unemployment, with 70% of individuals living below the poverty line (CIA, 20211a). The loss of jobs in Israel, the siege on Gaza, and the closure of the West Bank and Gaza from Israel led to an increase in male unemployment and family violence (Lindsay, 2007). The economic climate in Palestine exacerbates existing problems in addition to contributing to the creation of new problems. * Historical Overview of the Development of Mental Health Services Three main types of organizations--governmental, nongovernmental, and the United Nations Relief and Works Agency (UNRWA)--offer mental health services in the Palestinian territories (Al-Krenawi, Graham, Al-Bedah, Kadri, & Sehwail, 2009; Giacaman, 2004). These three types of organizations often provide similar services to similar populations within Palestine and do not yet have clearly defined roles. The development of the counseling profession in Palestine began with the establishment of the Palestinian Counseling Center (PCC) in 1983 by a group of psychologists, counselors, sociologists, and educational experts. Before the establishment of the PCC, mental health services were limited to psychiatric treatment for mental disorders (Ahmead, Rahhal, & Baker, 2010; PCC, 2010). The PCC's early work focused on raising awareness of the importance of counseling and of the psychological needs of children and refugees. They also worked to facilitate the entrance of psychologists and counselors into primary health clinics and the development of preventative intervention programs (PCC, 2010). NGOs, like the PCC, had and continue to have a prominent role in the development of organized mental health services in the Palestinian territories. …