Addressing the mental health crisis among children in Gaza
Authors: Amira Mohamed Taha, Cameron Sabet, Sarah A Nada, Samer Abuzerr, Dang Nguyen
Journal: The Lancet Psychiatry (2024)

Since Oct 7, 2023, escalating violence in Gaza has intensified a mental health crisis among its 2·1 million residents, of whom 67% are refugees and 65% are younger than 25 years.1UN Relief and Works Agency for Palestine Refugees in the Near EastGaza Strip.https://www.unrwa.org/where-we-work/gaza-stripDate accessed: January 17, 2024Google Scholar Constant bombardment and displacement and the loss of family members are predisposing many children to anxiety, depression, post-traumatic stress disorder (PTSD), and other adverse mental health conditions. In fact, a 2020 study showed that 53·5% of Gazan children had PTSD even before this conflict.2Abudayya A Bruaset GTF Nyhus HB Aburukba R Tofthagen R Consequences of war-related traumatic stress among Palestinian young people in the Gaza Strip: a scoping review.Ment Health Prev. 2023; 32: 1-15Crossref Scopus (3) Google Scholar Such conditions often go untreated due to a lack of awareness from health professionals, a shortage of mental health professionals, and Israeli restrictions on foreign aid. Consequently, many children are deprived of necessary care, jeopardising their education, social integration, and even future employment, perpetuating a cycle of social instability. The ensuing psychological distress can increase children and young people's susceptibility to radicalisation, as extremist groups often exploit feelings of hopelessness. In Gaza, the prioritisation of more immediate crises—such as the acute shortage of lifesaving resources such as food, water, sanitation supplies, and electricity—intensifies the challenge of providing youth mental health interventions. This issue is compounded by relentless bombardment, leaving no area safe. The health system has collapsed, with psychiatric facilities damaged or depleted of medications, and internet disruptions prevent teletherapy access. For these reasons, addressing the Gazan youth mental health crisis requires ceasefire efforts that can promise residents basic physical safety. Organisations outside of Gaza seeking to help could model interventions from the region's ongoing Brothers at Heart project.3The Jerusalem PostCrucial mental health project launched for Gaza region.https://www.jpost.com/israel-news/article-780383Date: Jan 2, 2024Date accessed: January 17, 2024Google Scholar This initiative provides immediate mental health care, including individual and group therapy, to children and educational staff traumatised by recent conflicts. Moreover, UNICEF should continue establishing spaces for children to engage in physical exercise, group games, drawing, and close interactions with care professionals. Such initiatives are conducted in partnership with The Education Above All Foundation (EAA), a Qatari non-profit organisation, which is offering such psychosocial support to 35 000 children, 15 000 caregivers, and 1000 frontline workers.4The Education Above All FoundationRebuilding hope for more than 233 000 Palestinians in the Gaza Strip.https://reliefweb.int/report/occupied-palestinian-territory/rebuilding-hope-more-233-000-palestinians-gaza-stripDate: Dec 22, 2023Date accessed: January 17, 2024Google Scholar EAA could expand this programme to reach even more children and caregivers in need. Save the Children could also provide more recreational kits and establish additional safe learning spaces for displaced and vulnerable children, as they have done for over 8000 children already.4The Education Above All FoundationRebuilding hope for more than 233 000 Palestinians in the Gaza Strip.https://reliefweb.int/report/occupied-palestinian-territory/rebuilding-hope-more-233-000-palestinians-gaza-stripDate: Dec 22, 2023Date accessed: January 17, 2024Google Scholar Furthermore, independent journalists and foreign organisations can increase efforts to improve English literacy, offering more outlets for Gazan youth to have a voice on the world stage. Such interventions can be structured similarly to the non-profit organisation We Are Not Numbers, run by the Euro-Mediterranean Human Rights Monitor, which offers 6–month English writing workshops for Palestinian youth. Such efforts could also expand into art therapy groups, public speaking courses to build proficiency in speaking with journalists, or digital storytelling seminars to help youth share their stories effectively across social media. Additionally, there should be initiatives that are more directly targeted at improving young women's health in the region. Given how the scarcity of sexual and reproductive health supplies is likely to impact this subpopulation psychologically, especially given the social taboos around discussing reproductive health issues publicly, Israeli border police should immediately allow the almost 70 Gaza-bound UNICEF trucks to enter Gaza, which have been held for several weeks, carrying essential hygiene kits with menstrual products.5Batrawy A Women in Gaza are desperately in need of washrooms, privacy and pads.https://www.npr.org/2024/01/05/1223193875/women-in-gaza-are-desperately-in-need-of-washrooms-privacy-and-padsDate: Jan 5, 2024Date accessed: January 17, 2024Google Scholar Along the lines of hygiene, the international community must also demand that Israel restores regular water and electricity access to Gaza. Local community health organisations in Gaza can also provide workshops to destigmatise menstruation and teach safe homemade alternatives to menstrual products. International advocacy groups for women should launch public campaigns calling attention to these health issues in Gaza. To address the urgent need for washrooms and showers, international aid groups that have provided sanitation facilities in past disasters could construct temporary toilets and washing areas at refugee settlements hosting displaced Gazans. Local groups could also organise rotating schedules that give vulnerable pregnant women and new mothers priority access to the limited washrooms available. Only by addressing immediate health needs can mental wellbeing be improved in Gaza. By ensuring ceasefire is the global political priority and introducing both local and foreign interventions, Gazan youth can have a clear path toward improved mental health. These endeavours are not just humanitarian imperatives but crucial investments in the future stability and prosperity of the region. We declare no competing interests.