As a Palestinian from the West Bank, I am no stranger to the trauma faced by Palestinians in the occupied territories, and I have spent my career trying to answer those questions and capture and convey the various injustices faced by Palestinians, specifically as they relate to health. Most current frameworks for mental health are almost totally insufficient to describe and reckon with the war-related trauma Palestinians in Gaza have endured these past several months. And by extension, our traditional methods of providing mental health care will not be enough, either.
The aftermath of this war will undoubtedly include a harrowing period of recovery that will require extraordinary financial and political investment. But it’s also a time to rethink mental health in populations that have experienced such devastating collective trauma, as well as what genuine healing may look like to ensure that hope and justice, not just continued trauma, are passed down to future generations. While military campaigns are being waged, the numbers of dead and physically injured tell us just one story about the entirety of the mental and emotional agony being perpetuated, funded and justified.
Some studies suggest PTSD and depression are among the most common mental health disorders observed in populations affected by war, but our understanding of how war affects mental health is fairly new. PTSD wasn’t a proper medical diagnosis until 1980, after over a decade of research and treatment of Vietnam veterans who returned home with what we previously called shell shock, war neurosis or gross stress reaction. The tools and questionnaires used to screen for PTSD were generally developed and tested in the West, but these days they are deployed extensively across populations affected by the brutality of war, including Syria, South Sudan and Ukraine.
While these tools can be valuable, a growing field of literature criticizes the lack of nuance or context in some of these framings, including how people describe trauma differently across cultures and process traumatic experiences, based in part on their perception of why the trauma is occurring. Too often we rely only on the relatively simple and straightforward analysis of surveys rather than the time-intensive and more subjective experience of interviews, observations and other methods that account for context.
Importantly, we also lack tools to adequately measure trauma that is ongoing and so deeply entrenched in a community. Because of its extensive history of violence, deprivation and other traumatic events, Gaza has been the site of many studies about the mental health burden of life in war, including many of children. A 2020 study of students in Gaza ages 11 to 17 found that nearly 54 percent of participants fit the diagnosis criteria for PTSD. A more recent study of Palestinians across the West Bank and Gaza found that 100 percent of participants had been exposed to traumas in 2021. The traumas that Palestinians face can include events as varied as land confiscation, detention, home demolition, loss of loved ones and fear of losing one’s life.
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