As the United Nations observed World Mental Health Day on October 10, experts in Palestine called attention to recent research indicating a growing risk of suicidal behavior among university students in the Gaza Strip.
This finding coincides with efforts to provide mental health programs on campuses in Palestine, in response to a recognition of the need for university graduates and a rise in mental health risks threatening Palestinian society. But in Gaza, those efforts often encounter social stigma and resistance.
A sense of hopelessness was behind the suicidal behavior among 17 percent of students at three universities in the Gaza Strip who participated in a study published in April. The study attributed that sense to “troubled living conditions in the Strip” that lead to psychological distress, uncertainty, depression, and anxiety.
The study, titled “Risk and Protection of Suicidal Behavior Among Palestinian University Students in the Gaza Strip,” was published by the International Journal of Mental Health. It analyzed the responses of 431 Palestinian students on five assessment tools used to gauge mental health, psychological resilience, and suicide risk. The participants were 20 to 29 years old and were students at three universities: Al-Aqsa University, the Islamic University of Gaza, and Al-Azhar University.
“The rate of suicidal behavior among students, equally divided between males and females, is high compared to that of the age group of university students, who are usually not among the groups at risk of suicidal behavior in most countries,” Yasser Abu Jamei, one of the study’s authors and director-general of the Gaza Community Mental Health Programme, told Al-Fanar Media in a Zoom interview.
“The rate of suicidal behavior among students, equally divided between males and females, is high compared to that of the age group of university students, who are usually not among the groups at risk of suicidal behavior in most countries.”Yasser Abu Jamei
One of the study’s authors and director-general of the Gaza Community Mental Health Programme
‘I Live in a Big Prison’
In his daily interactions with students, Radwan Abu Rukba, an assistant professor of psychology at Al-Aqsa University, monitors the repercussions of psychological distress on students’ lives, through their refraining from participating in lectures, expressing an opinion, joining discussions, or asking questions. These behaviors show their conviction that study is futile and will have no impact on their professional future. (See a related article, “Anxiety and Depression Often Shadow Arab Youth.”)
Khaled Adnan, a third-year medical student at the Islamic University of Gaza, believes that feelings of uncertainty about the future are the main factor behind the spread of social anxiety disorder among university students in the Strip.
“These symptoms push the majority of students to drop out of school, or to lag behind in their studies,” said Adnan. The lack of mental health programs on campuses further worsens the situation of students who show significant behavioral problems, including suicidal behavior, he added. (See a related article, “Mental-Health Care on Arab Campuses Is Increasing—Slowly.”)
The social and residential backgrounds of the students in the International Journal of Mental Health study vary, with 73.5 percent of them living in urban areas, 20.2 percent in refugee camps, and 6.3 percent in villages.
The study also cites government data confirming that most suicide attempts in the Gaza Strip, in recent years, are mainly related to family problems resulting from difficult economic conditions, besides the high youth unemployment rate that hit up to 50 percent.
“I live in a big prison,” reads one of dozens of answers that represent the opinion of 315 students or about 75 percent of respondents.
“Given these young people’s abnormal living conditions at the economic, security, and social levels, such a high percentage seems normal,” said Abu Jamei. That is especially true, he added, “for this generation that witnessed more than one aggression against the Gaza Strip, leaving them to live with constant threat and fear.” (See a related article, “Palestinian Education Is Impeded Under Protracted Conflict With Israel.”)
Scarcity of Support Programs in Gaza
Both mental health patients and professionals face many difficulties, including the lack of mental health support programs for students. There is also a shortage of rehabilitation study programs in Gaza’s universities, besides social and security restrictions on the work of academics, and even questions about the feasibility of such programs.
“Universities and security authorities consider discussing such issues a threat to societal peace.”Radwan Abu Rukba
A psychology professor at Al-Aqsa University
In recent years, the Gaza Community Mental Health Programme has established more than one center to provide psychological support to Gaza’s university students. However, they all stopped working because of the social stigma of mental illness, and the lack of specialists to work in these centers, says Abu Jamei.
Abu Rukba, the psychology professor at Al-Aqsa University, confirmed the lack of psychological support for Gazan university students for security and social reasons. He explained, in a phone call with Al-Fanar Media, that the few available training programs about psychological issues and their connection to society are provided by internationally supported nongovernmental institutions, while universities programs are limited to theoretical studies only.
Talking about suicide or the psychological needs of the Palestinian community are “taboos” in the classroom, Abu Rukba said. “Universities and security authorities consider discussing such issues a threat to societal peace,” he said.
Khaleda Younis, a physician supervising Gaza’s only psychiatric hospital, added that there is neither a specialization in psychiatry for medical graduates nor any programs in Gaza universities to graduate well-equipped professional psychiatrists. (See a related article, “Islamic University of Gaza to Offer First Psychiatry Diploma.”)
“To work in the psychiatric hospital, the Ministry of Health requires doctors to spend five years of training at emergency departments, which is far from qualifying them to work in this specialty,” she said in a phone call.
However, students in some universities complain about the ineffectiveness of psychological support programs on campuses. Yusriya Ghali, a student at Palestine Polytechnic University, said that her university’s center provides services during the academic year only and is not available year-round.
“Psychological counselors are not that experienced,” she added. She said she wished that psychological counseling would be made mandatory for all Palestinian university students, with the aim of promoting positive resistance to all the pressures they face.
Better Support in the West Bank
The mental health services at universities in the West Bank seem better than those in the Gaza Strip. The former’s medical schools offer undergraduate and master’s degree-level mental health programs, besides programs to support students’ mental health.
For example, Birzeit University, the oldest Palestinian university, offers more than one academic program in psychology, at the undergraduate and graduate levels, with the aim of graduating psychologists. It also offers training courses and academic programs in projects supporting mental health, in coordination with Palestine’s Ministry of Health.
“The main objective of launching the bachelor’s and master’s programs is to meet the needs of Palestinian students and community.”An assistant professor of mental health at Al-Quds University, in the West Bank
Similarly, the Faculty of Public Health at Al-Quds University also offers a master’s degree program in community mental health to medical graduates. Al-Quds Open University’s Faculty of Science began offering a bachelor’s program in counseling and mental health.
“The main objective of launching the bachelor’s and master’s programs is to meet the needs of Palestinian students and community,” said Salam al-Khatib, an assistant professor of mental health at the College of Public Health at Al-Quds University. “About 22 percent of people need psychological treatment, according to official data, as a result of the Israeli military bombing,” she said in a phone call.
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The first of its kind in a Palestinian university, the master’s program at Al-Quds began in 1999 before its being developed in 2014 to include branches specialized in trauma and psychological treatment methods.
Al-Khatib, the main program’s designer and supervisor, explained that the graduates of the program would master the basics of psychotherapy and mental health counseling skills. She stressed that there is a high demand for the program in light of the job opportunities it provides.