An overview of the mental health system in Gaza: an assessment using the World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS)

Abstract

BackgroundMental health system reform is urgently needed in Gaza to respond to increasing mental health consequences of conflict. Evidence from mental health systems research is needed to inform decision-making. We aimed to provide new knowledge on current mental health policy and legislation, and services and resource use, in Gaza to identify quality gaps and areas for urgent intervention.MethodsAs part of a mixed methods study, we used the World Health Organization’s Assessment Instrument for Mental Health Systems Version 2·2 to collect data on mental health services and resources. Data collection was carried out in 2011, based on the year 2010.ResultsGaza’s mental health policy suggests some positive steps toward reform such as supporting deinstitutionalisation of mental health services. The decrease in the number of beds in the psychiatric hospital and the progressive transition of mental healthcare toward more community based care are indicative of deinstitutionalisation. However, mental health legislation in support of deinstitutionalisation in Gaza is lacking. The integration of mental health into primary healthcare and general hospitals has not been fully achieved. Mental health in Gaza is underfunded, human rights protection of service users is absent, and human resources, service user advocacy, and mental health training are limited.ConclusionPriority needs to be given to human rights protection, mental health training, and investment in human and organisational resources. Legislation is needed to support policy and plan development. The ongoing political conflict and expected increase in need for mental health services demonstrates an urgent response is necessary.

Schizophrenia in the context of mental health services in Palestine: a literature review

“…Besides, the cost of treatment, medications, and inconsistent availability of medications on the WHO essential medications list present additional access issues [3]. Even at least 80% of essential psychotropic medications are provided free of charge, whenever a shortage in these medications happens, the cost of private purchases of antipsychotic and antidepressant medication is 5% and 7% of the minimum daily wage in Gaza, respectively [63]. Switching between the drugs when inconstant availability exaggerates the adherence and satisfaction.…”

Mental health nurses: conceptions about professional qualification in a Psychosocial Care Center

“…Therefore, this interaction can leave the professional feeling restless, since it requires something more from each of the constituents of the team. From this perspective, we can cite a study in which the strategies for care in the community were performed by nurses who work in mental health in partnership with social workers and psychologists (10) .…”

“…For example, the city of Gaza has only a few nurses and other professionals working in the area of mental health with training or specializations. There, some professionals have little contact with this knowledge during the undergraduate course, but they do not consider it sufficient to work in the mental health units (10) . In South Korea, there are also few nurses with a specialization in mental health, and most of them still work in psychiatric hospitals (13) .…”

Schizophrenia in The Context of Mental Health Services in Palestine: a literature review

“…Even at least 80% of essential psychotropic medications are provided free of charge, whenever a shortage in these medications happens, the cost of private purchases of antipsychotic and antidepressant medication is 5% and 7% of the minimum daily wage in Gaza, respectively [64].…”