Exploring the gendered mental health experiences of adolescents in Gaza during the Covid-19 pandemic

Abstract

Adolescent mental health is increasingly recognized as a critical concern. Globally, suicide is among the top 5 causes of death for 15–19-year-olds (girls and boys). In the Middle East and North Africa, the prevalence of mental disorders (17.3% for girls and 16.8% for boys) is the second highest in the world. The Covid-19 pandemic has exacerbated adolescents’ vulnerabilities, particularly through the impacts of lockdowns and school closures. This article explores adolescent experiences in Gaza, drawing on mixed-methods research carried out in late 2020 in refugee camps (29%) and urban settings (71%). The sample involved phone surveys with 505 adolescent girls and boys (12–19 years) and their caregivers, in-depth interviews with a subsample of 77 adolescents, and 9 key informant interviews with service providers. Using the Patient Health Questionnaire-8, 9% of adolescents show signs of moderate-to-severe depression, and 19% reported moderate-to-severe anxiety, according to the Generalized Anxiety Disorder-7, with older adolescents (15–19 years) more vulnerable overall, and older girls more prone to self-harm ideation. However, older boys were significantly more likely to turn to substance use as a coping mechanism than older girls (18% vs. 6%). The drivers of these negative mental health impacts during the pandemic include deepening household economic vulnerabilities, heightened intra-family tensions (boys and men spending more time at home, increasing domestic work burdens on girls and women), and isolation from peer networks, especially for girls. We conclude by discussing implications for policy and programming, in line with Sustainable Development Goal 3, to promote mental health and well-being for all. Measures include investing in age- and gender-responsive interventions (including social protection) to support positive coping repertoires among adolescents, mitigating risks of substance abuse, investing in counseling services (online and in-person), and paying particular attention to the most disadvantaged adolescents, especially those out of formal education.

Assessing the health, social, educational and economic impact of the COVID-19 pandemic on adolescents in low- and middle-income countries: a rapid review of the literature

“…51 , 52 There was one study each in Nepal, Palestine and Turkey with proportions at 46.1%, 10% and 28%, respectively. 26 , 34 , 47

Figure 2. Anxiety proportions across different countries

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“…Prevalence of depressive symptoms ranged from 4% to 75% across Southeast Asia, America, Western Pacific, Africa, Eastern Mediterranean and Europe 24–26 , 28–31 , 40 , 47 , 53 , 58–64 : “ Nothing would relieve my stress. I guess I haven’t accepted this situation yet.…”

“…They just started the distanced electronic learning yesterday, I still don’t accept it, I don’t want the distanced learning. ” (19-year-old girl, Palestine) 47 Figure 3 shows the distribution of depressive symptoms across the countries. A total of 21 studies outlined proportions of depressive symptoms.…”

“…53 , 55 , 59 , 64 In Jordan, Palestine and Turkey proportions were 19.3%, 5% and 37.6%, respectively. 26 , 47 , 60

Figure 3. Depression proportions across different countries

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“…They just started the distanced electronic learning yesterday, I still don’t accept it, I don’t want the distanced learning. ” (19-year-old girl, Palestine) 47 …”