No Peace of Mind - Palestinian Mental Health Under Occupation - Doctors of the World

No Peace of Mind – Palestinian Mental Health Under Occupation

Palestine 2

Over the years, the global community has repeatedly witnessed cases of extreme violence and breach of humanitarian law by Israel as it escalates its oppression against Palestinians. Israeli settlers, backed by the Israeli military, have forced many to flee their homes as they were being demolished, often in the dead of winter or the peak of summer. Since 2009, over 12,380 Palestinians have been forcibly displaced in the West Bank while demolitions have increased by an average 20% year after year since 2017.

The ongoing humanitarian crisis in Palestine is often discussed in the frame of international law, with decades of recorded human rights violations, however that limits the scope of the harm inflicted upon civilians. The mental health ramifications of living under occupation are poorly studied, but preliminary studies indicate long-lasting, damaging effects on mental wellbeing, especially for children. 

The report No Peace of Mind is a new study on the mental health for Palestinians living under Israeli occupation by Doctors of the World France (DoTW) and the Association of International Development Agencies. The report focuses on the experience of organizations providing Mental Health and Psychosocial support (MHPSS) services to Palestinians in 10 communities in the West Bank in the summer of 2021. The survey was given to 1 man, 1 woman and 1 child in the 10 communities selected. The results are startling, the stories shared by the participants are devastating, and the mental health implications are grave. 

“They came in the morning, demolished our tents with bulldozers. They took everything with them. I was scared. We were making cheese. We were not expecting this demolition because we had had our house already demolished in the past.”
-Young girl from Humsa al Bqai’a

Since the start of occupation in 1967, Israel has established ruthless policies of land confiscation, illegal settlement and dispossession, coupled with rampant discrimination.

Walls and borders have been built around Palestinian communities, hindering their ability to go to work, see family, and move around freely. Violence and oppression has continued to increase over the last few years. In May 2021 the war on Gaza, which lasted for 11 days, killed 260 Palestinians, including 1 of the 2 psychiatrists in Gaza, and injured thousands more. It marked the fourth round of intense Israeli violence on Gaza since 2008. The World Bank found that 70% of Palestinians in Gaza and 57% of Palestinians in the West Bank reported symptoms consistent with Post-Traumatic Syndrome Disorder (PTSD)

Our study, No Peace of Mind, seeks to further illuminate how the everyday experience of occupation generates as many mental health consequences. 2021 saw the highest level of settler violence recorded since UN OCHA started monitoring in 2006. Overall, 977 incidents of settler attacks were recorded in 2021, that  included extensive damage to Palestinian property. Unforgivably, 5 Palestinians lives were lost as a result of these attacks.

Occupied Palestinian territory is a milieu where there is an utter lack of political hope. Loss of faith in social institutions is pervasive. Daily life is constrained through discriminatory law that creates powerful sentiments of powerlessness and insecurity, while also undermining economic security and access to healthcare.

“One time, settlers attacked us at night, they stole the sheep and had weapons with them. They went after my children wanting to hit them. Now every time we hear the sound of a car we are scared. In January 2021, 30 settlers attacked us. They had weapons and were backed up by the army - who usually stay far away, except if they feel that the settlers are unsafe. They fired gas and sound bombs at us, we suffocated from the gas. ”
-Woman from Al Mughayyir
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For many living under occupation, what is sometimes mistaken for resilience is unfortunate necessary adaptation to a stressful environment, in which encountering violence is part of the “daily routine” and where acute stress is the norm. By taking a closer look, the No Peace of Mind report indicates that although resilience prevails, so do the mental health ramifications of systemic violence. 

Research on the biological effects of violence have indicated a range of issues from increased risk of cardiovascular disease and premature mortality. It is also linked with growing rates of depression, anxiety, PTSD, and suicide. 

In the No Peace of Mind report, our research focused on 4 key areas of health:

  1. Physical: Headaches are the main category among the physical impacts.
  2. Emotional: Fear, anxiety, sadness, despair and lack of safety are the main categories among the emotional impacts.
  3. Behavioral: Isolation is the main impact among behavioral issues assessed.
  4. Cognitive: Impact on concentration is a key point in cognitive health.

The graph shows our results on the impact of occupation on Palestinian health. Across all categories, Palestinians experienced negative health implications. Men, women and children must grapple with these effects while continuing to survive in a restrictive and violent environment. Many children experience regression, impacting academic progress or developing social skills for instance. 

“I just want to feel safe, but I cannot feel safe in all of the West Bank from North to South, tell me where is it safe? ”
-Elderly man from Al Jiftlik

Despite the enormous need, circumstances show that access to MHPSS is lacking for many.

The Palestinian Health care system is not able to deal with this growing issue. Despite the Palestinian Ministry of Health (MoH) stating that Mental Health is one of its priorities, it has yet to be reflected in the financial resources allocated. It is not a surprise that MHPSS is underfunded, it is difficult to prioritize during crises; the MoH would rather invest in physical life-saving activities than psychosocial support. 

Besides the struggle to access MHPSS services, stigma and shame prevents many from seeking aid, particularly men, who associate demolitions and settler violence with an inability to protect their families.

Alaa Regashots

Since 1999, Doctors of the World has been providing aid in Palestine, starting with mental health and psychosocial support programs in the West Bank. Currently, its operations are widespread. DoTW operates in the Gaza Strip to prepare healthcare facilities for emergency situations. 

DoTW is also working alongside the Palestinian NGOs “Association for Culture and Free Thought” and “Al Ataa” to provide MPHSS care to the affected population. This work has already made it possible to respond to numerous cases of psychosocial disorders over the past 6 years, as well as several cases of gender-based violence.

In the Nablus region and in the northern Jordan Valley, DoTW works to provide psychosocial support to victims of violence by settlers and the Israeli armed forces. The medical staff is trained in the detection of psychosocial disorders, in order to facilitate referral to the appropriate health structures. A referral system for mental health disorders DoTW developed with the MoH has been adopted as an official national tool.

Our principal approach to psychosocial support focuses on discussion groups. People who have been attacked or who feel threatened can share their experiences here. Our work takes place in villages and certain schools, in areas where children are particularly exposed to such violence. Through MHPSS care, we aim to strengthen their resilience and better manage their stress.

“Wellbeing is a rare thing for Palestinians. Their lives are being stolen from them. ”
-Social Worker from Doctors of the World
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Palestine and the Gaza Strip face a complex humanitarian crisis. In Gaza, of the 1.9 million people who live there, 1.3 million are refugees. The ground, air and sea blockade imposed by Israel in 2007, has led to a permanent shortage of medicine, food, and equipment. Nearly a third of the population lives in extreme poverty. A mental health crisis is further unfolding as violence escalates. These alarming figures leave no doubt about the need for medical aid in Palestine .

However, humanitarian aid has long been present in Palestine and yet the crisis continues to escalate. If the crisis is political, then the solution must lie in the political: ending the occupation and eradicating the structures of repression and inequality. 

Time and again, the testimonies and evidence collected by humanitarian organizations have demonstrated that providing aid is no longer enough. The international community should be reminded that humanitarian aid is not a substitute for meaningful and applied engagement, which addresses the root causes of the coercive environment Palestinians live in. Sustainable development only thrives where international human rights law and international humanitarian law violations are not consistently ignored and infringed upon. 


“We are only a few here and no one defends us. I stay away from them, I can’t do anything, nor can I defend myself. ”
-Father from Al Jiftlik



    • Alaa Ali Abdallah / Regashots
    • Olivier Papegnies
    • MdM Spain
    • AIDA 2022