2022 Humanitarian Response Plan for Gaza and West Bank

social isolation, health-related fears, stigma, discrimination and the loss of family members. It moreover highlighted pre-existing challenges in mental health provision and hindered access to essential health services. People with pre-existing mental health conditions were at risk of experiencing an increase of stress and anxiety and difficulties in accessing services, information or medicine. Similar to other countries, pressures and struggles due to the pandemic created tension in families which resulted in a continued increase in domestic violence against women and children.52 Conflict-related violence/prolonged periods of tension Exposure to violence including decades of conflict and the ongoing military occupation hinder the development of Palestinian communities, greatly increasing the vulnerability of children, women and the disabled and causes severe and chronic mental health problems. 53 Recent studies show the political situation and insecurity, including the aftermath of escalations of violence, have a significant impact upon mental health and psychological well-being and often lead to a spike in deterioration of mental health. The fear for life, loss of loved ones, physical injuries and wide-spread damage and destruction significantly increases the risk of psychological distress and mental disorders. In the aftermath of the May 2021 escalation cluster partners providing MHPSS services reported major spikes in calls to helplines. SAWA, a major provider of emergency psychosocial counselling 24 hours daily registered a near doubling of calls in May 2021 after the escalation (compared to the first quarter 2021).54 Vulnerable groups Vulnerable groups such as those who have suffered from internal displacement, children, persons with disabilities and GBV survivors are at greater risk of psychological distress. 55 Furthermore, those with pre-existing mental health and psychological trauma and illness risk relapsing 56 and those on the frontline in health care or in caring roles responding to the intense and ongoing levels of need risk burn-out and work-related stress due to shortages in human resources and an overburdened and under funded health system. 57 The 2022 HNO estimated that some 678,000 children (345,800 boys, 332,200 girls) across the oPt are in need of child protection and MHPSS services, including 122,000 in need of focused nonspecialized support or specialized services. According to recent assessments by partners, measuring psychological distress and deterioration in mental health for both children and caregivers, found that the overall situation to be "alarming" and in need of immediate action. A Save the Children study (2022) on the impact of blockade on the psychosocial wellbeing of children showed alarming trends when comparing the 2018 and 2022 studies. Notable was that children are experiencing higher levels of emotional distress (average increase from 55% to 80%) exhibited in concerning behaviors such as bed-wetting (79% in 2022 compared to 53% in 2018) and are less likely to find positive ways to cope with their situation and have lower levels of resilience. A joint study recently released by War Child Holland and Save the Children (2022) showed the negative impact of the crises on the wellbeing of families, where 38% of respondents did not feel safe even 48 days after the escalation, particularly those displaced during the escalation especially in Gaza and North Gaza areas. The assessment also showed that at least 78% of surveyed adult respondents said they experienced signs of distress and observable changes in their own mood or behavior. This includes sadness, 52 Assessment of MHPSS interventions in the West Bank and Gaza Strip, UNFPA, August 2021 Save the Children and War Child Holland, Gaza Needs Assessment March 2022 53 54 SAWA Annual 2021 Fact Sheet 55 HNO 2022, page 32 56 Various, including https://www.sciencedirect.com/science/article/pii/S0883941721000686 57 Various, including Assessment of MHPSS interventions in the West Bank and Gaza Strip, UNFPA August 2021 14

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