A Call for Social Justice and for a Human Rights Approach with Regard to Mental Health in the Occupied Palestinian Territories

This paper examines the process of depoliticization of mental health in the occupied Palestinian territories (oPt) and links it to a critical analysis of post-traumatic stress disorder and the role of international humanitarian aid. It is based on a human rights framework that focuses on the right to health and that is instrumental in connecting human rights violations to demands of social justice. Efforts to weaken justice and reparations are analyzed by looking at the role of mental health professionals and assumptions of psychotherapy as a neutral and nonpolitical sphere. By drawing on models of decoloniality and liberation psychology, we advocate for a shift from a decontextualized and individualistic approach to mental health to acknowledging the structural, social, and political oppression that are the underlying factors for suffering in the oPt. In order to alleviate the social suffering of Palestinians and to prevent their victimization, interventions that acknowledge the political nature of mental health ill-being and promote a human rights approach are needed

Postpartum depression in the Occupied Palestinian Territory:a longitudinal study in Bethlehem

BACKGROUND: Postpartum depression (PPD) affects women from different cultures around the world. No previous studies have investigated PPD among women in Palestine. Fertility rates in Palestine are among the highest in the world, hence even low rates of PPD could have considerable national impact. The aim of this study was to determine the prevalence of, and risk factors for, PPD among Palestinian mothers. METHODS: 101 mothers were recruited during the registration of their child’s birth (within 1 week) at the Bethlehem branch of the Ministry of Interior. Participants were assessed via a face to face interview, and were followed up 1 week, 2 weeks, 6 weeks, 3 months, and 6 months later by telephone interview. Interviews included the Arabic Edinburgh Postnatal Depression Scale (EPDS), with PPD indicated by depressive symptoms (EPDS score ≥11) at ≥2 follow-up time points. Pearson’s correlation was calculated between repeated EPDS scores, and multivariable logistic regression was used to investigate risk factors for PPD. RESULTS: The prevalence of depressive symptoms was fairly constant (14–19%) over the follow-up period. Most depressive symptoms developed within 1 month of delivery; mothers with depressive symptoms at 3 months postpartum were highly likely to still have symptoms at 6 months. 27.7% (28/101) of women met our criteria for PPD. High parity (odds ratio (OR) 4.52 (95% CI 0.90, 22.8) parity 3+ versus primiparous), unplanned pregnancy (OR 2.44 (0.99, 6.01)) and sex of child not being the one desired (OR 5.07 (1.12, 22.9)) were associated with PPD, but these associations were attenuated in multivariable analysis. CONCLUSIONS: The prevalence of PPD in Palestine appears to be higher than in high income countries, but similar to the prevalence in other Middle Eastern countries. High parity and unplanned pregnancy were identified as risk factors for PPD, suggesting that fully meeting the need for family planning could reduce the incidence of PPD in the Palestinian population

Une clinique sous occupation. Entretien avec Dr. Samah Jabr

International audienceObjectifSamah Jabr, psychiatre psychothérapeute palestinienne, dirige l’unité ministérielle de santé mentale en Cisjordanie occupée. Cette contribution vise à mieux faire connaître ses travaux ainsi que la question de la santé mentale en Palestine au lectorat francophone intéressé par les liens entre psychiatrie, guerre et occupation coloniale.MéthodeCet article a été conçu à partir de la retranscription d’un entretien réalisé avec Samah Jabr en janvier 2018 au laboratoire UTRPP de l’Université Paris 13-Sorbonne Paris Cité.RésultatsTravailler au sein d’une nation occupée amène à développer des politiques de santé mentale et des outils cliniques spécifiques. Après un aperçu de sa formation entre Jérusalem, Bethléem, Paris et Londres, cet entretien rend compte du travail institutionnel de S. Jabr qui consiste, d’une part, à développer des services de santé mentale dans les Territoires Occupés, et, d’autre part, à disséminer le soin et l’implanter dans la communauté. Les perspectives clinico-théoriques élaborées par S. Jabr y sont également dépliées : elles s’organisent autour d’une différenciation qualitative entre la démoralisation, c’est-à-dire la souffrance psychosociale et la psychopathologie.DiscussionCet entretien interroge la pratique clinique et politique de l’auteure, dont les travaux se situent dans la lignée du psychiatre Frantz Fanon. C’est à travers une approche holistique que seront discutées des prises en charges de jeunes adolescents post-détention, ou de patients manifestant une symptomatologie réactionnelle à la torture ; les effets de l’humiliation à motivation politique ; ou encore, les difficultés du contre-transfert face au mécanisme de l’identification à l’agresseur.ConclusionL’article se clôt sur les ressources favorisant la résilience de la société palestinienne

Fanon yesterday, today and tomorrow

Moderators: Firoze MANJI (Daraja Press, Canada/Kenya) SIT Tsui Jade Margaret (Southwest University, China) Speakers: Nigel C GIBSON (Emerson College, Boston and Rhodes University, South Africa) Toussaint LOSIER (University of Massachusetts-Amherst, USA) Samah JABR (Palestinian Ministry of Health, Palestine) Lou TURNER (University of Illinois Urbana-Champaign, USA