This document summarizes the activities and projects of a mental health consortium in Gaza in 2013. It discusses 6 projects focused on parenting skills, school mediation, summer camps, counseling units, play therapy, and specialized therapeutic interventions. It also covers awareness raising, advocacy for human rights, rehabilitation for torture victims, occupational therapy, support for orphans, professional development, capacity building, academic programs, and crisis intervention studies. The overall goal is to improve mental health and respect for human rights in Gaza through community-based programs and services.

1. Consortium Meeting
Narrative Report 2013

3. • Vision
• To reach a Palestinian society governed by the rule of law and
respect for human rights principles and free from all kinds of
oppression.
• Mission
• To make a specialized institution that represents a knowledge base
in the field of mental health, to enhance the efficiency and abilities of
local community cadres to deal with mental health problems.
• Strategy
• To provide supportive and therapeutic services in the field of mental
health to children, families, torture and human rights violations
victims.

4. Contribution to Improve the
Mental Health Situation of the
Gaza Strip Population

5. Project (1): COPE
• This program aims at helping
parents develop their skills and
abilities, to improve their relationship
with their children, increase
collaboration, problem solving and
confidence building.
• 6 groups of parents including 141
mothers were formed during the
project, in cooperation with 3
kindergartens, and 3 associations
across Gaza strip.
• The results showed the positive
effect of the project according to the
reviews of mothers.

6. Challenges
• Some fathers refused to attend the sessions.
• Some couples preferred to be separated during sessions.
• Some of the associations lacked proper training halls, and
some mothers preferred to hold the sessions in their areas
instead of going to far places.

7. Project (2): School Mediation
• Aims to reduce the level of violence and to encourage the
resolution of disputes by peaceful means among children.
• It also aims to provide the necessary support for children who
have been subjected to violence, which enhances their
resilience and protects their mental health.
• The program was implemented in 6 schools after signing the
memorandum of understanding with the Ministry of High
Education.
• A 25 hours training course was held for school counselors and
a number of teachers.
• The professionals trained 203 students on school mediation
skills, and held a graduation ceremony for mediators at the six
schools where the program was implemented.

8. • Post training phase:
• 111 specialists conducted supervisory visits to schools to follow up
the implementation of school mediation with student mediators and
counselors.
• 6 workshops targeting 142 parents and teachers were held,
addressing different topics, including trauma, psychological and
behavioral problems faced by teenagers.
• 6 recreational trips were organized for the mediator students.

9. Results
• 96% of participants were satisfied with the topics.
• 94% praised the content of the workshop and its suitability for
their daily needs.
• 88% of participants wanted to apply their newly acquired skills in
their schools.
• Choosing 203 students instead of 180 students as a result of
high demand.
• A marked improvement was noticed in the academic level of 7
students who joined the school mediation program.

10. • In a first of a kind gesture, a group of students who completed
their school mediation training in 2010, took the initiative to
apply the program in their neighborhoods in 2013.
• One of the schools reported that this program is the first to
target the school since its foundation 14 years ago.

12. Summer camps are a preventative and developmental method of
psychological intervention, to help children mature in the social
framework, and to protect them from mental and psychological
disorders in the future.
Project (3): Summer Camps

14. During the Project

15. Project (4): Activating Counseling Units
• Based on the Memorandum of
Understanding that was signed with the
Ministry of Education, the Programme
continued its efforts to provide
community mental health services
within the educational system.
• The formation of a joint committee from
the Ministry of Education and the
Programme to follow up activities in
schools.
• 6 new schools were selected to host
the new counseling units.
• The professionals conducted 133
weekly supervision and intervention
visits to the counseling units, including
86 new cases, who were discussed
with the school counselors, and
conducted individual and group
sessions for a group of 238 children.

16. • A 25 hours training Was held for school counselors working in the 12
selected schools.
• 8 awareness meetings Were held for about 126 parents and 128
teachers.
• The role of counseling units was not only limited to the selected
schools, but also extended their services to neighboring schools.

17. • According to clinical results,
25 cases were transferred
from the counseling units to
Community Centers Affiliate
to the Programme, to receive
the necessary specialized
intervention.
• A unified registration file was
developed and imposed in the
targeted schools, that’ll be
used by the Ministry of
Education for all counselors,
which has a significant role in
the development of
documentation system at the
schools of the Ministry.

18. Project (5): Play Therapy Units
for Early Childhood
• The Programme continued its early childhood Intervention
throughout systematic interventions with 16 kindergarten across
the Gaza Strip.
• In addition, it established play therapy units in targeted
kindergartens to provide a healthy environment for children,
which enables them to grow and reach their full potentials.

19. Activities of Play Therapy Units
for Early Childhood
• 105 evaluation and
intervention visits targeting:
• 13 QSN kindergartens
• 3 new kindergartens
• Number of beneficiaries:
220 children
• 40 awareness
sessions targeting
497 mothers.
• 48 Supervision
Sessions

20. Activities of Play Therapy Units
for Early Childhood
Organizing 16
recreational trips
Referring 4 cases to
the Programme for
an advanced therapy

21. Project (6): Specialized Therapeutic
Interventions for Families and Children
Throughout the report duration, The Programme’s specialist
provided 1408 therapeutic intervention sessions as follow:
Therapeutic intervention
services for children
501 children
66% males
34% females
New cases221 cases
145 males
76 females
Follow up cases280 cases
181 males
99 females
EGG services142 cases
86 males
56 females
Physiotherapy services31 cases
8 males
23 females

22. • According to clinical data, the most common diagnosis
among treated children were:
• PTSD
• Enuresis
• OCD
• Epilepsy
• Depressive disorder
‫إشراف‬ ‫جلسات‬
‫جماعية‬,55
‫جلسات‬
‫إشراف‬
‫فردية‬
‫للمهنين‬,8
‫نفسية‬ ‫إستشارات‬
‫لألطفال‬189

23. Rehabilitation and Integration of Orphans in
Community Project
• The project targeted 421 children
who lost their dependents during
the Israeli aggression on Gaza in
January 2009, and the second
aggression in November 2012.
• 225 intervention session were
implemented for groups of children.
ActivityNumberAge
Activities at local associations such as role
playing, drawing, and narratives ..etc
140
children
7-12
years old
Psychodrama groups69
children
12 – 17
years old
Mind and Body groups140childre
n
12 – 17
years old

24. • The Programme uses the Strength and Difficulties Questionnaire
scale (SDQ), to assess the effectiveness of therapeutic intervention
with children, this scale briefly examines the behavior of children
between 3-16 years, and includes 25 items divided in the form of
five evaluation standards as follow:
Decrease of emotional problems after the interventionFrom 54.7% to 34.8%
Decrease of behavioral problemsFrom 54.8% to 42.5%
Decrease of ADHDFrom 14.1% to 4.4%
Improvement of peers relationshipFrom 76.6% to 86%
Social behaviors did not show a remarkable
improvement
From 11.3% to 11.4%
The questionnaire total showed a decrease in problems
and a 19.97% improvement after a month of treatment
From 69.1% to 55.3%

25. Strategic Goal 2
Promote the Understanding and Community
Adoption of Practices Suitable for the
Standards of Human Rights and Mental Health

26. Project (1): Raising Community Awareness in
the Field of Mental Health and Human Rights
• Is considered one of the most important activities to fight
stigma related to mental health, and to promote human rights
principles.
• Most important implemented activities:
42 Radio Episodes6TV Programs17 Articles

27. During the year 2013, a scientific material was prepared for three
awareness brochures, which were finalized and printed at the beginning
of the year 2014.

29. • The Community working in this field views the Programme as a
primary provider of more specialized treatment and
rehabilitation for victims of torture.
• The Programme provided 28 legal advice related to humane
issues, in cooperation with the Physicians for Human Rights
organization (PHR) – Israel, and the Legal Center for Freedom
of Movement (GISHA), as 19 of these cases were patients who
were not approved to be treated in hospitals.
• 9 cases were reunited with their families.
• The Programme continued to document 20 cases of torture
patients.
• A Memorandum of Understanding was signed with:
Project (2): Advocacy and Lobbying for
Human Rights

31. • Two training sessions were held, targeting
45 officers working at the Ministry of
Interior; to raise the level of knowledge
and awareness among workers in the
field of law and to respect human rights.
• A training manual for mental health and
human rights was prepared for police
officers, which would be useful in future
training for this group, and all employees
working in the field of law in the future.
• The Programme contributes through its membership in the National
Committee for the Protection of Rights in forming Palestinian NGOs,
which is a coalition of 14 non-governmental civil institutions, hosted by
Al Dameer Association for Human Rights.

32. Project (3): Specialized Therapeutic Intervention for Victims
of Torture and Human Rights Violations and their Families
ActivityBeneficiaries
Therapeutic interventions for victims of
torture and humans rights violations
1130
56% males
44% females
Therapeutic interventions for victims of
torture and humans rights violations
including new cases
343
206 males
137 females
Follow up cases787
428 males
359 females
Professionals conducted 3867 clinical sessions as follow:

33. The Programme offered 2367 therapeutic
interventions as follow:
ActivityBeneficiaries
General disorders patients48657% males
43% females
New cases6643 males
23 females
Follow up cases420234 males
186 females
• EGG service was provided to 200 cases, including
116 males and 84 females.
• Physiotherapy service was provided to 96 cases,
including 76 males and 20 females.

34. Challenges
• The Programme used the International Classification of Functioning
(ICF) questionnaire, as a tool to assess the effectiveness of therapeutic
interventions for adults, and the results showed:
• Improvement by 20.4% in the capabilities of patients between the
first and second sessions,
• In addition to improvement by 17.2% between the second and third
sessions.
• Patients refused to fill in their (ICF) questionnaire, and some of them
filled in the first evaluation only, so it must be taken into account the use
of other follow up methods in the future, and to think about the most
appropriate means to achieve this goal.

35. Project (4): Rehabilitation and Occupational
Therapy for Patients of Mental Health and Victims
of Human Rights Violations
• The Programme developed a guide for occupational therapy
and rehabilitation interventions, and signed a memorandum of
understanding with the Directorate of Mental Health
Department at the Ministry of Health, for the success of the
occupational therapy project. In addition, a referral mechanism
was established in 2012 and continued in 2013.
• The results showed the high number of
patients who were transferred to the
Occupational Therapy and Rehabilitation
Center after signing the memorandum of
understanding with the Ministry of
Health.
• The vocational training enhanced the
social and psychological safety of
professionals, and contributed to the
strengthening of resilience and social
development.

36. Project (5): Rehabilitation and Integration of
Orphans in the Palestinian Society
Working with Al Rabee Institution for Juveniles Care
• A training course entitled "Advanced
Training in Dealing with Juveniles"
was held for (30) professionals from
the Ministry of Social Affairs and Al
Rabee Institution.
• Conducting 26 weekly supervision
sessions.
• 40 home visits targeting juveniles.

37. Working with Al-Amal Institute for Orphans
• A 24 hours training course was
held targeting 15 professionals
working at Al-Amal Institute for
Orphans.
• The Programme’s professionals
conducted 29 weekly professional
supervision sessions.
• The professionals also
conducted 30 home visit to
orphans in order to:
• Assess the status of the
family.
• Monitor the behavioral and
emotional problems
among children.

38. Strategic Goal (3):
Strengthening the Programme's Role as a
Unique Center in Treatment Development
and Provision of Community Mental Health
Services

39. Project (1): Integration of Mental Health Within the
Primary Health Care Service.
• The Programme signed an agreement with the Islamic University to
provide theoretical and practical training for Psychiatry students in
February, May, and November 2013.
• The number of 54 students included 23 female and 31 male
students.

40. Professional Development in the Field
of Mental Health
• Eight professionals were selected to receive a training program
led by Dr. David Becker from Germany, Dr. Patric Hammerle,
and Dr. Conrad Frey from Switzerland.
• The training included several visits to get to know the practices
and methods of service delivery in Berlin. After their return,
they held a training to new trainees and supervised them
throughout the hole training period.

41. Challenges
• Timing of the training in Berlin
was inappropriate, because
several main directors of
departments had to leave, which
coincided with the consortium
meeting.
Results
• The Programme is
considered an institution that
oversees the work of other
institutions, and the capacity
building of professionals
working in the field of mental
health.
• This project provided a rare
opportunity for those working
in the field to exchange
experiences among them.
• This exchange established a
dialogue between
professionals working in
different institutions or
disciplines.

42. Project (3): Capacity Building of Partner Associations
working in the Field of Mental Health and Human Rights
• A training program was developed to meet the needs of trainers, to
enhance their ability to promote early detection of cases that need
intervention and provide basic services, and transferring cases that need
special intervention.
• Trainees expressed their desire to transform the traditional perspective
of their work of focusing on families’ economic evaluation, to expand
their services to include intervention on social levels as well.

43. • The 10 training days of 40 hours included:
• Social intervention techniques.
• Child development.
• Children mental disorders and means of intervention.
• Symptoms of psychological disorders.
• Stress management and dispute analysis.

44. Project (4): Academic and Scientific Programs for
Professionals Working in the Field of Mental Health
(High Diploma Program)
• The Programme prepared in partnership with an external expert the
high diploma program, as a response to the needs of mental health
professionals in Gaza Strip. In addition, two new courses have been
added (Profession Ethics and Families Intervention).
• A study of higher education needs in the field of mental health showed
the importance and effectiveness of the diploma program in meeting
community needs, it also suggested certain modifications to be brought
into the application based on the recovery process and evidence.

45. • Since 1997, the Programme has provided the community with more
than 150 professionals in the field of community mental health.
• Because the course “Family Intervention” is still innovative in Gaza
Strip for academics and local trainers, the Programme searched for
an international expert in this field, and had an agreement with the
Italian expert Dr. Guido Veronese to begin a training in May 2014.

46. Project (5): Standardizing Psychosocial
Manuals
The Programme concluded the “Standardization of Psychosocial
Manuals in the Gaza Strip" project, which aimed at standardizing
four psychosocial manuals suitable to the Palestinian environment.

47. • Participants assured that their
experience in standardization has
contributed actively in creating a
Palestinian vision for the standardization
of manuals.
• Participants expressed their desire and
willingness to standardize new manuals
within their organizations, through the
development of professional
psychosocial references consistent with
the Palestinian environment and local
culture.
• Working with other institutions
contributed to the increase of positive
change in communication between
institutions, acceptance of other
opinions, developing the capacity of
participants and their critical thinking,
strengthening positive behavior, and
building their confidence in their
professional ability regarding
standardization.

48. Strategic Goal (4)
Crisis Intervention

49. Project (1): Studies to
Specify Common Problems
• The Programme conducted a study entitled (Long-term
Psychological Effects of the Recent Israeli Aggression on the
Palestinian Children and Parents).
• The survey was conducted by Researcher Dr. Vivian Khamis
between October and December 2013.
• The study contributed to the development of scientific basis about
the long-term effects of the recent Israeli aggression on the mental
health of Palestinian children and parents.
• Which was used in the mental health sector and psychosocial
support, supervised by the World Health Organization and
UNICEF.

50. Project (2): Capacity Building of
GCMHP and Society to Deal with Crisis
• The Programme selected 21 mental health professionals (14
females and 7 males) and five psychologists (3 females and 2
males), then formed ten multi-disciplinary teams of
professionals.
• The teams received a 40 hours training on intervention
techniques and most common problems, and started to
intervene after the training with community field work through
visits to homes, kindergartens and community institutions.

51. • The Programme partnered with “Mercy Corps" in order to
integrate programs in the field of psychosocial support for
children and families affected by the aggression on Gaza.
• The Programme developed a training program targeting 30 (8
males and 22 females) workers in the psychosocial field from
16 local institutions, partners of Mercy Corps in Gaza Strip.
• The program included 30 hours of theoretical training and
topics related to intervention after crisis.
• Cooperation with "Mercy Corps" enhanced the impact and
sustainability of joint programs for the sake of beneficiaries,
especially that it deals with 16 local institutions that provide
psychosocial services to thousands of traumatized children.

52. Project (3): Free Telephone
Counseling Line
• 776 callers benefit through 1288 calls.
• beneficiaries were classified as follow:
• 75.4% females and 24.6% males.
• Of which 8% were children and 92% adults.
• Most problems experienced by callers were as follow:
• 58.8% psychological problems,
• 20.2% social problems,
• 10.7% behavioral problems,
• 8.1% emotional problems.
• Beneficiaries during the morning period were 52.3%,
• Beneficiaries during the evening period were 47.7%
1800222333

53. • The results showed that 47.7% of beneficiaries held a university
degree, while 52.3% held a high school degree or less.
• The results showed that 31.7% of beneficiaries are housewives, and
43% are students.
• Social and behavioral problems were more common among female
beneficiaries, especially widows and divorcees.
• Follow up reports indicated the emergence of new phenomena in
Gaza Strip, such as increased drug use, especially among young
people, and increased levels of stress and anxiety among housewives
and students as a result of the deteriorating economic situation.
• The free counseling line Service covers all Palestinian territories,
including West Bank, the results showed that 2.2% of beneficiaries
were from the West Bank.
• The percentage of female callers was 74.4%, this is an indication
that females may have difficulties accessing mental health centers as
a result of stigma related to mental health and living in remote areas.

54. Project (4): Intervention after the Israeli War on
Gaza strip in 2012
• The professionals intervened at community level in all affected areas as
a result of the Israeli aggression, the teams conducted 1959 home visits,
benefiting 10249 people.
• The Programme targeted 10 kindergartens in the affected areas in Gaza
City and the northern areas of Gaza Strip, which have been targeted by
the recent Israeli aggression, where ten play therapy units in these
kindergartens were furnished and provided with toys.
• Forming and preparing
10 teams of multi
disciplinary mental
health experts.

55. • Psychologists conducted 200 weekly intervention and supervision visits
to kindergartens which benefit nearly 1,300 children.
• The Programme held 100 public meetings in the affected areas across
Gaza Strip, which benefit nearly 2480 mothers and fathers.
• Nearly 600 parents benefit from the crisis management sessions. In
addition, 45 parents benefit from the psychodrama sessions.
• The Programme prepared a set of 24 episodes in two local radio
stations, to raise awareness in community mental health issues.

56. Strategic Goal (5)
Development and Sustainability of GCMHP

57. Project (1): Building the Capacities of
GCMHP Staff
• A professional at GCMHP obtained a
PHD certificate in psychology, and four
others obtained master degrees in
different disciplines. In addition, a PHD
graduate was able to publish scientific
articles in an international journal.
• Many international trainers and experts
in clinical and intervention fields have
visited GCMHP, and held different
training courses to its professionals.

58. Project (2): Strengthening GCMHP Role
Locally and Internationally
• The Programme organized an
international scientific conference in
cooperation with the "GIZ“ organization, in
the presence of nearly 120 local and
international participants, experienced in
the field of mental health and
psychosocial support.
• A Korean delegation of 5 students from
the “Medical Peace Foundation” visited
the Programme to inquire about the
effects of the Israeli violations and
violence on the psychosocial situation of
the Palestinian society, in order to use it
for research purposes.
• The Programme hosted an American
medical delegation of different fields from
the "Physicians for Social Responsibility“,
to build the capacity of medical staff and
perform surgeries.

59. Challenges
• Stigma due to mental health issues.
• Staff turnover rate in the targeted institutions.
• The number of applicants for training programs are
beyond the Programme’s capabilities.
• Difficulty hiring Researchers.
• Lack of sufficient coordination between institutions working
in the field of mental health.

60. Lessons Learnt
• The diversity of services and the importance
of tasks distribution.
• GCMHP is the provider of moral services in
Gaza Strip
• Professional guidance, supervision and
taking care of service providers must be a
part of the professional process.
• Partners are more aware that marginalized
groups have the right to mental health
services.
• Partnership agreements with various
institutions is essential to the organization of
work.
• The need to develop a model of community
mental health to be a scientific reference to
the provision of services in Palestine.

61. Sustainability
• Long term experience and good reputation on the professional
level had a role in attracting financiers interested in alleviating the
psychological effects of political conflicts.
• Development of a strategy to maintain secure financial resources
for the Programme and its activities.
• Projects aiming at capacity building, which enhances continuity
and professional development, to provide specialized services in
community mental health.

63. • A tenth grader complains of his fear of exams, confusion and lack of
concentration, the counseling unit helped him overcome his fear and
build his self confidence, he passed his monthly exams successfully.
• Student “X" was subjected to sexual harassment, verbal and physical
abuse by a group of students, his school counselor intervention
contributed in providing moral support and boosted his self
confidence, making him more resilient.
• Her parents ambitions for her to obtain the highest score in
secondary school made her extremely anxious and tense. The
counselors analysis of the situation in an objective way has
contributed to the amendment of their thought in a more rational
manner.
• Difficult circumstances of her family, and being deprived of her
father’s tenderness has made her more aggressive at home and
school. Following her up at the counseling unit contributed to
modifying her behavior, made her calmer and more adaptive to her
teachers and her classmates