Enhancing healthcare providers' diagnostic and intervention skills to deal with suicidal patients at emergency departments in the Palestinian hospitals: a quasi experimental study.

BACKGROUND: Suicide cases in Palestine continue to record a remarkable annual increase, but we lack a comprehensive verified national data collection system of suicide and it is expected that real numbers of attempted/suicide in Palestine are higher because not all suicide or attempted suicide cases are reported. The purpose of this study was to test the effectiveness of a time-limited training intervention in enhancing healthcare providers' diagnostic and intervention skills to deal with suicidal patients who visit emergency departments in Palestinian hospitals. METHODS: The sample consisted of 43 healthcare providers who work in public hospitals in the northern of the West Bank of Palestine, ranging from 25 to 56 years, involving 36 males and 7 females. A one-group quasi-experimental design was used, in which the experimental group received a training program to enhance healthcare providers' diagnostic and intervention skills to deal with suicidal ideations and attempts, the intervention lasted for 8 weeks, with 1 session per week. The performance of the experimental group was tested before and after the intervention. RESULTS: Our findings revealed the effectiveness of the training intervention in enhancing participants' suicide assessment, diagnosis, and self-care skills. CONCLUSIONS: These results suggest that a brief and carefully developed training intervention can potentially change healthcare providers' perceptions and behaviors toward suicide with a possible impact on clinical care therein.

The association between posttraumatic stress symptoms and suicidal ideations among Palestinians: The mediating role of spirituality, social support and mindfulness.

The current study aimed to test whether social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideation among Palestinians. The study sample consisted of 520 Palestinian adults selected using online tools. The findings of the study revealed that posttraumatic stress symptoms positively correlated with suicidal ideations (r = .32, p < .01), and negatively correlated with social support (r = -.34, p < .01), spirituality (r = -.16, p < .05) and mindfulness (r = -.72, p < .01), whereas suicidal ideations negatively correlated with social support (r = -.46, p < .01), spirituality(r = -.27, p < .01) and mindfulness (r = -.72, p < .01). Results of the path analysis showed that social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideations. Developing intervention programs to enhance social support, mindfulness and spirituality to mitigate the effect of ongoing traumatic experiences among Palestinians is crucial to reducing suicidal ideations. Further studies are also recommended to investigate the role of potentially protective factors that may reduce suicidal ideations and appropriate techniques to deal effectively with traumatic and stressful events.

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.

Child and adolescent psychiatry training and services in the Middle East region: a current status assessment.

Mental health is a key component of health, yet appropriate care is limited. Evidence concerning child and adolescent mental health has predominantly come from western countries, while the Middle East region, with a large youth population, has reported very little on it. This original, cross-sectional study of child and adolescent psychiatry in the Middle East provides an assessment of current postgraduate programs, services and what is needed to build workforce capacity. Academic psychiatrists from 16 Middle East countries were invited to form a Consortium to map current postgraduate training as one of the determinants of available child and adolescent psychiatry services, identify gaps in the distribution of child and adolescent psychiatrists, and propose potential steps to improve access to child and adolescent mental health care. The study collected data from 15 of the 16 countries invited (no data provided from Yemen). The study revealed underdeveloped child and adolescent psychiatry academic systems throughout the region. Despite recognition of the specialty in a majority of the countries (11/15), only six countries had established a designated child and adolescent psychiatry training program. The overall shortage of child and adolescent mental health specialists varied, yet all Consortium members reported a need for additional child and adolescent psychiatry specialists and allied professionals. Lack of child and adolescent psychiatry specialized programs in place throughout the region has evidently contributed to the shortage of qualified child and adolescent mental health workforce in the Middle East.

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.