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The Mental Health Impact of War and Terrorism: Israelis and Palestinians

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By Maya Robin

Until a recent ceasefire, the past few weeks consisted of a constant fear of rockets for the Jewish and Arab residents of Israel and Gaza. The 2021 rockets were not a first, and many similar instances have contributed to the mental health vulnerability of all members of Israeli society. A 2008 study compares the mental impact of terrorism in the region. “After 19 months of terrorist attacks, Arabs and Jewish Israelis reacted roughly similarly to the situation; however, after 44 months of terror, posttraumatic symptom disorder in the Arab population increased three-fold, posttraumatic symptomatology doubled and resiliency has almost disappeared” [Dr. Gelkopf, University of Haifa].

Warfare and terrorism have had a grave effect on all demographics throughout the region; however, children seem to show the most prominent displays of PTSD and mental health vulnerabilities. Children living in Gaza, under Hamas rule, exhibit high levels of abnormal behavior. Whether it be rockets or simply due to life under a terrorist regime, the prevalence of violence presents a commonness of mental health difficulties among the children of Gaza; they have issues with nail biting, bullying, and a common phobia of attending school [Eastern Mediterranean Health Journal, Vol. 7, No. 3, 2001].

While PTSD among Palestinian children living in Gaza is more widespread, PTSD among Israeli children is often dependent upon their geographical location. A study conducted by Lavi & Solomon (Tel Aviv University) found that children living in the territories or areas bordering Gaza or the West Bank have a similar PTSD prevalence rate as the Palestinian children living in the war zones. However, Israeli children living in areas with less conflict display much lower rates of prevalence.

Furthermore, the heated political climate in the area also contributes to the degree of resilience and coping mechanisms of those exposed to violence. In Gaza, there is a less stable governing body and, therefore, a less centralized approach to ending this mental health epidemic. The resources for psychiatric care favor heavy drug treatments rather than therapy, leaving the remainder of the mental health strategies in the hands of community centers, donors, and non-profit organizations [Washington Post, 2018].

To the contrary, in this heated time, Israel has issued state-wide guidelines on how to calm down after a rocket siren in order to take preventative measures against PTSD. Many different factors likely contribute to the contrasting rates of mental health problems, whether it be a genetic predisposition, the government’s strategic approaches, geographical location, or cultural resilience. Regardless of the causes, the epidemic of helplessness, anxiety, and fear is an on-going issue.

The Israeli-Palestinian conflict is a multi-faceted, intense matter; however, the mental health epidemic in the region is not a socio-political, religious, or geographical issue. In these times, it is imperative to look at both Israelis and Palestinians as people who are so traumatized that mental health challenges are common.

#stopasianhate

Ever since the Covid-19 pandemic began in 2020, backlash against Asian Americans have reached an all-time high, with around a 150% increase in hate crimes against Asian Americans and Pacific Islanders this last year. Part of this stems from Wuhan, China, being the supposed epicenter of the coronavirus, but it is also the actions of our world leaders that invigorate fear and hatred against Asian Americans. During his second election campaign in 2020, U.S. President Donald Trump referred to Covid-19 as the “Kung Flu” at two of his rallies, once in Oklahoma and again in Arizona. The president also frequented his Twitter account with racist tweets about the “Chinese virus.” This is in direct violation of the World Health Organization’s guidelines for the naming of diseases, which state that since 2015, infectious diseases should not include geographic locations in order to avoid backlash against certain people. Others have since followed his example, tweeting out floods of anti-Asian rhetoric with the hashtag #chinesevirus.

The resentment against Asian Americans doesn’t just stop with harassment online. It also takes the form of twisted mouths screaming racist comments, clenched fists beating down elderly men and women, bullets tearing through wives and mothers just because of their ethnicity. In New York City, Brandon Elliot violently assaulted a 65-year-old Asian American woman outside of an apartment building. In Georgia, Robert Aaron Long murdered 8 people, 6 being of Asian descent, in Atlanta spas. These aren’t just isolated circumstances. Incidents like these are plastered all over the news and some days it seems hopeless; life feels overwhelming in the face of hate.

However, the actions of a few can and will make a difference. In spite of the massive wave of backlash against Asian Americans, people like Jacob Azevedo have banded together to protect victims of violence. Azevedo created Compassion in Oakland after hearing about the swell of anti-Asian attacks and exists to chaperone people in the Oakland Chinatown area in order to help them feel safe. The organization has over 400 volunteers and a working hotline to call whenever you need a walking friend. The name Compassion in Oakland comes from their mission statement, which reads, “We promote compassion not indifference, unity as opposed to divisiveness.” This is why you should care about what’s happening in the world right now, because we can’t just ignore it. Just like Jacob Azevedo, a Latino man who demands the unification of all minorities, we cannot just stand by while our family and friends are threatened and injured. We must call attention to the upheaval of hate against Asian Americans, and we have to say it loud.

By Callum Lee

Too Fast Too Soon

Mentally Leaving the Pandemic

There have been five hundred and fifty thousand deaths from COVID-19 in the United States and 2.81 million worldwide, according to the (New York Times March 31, 2021). When we address the issues, let us remember that it is global disease and the measures taken by governments in many countries have largely been to prevent more deaths.

There is a mental fatigue from the pandemic, affecting overall health. It is from staying indoors and not seeing friends or family no matter where you live or what country you are in. There is also the loss of work and income, and the impact on long-term financial stability while trying to pay one’s current bills.

We should also remember that the younger generation facing social issues and the difficulty of hanging out with friends. Now we have family or at home schooling. To be at home with one’s parents and siblings must be frustrating at times, and our youth, like some adults, are not able to hold part-time jobs.

What do we do?

COVID-19 has not gone anywhere. If we compare this pandemic to the Spanish Flu from 1918 – 1920, we see that the number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States (from CDC.org). We understand the gravity of the pandemic, but can we afford mentally, physically, and financially to remain in the pandemic mindset?

If we look at the recent Spring Break in Miami, it’s been hard for young people. The parties, the drinking, and the having fun are things we all miss. Yes, there is also the destruction, fights, and recklessness that we cannot condone nor can we overlook the transmission of the virus it may have caused. YouTube Video Should we have totally canceled Spring Break and closed our bars and restaurants?

Let’s go back to the debate on mental health and leaving the pandemic. There is a physical leaving and a mental staying in place. Traveling, vacations, getting out with people and going to our usual places help maintain our mental health. It is also about the planning and the anticipation. If we take that away, then mentally we lock ourselves indoors.

As we ponder the situation in America, we are seeing a rise in COVID Cases. Some European countries are already looking at their fourth wave and we are seeing the lockdowns begin. Let’s not forget the direct impact of the disease – the rampant death – but also what has been done to us on global level both mentally and physically.

by Dane Flanigan ultraHealth Agency

Healthcare Worker Burnout During COVID-19

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Along with the rise of COVID cases has come a wave of mental health crises, especially among healthcare workers. As the pandemic goes on, those on the front lines are, understandably, experiencing sustained levels of stress, anxiety, and frustration, in other words, burnout. Fortunately, conversations about mental health and illness have become more mainstream in recent years leading to a wealth of resources now adapted to address the specific needs of healthcare workers during this time.

Handling stressful situations, making life and death decisions, and confronting illness are not new for medical professionals. However, the scale and particularities of each have changed. Healthcare workers managing heavy caseloads and working long hours in stressful environments may do so in bursts by running off adrenaline. But over an extended period of time, the adrenaline wears off. This chronic period of elevated stress is “akin to what people might experience during prolonged war or refugee crises.” U.S. Military personnel assisting in New York hospitals even said this is the closest to combat they have seen in a civilian setting.

In regions with high mortality rates, “‘clinicians often describe a feeling of helplessness-an inability to render care…to the fullest extent they would desire.’” Changing safety protocols and information compound feelings of helplessness by making it difficult for workers to feel they are properly caring for patients and adequately protecting themselves.

Having sufficient protective equipment is not a guarantee. Even with it, workers still worry about their own health and the health of loved ones. That’s why many have sacrificed living with their families and support networks to limit risks. Not only are they separated from their own families, but they are also taking on the roles of patients’ loved ones. Nurses and nursing assistants often act as “conduits for video calls and emotional support” because patients’ families cannot be at their bedsides. Many have “forgone breaks to hold patients’ hands as they die,” says Dr. Jessica Gold, assistant professor of psychiatry at Washington University in St. Louis, Missouri.

In addition to feelings of helplessness and isolation, healthcare workers are also experiencing high levels of frustration. Many feel the concern and support they provide for others is not reciprocated outside hospitals. An article in the American Cancer Society Journals cited the politicizing of mask-wearing rather than focusing on the science as an example. One doctor even said it feels like “‘nobody’s listening, nobody’s following the rules…and the numbers aren’t going down.’” Refusing to wear masks or follow social distancing has a direct effect on healthcare workers making their jobs more difficult. This results in anger and even PTSD symptoms. A lack of time to process and heal as well as “a culture of stoicism” keep healthcare workers from seeking help.

It’s important to be able to recognize burnout so healthcare workers can receive help. According to the Minnesota Department of Health signs of burnout may include getting easily frustrated, experiencing sadness, depression, or apathy, disconnecting from others, poor self-care (diet and hygiene), and using unhealthy or unsafe coping mechanisms such as drugs or alcohol.

While these feelings are normal and valid, healthcare workers do not have to suffer from them. Coping strategies include diving back into old hobbies or picking up new ones, limiting media exposure, exercising regularly, and maintaining good sleep habits. Technology can help by tracking steps, glasses of water, heart rate, and setting alarms to take breaks, even if it’s just for a few moments to breathe.

Co-workers can adopt the buddy system. Partners “monitor each other’s stress, workload, and safety.” This is especially useful for those living alone or away from family by giving a sense of connection and being looked after. Buddies should set a schedule for check-ins either through texts, calls, or video chat. Social media support groups offer places to share, vent, and connect. For professional help, teletherapy companies, Talkspace and BetterHelp, offer healthcare workers 50% off their first month.

It’s also important to maintain connections outside of work. Have a game night via video chat; Pictionary and charades are great options using minimal supplies. Play video games or host a movie night. Amazon Prime even has a Watch Party feature they say is “almost like watching side-by-side in real life–without having to share your popcorn.” A list of more resources such as live mental health counselors and meditation apps can be found here.

If you are concerned you or someone you know may want to harm yourself or someone else, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255). Para obtener ayuda en Español, llama al 1-888-628-9454. Or call the National Domestic Violence Hotline at 1-800-799-7233 and TTY 1-800-787-3224.