Community-based approach to mental health promotion in a civilian population living under military occupation

Mental health problems related to exposure to violence, injustice, and the stress of ongoing conflict affect the majority of the Palestinian population. Based on the concept that mental health problems caused by the social suffering of war require a social response, PMRS has integrated mental health intervention into its existing community based rehabilitation (CBR) program. Begun in 1992, the program includes 100CBR workers in 200 communities throughout the West Bank. CBR workers have received basic training in community and rehabilitation work for two years. The mental health intervention aims to assist those affected in positively managing distress. The principle is that the majority of those affected heal within community, that is, with social support, understanding, collective problem solving, and the expansion of spaces to allow for their active engagement in the solution of their problems, supported by community. The rationale entails the fact that most in community are negatively affected by ongoing chronic violence and poverty and the lack of space for agency and participation. In the meanwhile it is also known that social fabric weakens or disintegrates during such difficult times. Thus the task is to assist communities by working to rebuild or strengthen social fabric, provide the space for participation, and assist communities in helping themselves by drawing on existing communal resources. This program may well be an option for replication elsewhere, especially low-resource communities affected by violence and deprivation.