Mental health has long been a pressing concern for children in Gaza, where, for decades, Palestinians have faced food insecurity, contaminated drinking water, periodic assaults by Israeli forces, and confinement to the twenty-five-mile coastal strip. But in the nearly seventeen months since Hamas’s attacks against Israel on October 7, 2023, Israel’s full-scale assault on Gaza has created horrifically traumatic conditions that have led to widespread alarm about children’s mental health needs in the region.
A new report was released in December from War Child Alliance, a United Kingdom-based organization that advocates for the mental health and well-being of children in conflict zones around the world. It reveals the staggering toll on the mental health of Gaza’s children, who struggle every day to survive amid bombing, armed assaults, starvation, and disease while lacking adequate shelter and medical care. The report, based on data gathered last June, includes interviews with 506 children who had been injured or lost a family member. It found that 96 percent of children interviewed felt that death was imminent, 87 percent displayed severe fear, and 49 percent wanted to die because of the war.
Kieran King, War Child’s global Head of Humanitarian, told The Progressive in an interview shortly before the six-week ceasefire took effect on January 19 that while these figures are shocking, they represent a longstanding state of affairs in Gaza.
“It didn’t start on October 7,” King says. “There was a report published by Save the Children in 2022 called Trapped, which found that 59 percent of children were showing reactive signs of mutism, not speaking entirely or partially due to a specific traumatic event; 79 percent of children exhibiting bed-wetting. These are figures you don’t see anywhere else. Those statistics really laid bare the unimaginable psychological impact on children in Gaza.”
King, in this interview, pointed to a recent study published by the leading medical journal The Lancet, which showed that the mental health impact of conflicts in several countries over a period of years was that, on average, 22 percent of children suffered from some acute trauma related to that conflict.
“In Gaza, it’s undeniable that every child is affected,” he said. “Four out of five demonstrate signs of acute trauma—nightmares, acute anxiety, withdrawal, mutism and also symptoms of physical pain, not from injury but from mental trauma. I think it speaks to one of the areas that is unique about the conflict in Gaza, which is the impacts affecting the entire population and the mental health crisis, and the only remedy to that is a ceasefire.”
According to King, War Child and other organizations are also working on child protection and education as well as mental health and psychosocial support. “We run programs to identify children with specific vulnerabilities and protection risks,” he said. “We work through those cases with those children to address those risks, but when it comes to the mental health solutions, we do group therapy sessions, we do individual counseling.”
King said this work is being done “with children who are subject to repeat trauma and repeat displacement,” adding that the risk this compounded trauma “poses for their future well-being can’t be quantified today, so that’s a massive concern for us and everyone else.”
James Leckman, a professor of child psychiatry at the Yale University School of Medicine who has worked in Israel and Palestine, notes that certain fundamentals are necessary to ensure good trauma care. Such care, he says, starts with “adequate nutrition, a safe place to live and to learn, and that they actually can envision a realistic path to a positive future. And the reality in Gaza is none of those things.”
Leckman is the co-founder of the Empowerment and Resilience in Children Everywhere, which provides training and support programs for professionals working with children in Gaza, and is a member of the Early Childhood Peace Consortium. His work, he says, involves “giving presentations and speaking with counterparts and raising money and being supportive of peace-building.” Some of his colleagues teach psychologists and others from both sides of the divide.
King echoed Leckman’s assertion that psychotherapy is inaccessible for nearly every child in Gaza. This shortage, King said, stems from a widespread lack of professional expertise: As of January, there were only five psychiatrists and a few dozen psychologists remaining in Gaza, serving a population of more than one million. “We’re working with our partners and with those specialists for ways we can embed mental health expertise into other sectors, such as health and education,” said King.
Four weeks in, the six-week ceasefire has mostly held, aside from Israel’s killing of roughly 130 Palestinians in the strip. But both Prime Minister Benjamin Netanyahu and President Donald Trump have indicated that Israel will most likely carry on the war when the ceasefire ends.
“While this fragile ceasefire means the bombs have stopped falling for now, there has been systemic damage to the society in Gaza,” King told The Progressive via email on February 18. “Until we have a safer and more stable environment, and full access, then we will not be able to fully address the immense psychological trauma that children have experienced. States and donors must be ready to support a Palestinian-led, long-term, wide-ranging rehabilitation program for all the children of Gaza.”