Médecins Sans Frontières’ community-based mental health programme, which opened in December 2008, has been alone in offering free consultations in the refugee camp and its vicinity. Since then, the services have also been provided inside the facilities of the main health providers in the camp: the Palestinian Red Crescent Society (PRCS) and the United Nations Relief and Works Agency. By breaking the taboos associated with mental health issues, and by giving individuals support and lending them a sympathetic ear, people are beginning to bring their troubles out into the open. A team made up of international, Lebanese and Palestinian staff is providing psychological, psychiatric and social support to the most vulnerable people, regardless of their gender, nationality or religious and political convictions. In 2009 and 2010, more than 1,000 patients had consultations with Médecins Sans Frontières’ psychologists and psychiatrists, the majority of them Palestinian and Lebanese women aged between 25 and 40 (60%).
Many of the camp’s residents have been deeply affected by successive wars and conflict; their prospects for the future are bleak; employment is hard to come by; and most suffer difficult living conditions and a precarious socio-economic situation. In such an environment, depression is very common, affecting almost one-third of patients seen, while others are affected by anxiety (22 percent of patients), psychosis (14 percent of patients), bipolar disorders (10 percent of patients) and personality disorders.
“Médecins Sans Frontières always tries to set up a community-based and multi-disciplinary approach,” says Pierre Bastin, Médecins Sans Frontières’ mental health advisor in Geneva. “This means that we do not limit ourselves to prescribing drugs, but try to provide comprehensive bio-psycho-social care. We like using this model. As the factors behind the illness are of a biological, psychological and social nature, so the treatment must also address these three issues. In practical terms, this means that the biological factor will be treated with drugs by the psychiatrist, and the psychological aspect will be treated by the psychologist working with the patient and possibly relatives. As for the social side, there are also social conditions that must be addressed to help the patient improve.”