Introduction
The Gaza Strip faces an unprecedented humanitarian crisis. The death, destruction and displacement caused by the ongoing conflict, coupled with lack of access to basic needs, is contributing to an unfolding mental health emergency. As a health worker you are a vital part of the humanitarian response, providing support and hope. This guide, which emphasizes risk communication and community engagement (RCCE), equips you with practical strategies to navigate this challenging landscape.
Understanding the mental health landscape
Gazans are grappling with immense physical, social and emotional distress. Constant exposure to violence, death, destruction and frequent displacement have created a pervasive atmosphere of uncertainty, lack of control, intense fear and anxiety. The constant sound of bombs and the noise of drones is a constant and terrifying reminder of ever-present threats. Combined with the degradation of social structures and institutions, individuals and communities are vulnerable to both mental and physical health challenges.
Remember: your role is not to provide professional mental health treatment but to offer compassionate support and facilitate access to available resources.
Section 1. Communicating effectively in crises
Building trust and connection
Active listening
Create or find a space where you can communicate openly. Listen attentively, validate feelings and offer comfort and encouragement.
Validate feelings and emotions
Acknowledge and affirm people’s emotions and experiences. This builds trust and connection by demonstrating that their feelings are respected.
Empathy and respect
Treat everyone with dignity and understanding.
Non-judgmental language
Use simple, clear language free of medical jargon. Avoid labelling or stigmatizing behaviour that stems from ongoing traumatic experience.
Remember that everyone in Gaza experiences crisis differently. Avoid making assumptions about individual needs or reactions.
Addressing rumours and misinformation
Be a source of accurate information
Provide accurate, timely and relevant information about available services, coping strategies and sources of support.
Counter harmful narratives
Address rumours and misinformation with empathy and facts. Promote hope and resilience.
Engage with community leaders. Collaborate with religious leaders, elders and influential community members to disseminate accurate information and promote positive mental health practices.
Section 2. Supporting community resilience
Promoting supportive environments
Identify communal spaces
Help communities identify and create spaces where people can come together, share their experiences and find respite from ongoing stress.
Facilitate support groups
Organize support groups for women, men, youth and other specific groups to connect, share coping strategies and support a sense of community.
Strengthen family support
Encourage family members to communicate openly, offer support and practice self-care together.
Empowering communities through information
Develop accessible resources
Collaborate with communities to design culturally relevant and easily producible information, education and communication (IEC) materials (posters, flyers, radio, SMS) that address common mental health concerns, taking into account difficulties in securing materials and adapting them to what can feasibly be produced or used. Consider alternative options that work until more suitable materials can be sourced.
Utilize traditional communication
Leverage available community networks — including makeshift gathering places and community radio — to reach broader audiences with mental health messages.
Harness the power of social media
When possible, share credible mental health information and resources through social media platforms, tailoring content to specific age groups.
Section 3. Practical skills for supporting mental health and psychosocial well-being
Promoting healthy coping mechanisms
Focus on immediate needs and support
Rather than focusing on long-term goals, help individuals focus on what they need right now and what they are feeling at this moment. Offer practical assistance whenever possible — sharing information, connecting people to resources or simply offering a listening ear. Acknowledge the overwhelming challenges and the limited availability of real support and provide whatever immediate assistance is possible in dire circumstances.
Encourage basic self-care
Emphasize the importance of self-care in the midst of crisis. Promote healthy coping strategies like:
Breathing exercises
When anxiety takes hold, take slow, deep breaths. Try inhaling for 3 seconds, holding for 3 seconds and exhaling for 3 seconds. This simple practice may decrease stress levels and help you feel calmer.
Gentle movement
Even amid constant noise and chaos, stretching can help ease the tension you carry in your body. Try gently rolling your shoulders or tensing and relaxing each muscle group, starting with your toes and working up to your head.
Shift your focus
When your mind is overwhelmed with worry, try to gently shift your attention to something specific. If it helps, try the 5-4-3-2-1 technique: name 5 things you can see right now, 4 things you can feel, 3 sounds you can hear, 2 things you can smell and 1 thing you can taste. Even if you can't complete the list, this technique can help ground you in the moment.
Simple routines
Even in chaos, small routines can offer a sense of order. Maybe it's saying a prayer at the same time each day, making a point to share a story with a loved one every evening, or setting aside a few minutes each morning and night to find a quiet corner and breathe deeply. These small acts, practiced regularly, can make a difference in a world where so much feels out of control.
Remember your strengths
Remind yourself of what you can do, even in this difficult situation. Small acts of kindness, caring for those around you and simply getting through each day are all signs of your strength.
Be kind to yourself
These are unimaginable circumstances. Treat yourself and those around you with patience and understanding. We are all doing the best we can.
Avoid false hope. Be careful not to minimize suffering or offer unrealistic expectations about the future.
Sharing and supporting one another
Emphasize the power of human connection. Encourage people to share stories, traditions or songs that offer hope and remind them of their shared strength and resilience. Even in the darkest of times, these moments of connection can be a source of comfort and strength.
Emphasize collective strength
Frame resilience as a communal effort rather than an individual burden. Highlight that resilience is built and sustained together, not in isolation.
Remember: the goal is not to pretend things are normal but to offer small, meaningful ways to cope with unimaginable stress.
Recognizing signs of distress and taking action
While everyone reacts to crisis differently, pay close attention if someone is:
Withdrawing deeply from others, even those they trust
Expressing hopelessness or despair that seems beyond their usual emotional state
Showing increased agitation, aggression or recklessness
Seeming unable to cope with daily tasks or care for themselves or their children.
Know when to refer
While you may not be a mental health professional, you can recognize when someone needs additional support. When this is the case, contact the relevant mental health professionals.
Facilitate access to resources
Familiarize yourself with available mental health services and assist people in accessing them. This might include providing information, making referrals or accompanying someone to access care.
Section 4. Addressing specific needs
Children
Remember that children are deeply affected by this crisis, even if they can't express their feelings. At every opportunity:
Prioritize their safety
Even though we can't always control what happens around us, let children know that you are there to care for them and keep them as safe as possible. Remind them that you are a source of comfort and protection, even amidst the fear.
Offer comfort through familiar activities
Engage them in simple, familiar activities while offering comfort and reassurance — singing songs, telling stories, a hug, a gentle touch as appropriate, a calming voice — even if just for a few moments to provide a sense of normalcy.
Older adults
Support older adults in accessing necessities, social support and information that is relevant to their needs.
People with disabilities
Advocate for inclusive access to services and support for people with disabilities who often face heightened barriers during emergencies. Help as much as possible to ensure that their basic needs are met, such as access to wheelchairs, diapers, hearing aids and glasses.
People with chronic conditions
Remember that people with existing physical health needs face even greater challenges during times of crisis. If possible:
Help them access essential medications or treatments, even if supplies are scarce. This is a significant challenge in the current context, so be proactive in seeking out alternative solutions and available resources. When medications or treatments are unavailable, de-escalating the situation may be the best possible option. Here are some key de-escalation techniques to consider:
Respect personal space
Respect the individual's and your own personal space. Maintain a distance of at least 2 arm's lengths.
Do not be provocative
Avoid escalation by remaining calm in your language and demeanor. Keep your hands visible and avoid staring.
Establish verbal contact
Only one person should verbally interact with the agitated individual to avoid confusion and further escalation. Introduce yourself, listen to them, provide orientation and reassurance, and be polite.
Be concise
Use short sentences with simple vocabulary. Allow time for the information to sink in and repeat essential points. Repetition aids understanding.
− Be optimistic and honest
Honesty is crucial. Short-term dishonesty can lead to greater problems.
Identify needs and feelings
Use structured questions to identify needs and feelings. Ask questions like: “I really need to know what you expected when you came here? Even if I can’t provide it, I would like to know so we can work on it."
Family and friends as allies
Identify trusted others who might help in the situation. Don’t assume you know what the patient wants.
Agree or agree to disagree
Find common ground without necessarily agreeing completely. For example, if the agitated person is complaining about being disrespected, you can agree in principle by saying, “I believe everyone should be treated respectfully”, to acknowledge their feelings and emphasize the importance of mutual respect.
Lay down the law and set clear limits
Set reasonable limits in a respectful manner, emphasizing mutual respect.
Propose alternatives and coach self-control
Be assertive and quickly propose alternatives to violence to prevent spiraling aggression from turning into assault. Coach the person on maintaining control. For example, “I can’t pay full attention to what you are saying. You could help me understand better if you were to calmly tell me your concerns”.
Offer extra reassurance and support as people navigate their health needs amid chaos.
People with pre-existing mental health conditions
The stress of this crisis can severely impact those with existing mental health conditions. Let them know:
You will do everything you can to help them during this incredibly difficult time, including helping them access essential medications or treatments, even if supplies are scarce, and acknowledge that managing their mental health during this period is also incredibly difficult. When medications or treatments are unavailable, de-escalating the situation may be the best option. (Refer to the pointers above for key de-escalation techniques).
You are there to offer extra support and reassurance as they navigate the challenges of this crisis.
If they had coping strategies that worked for them before in difficult times, encourage them to try using those strategies again as much as possible.
Section 5. Self-care for health workers
Supporting your own well-being
Acknowledge your own stress
Recognize that your emotional well-being is as important as your physical health. You are not immune to the impact of the crisis.
Prioritize your needs
We know that even the simplest comforts feel impossible now. But in chaos, tiny moments of peace matter. Find a quiet corner or moment, if only for a few breaths. Close your eyes, slowly count to 10 or share a moment of silence with a colleague. If finding a quiet place is impossible during the day, try to take these moments of calm late at night when it is more feasible. These pauses help us keep going.
Seek support when needed
Talk to trusted colleagues, friends or family members. Don't hesitate to access professional support if you are struggling.
Remember: by prioritizing self-care, you are better equipped to support others.
Section 6. Available mental health resources
You are not alone in this effort. Services are available to support those struggling with their mental health. We encourage you to familiarize yourself with these resources and assist individuals in accessing them. Medications to support those with pre-existing mental health conditions are also available.
This guidance is a "living document", meaning it will be updated as the situation evolves and more resources become available.
Sources
Mental health and psychosocial support for humanitarian workers
Mental health and psychosocial support platform
