'Anxiety, nightmares and self-harm': How Israel is pushing children’s mental health beyond breaking point in Gaza

A month of relentless bombardment has exacerbated the already-critical mental health crisis for Gaza’s children with far-reaching consequences, as Save the Children warns that children’s mental health in Gaza has been pushed beyond breaking point.

About half of Gaza’s 2.3 million population are children, whose coping strategies and safe spaces have been ripped away while mental health services and assistance have been cut off.

These extremely vulnerable individuals have been barely surviving since October 7 due to the ceaseless shelling and strikes from the Israeli military, which has resulted in unprecedented levels of violence — 10,812 people have been killed, including 4,412 children, and 2,918 women. Meanwhile, 26,905 people have been injured.

"Some are ripping out their hair or scratching their thighs till they bleed. They’re in extreme distress, leading to self-harm and noticeable behavioural changes"

Countless families with children have been forced to vacate their homes with limited access to basic resources such as clean water and food. 

Children are writing their full names on their arms and legs in fear of being registered as an “unidentified person” if they were to get killed by Israeli attacks. In many cases, entire families have been killed all at once.

There is so much focus on the physical toll of this war simply because Palestinians do not have the luxury to think about mental health, especially children. 

“Some are ripping out their hair or scratching their thighs till they bleed. They’re in extreme distress, leading to self-harm and noticeable behavioural changes,” Iman El Madhoun, a psychologist who has worked across clinics in Gaza, explained to The New Arab.

“The unfortunate act of children having to write their names on their body in case they die is extremely harmful to the child’s thoughts, it destroys their mental health. It is like preparing them for death, thus making the child more anxious, overwhelmed, and fearful,” Iman added.

Save the Children's mental health experts have warned that the current conduct of hostilities in Gaza is exposing children to extremely traumatic episodes while stripping away options to help them cope. 

There is no safe place, no sense of security and no routine, with thousands displaced from their homes, the leading children's organisation said. 

"Children are experiencing a whole host of signs and symptoms of trauma including anxiety, fear, nightmares and disturbing memories, insomnia, bottling up emotions and withdrawing from loved ones"

Caregivers experiencing their own stress are struggling to help children cope with the overwhelming emotional reactions typical of young people traumatised by violence.

Under current conditions in Gaza, children are experiencing a whole host of signs and symptoms of trauma including anxiety, fear, worry about their safety and that of their loved ones, nightmares and disturbing memories, insomnia, bottling up emotions and withdrawing from loved ones.

The trauma giving rise to these symptoms is ongoing, relentless and compounding day by day.

“Time and time again, we’ve warned that the toll of conflict and the blockade on children’s mental health is too great. Even before this escalation, more than half of the parents we spoke to reported that their children were self-harming or experiencing suicidal thoughts," said Jason Lee, Save the Children’s Country Director for the occupied Palestinian territory.

"We are running out of words to raise the alarm in strong enough terms or to articulate the scale of children’s suffering."

A report by the Euro Mediterranean Human Rights Monitor found that 91% of children are diagnosed with PTSD.  

Additionally, studies conducted by Save the Children after earlier conflicts have shown that there was a significant increase in the number of children who reported feeling fearful — 84% compared with 50% in 2018, nervous — 80% compared with 55%, sadness or depression — 77% compared with 62%  and grief —78% compared with 55%.

"More than half of Gaza’s children thought about suicide, and three out of five thought about self-harm"

Save the Children also reported that more than half of Gaza’s children thought about suicide, and three out of five thought about self-harm.

For most children in Gaza, this trauma has been part of their lives since they were born, growing up with the sound of bombs, scenes of destruction, horror and death, while frequently having to mourn their loved ones.

Countless children have been pushed to the brink of life and death situation, causing some to endure the pains of ageing alone due to the loss of their entire families.

Heartbreakingly, in an effort to enhance their likelihood of survival, parents are increasingly forced to separate siblings and give them to different relatives.

Many families have already been completely obliterated from the civil registry, according to official media sources.

Medical professionals in Gaza including Médecins Sans Frontiers/Doctors without Borders have shared that the number of children without surviving family members arriving for medical care is so high that a new acronym has been coined to identify them – “WCNSF” (Wounded Child No Surviving Family).

“I genuinely thought our world could not be this horrible, every single Palestinian right now feels that humanity is a delusion,” Reham Dalloul, a multimedia journalist from Gaza and mother to three young children said to The New Arab.

“The world is deaf to our suffering, we are being eliminated whilst the world is watching,” Reham added.

"Death is everywhere. My children look into my eyes every day, they are searching for answers. I have no answers for them"

A Save the Children staff member in Gaza and a father of three children aged under 10, said, “There is a lot of loss and a lot of pain. We are fearful: of what the coming hours will bring, of what tomorrow will bring. Death is everywhere. My children look into my eyes every day, they are searching for answers. I have no answers for them. It is very hard, especially for children. We try to pull ourselves together to support and protect children. The needs are huge.” 

With Israeli airstrikes over the last month hitting thousands of civilian spaces in Gaza including schools and hospitals sheltering families the violence, fear, grief and uncertainty are causing serious mental harm for children with no safe place to go.

Previous studies indicate that the present reality has placed children under graver circumstances, leading to an increase in psychological distress.

"Instead of writing their names on their homework, they’re preparing for death? What a cruel world we live in” 

“Palestinians, especially Gazans feel completely isolated — they feel devalued as they watch the world leaders remain volntarily silent to their pain and suffering. This in itself evokes a completely different type of psychological trauma," Iman said.

Reham added, “'If my hand survived, this is my name,' how devastating is it for a child to write that? Instead of writing their names on their homework, they’re preparing for death? What a cruel world we live in.” 

According to the UN Office for the Coordination of Humanitarian Affairs, 15,000 people evacuated the north on Tuesday, with the Israeli army saying that its forces were moving towards the Al-Shifa Hospital in Gaza City. 

On November 8, G7 foreign ministers said that they supported "humanitarian pauses and corridors" but refrained from calling for a ceasefire.

"We stress the need for urgent action to address the deteriorating humanitarian crisis in Gaza... we support humanitarian pauses and corridors to facilitate urgently needed assistance, civilian movement, and the release of hostages," the ministers said in a joint statement after talks in Japan.

But "without an immediate ceasefire, there’s a very real risk that children’s mental health will be pushed to the point of no return,” Jason Lee from Save the Children said.

"Every day of violence means more mental and physical scars that will last a lifetime."

Rodayna Raydan is a Lebanese British journalism graduate from Kingston University in London covering Lebanon

Follow her on Twitter: @Rodayna_462