At its founding, GCMHP represented an important new effort to address the pressing mental health needs of a society rocked by violence, upheaval, and uncertainty.

Mental health services in the Gaza Strip were extremely scarce at a time when the need for such services was perhaps at its highest.

The Mental Health Services Department (MHSD), which over time has come to incorporate more and more clinical services, aims to improve the state of mental health in the Palestinian community, particularly among the most vulnerable sectors. Even as the scope of the Programme has expanded, clinical work still remains at the heart of GCMHP's sustained efforts to heal the wounds of violence and suffering.

The Mental Health Services Department represents a comprehensive system with standard procedures and a community-based approach to mental health services appropriate to the needs and demands of Palestinian society. Treatment plans routinely involve the family, and patients are often visited in their homes, to ensure a supportive and relaxed environment and to emphasize the communal aspects of mental health therapy. From its inception as a single clinic with three staff members, GCMHP has expanded to include three clinics, one community day treatment program (CDTP), an occupational therapy unit, an Electro-Encephalo-Graphy unit (EEG), a pharmacy, and a physiotherapy unit.

Clinics:

The Mental Health Services Department operates four clinics distributed throughout the Gaza Strip. The more recent of these was opened in 1999 in the town of Deir al-Balah, serving the middle of the Strip, which previously lacked a specialized mental health facility. GCMHP's other clinics are located in Gaza City, Jabalia, and Khan Younis.

Over the past several years, the clinical staff has become increasingly specialized through advanced training and experience. With a multi-disciplinary team in each clinic, GCMHP has adopted a specialized case management process comprised of identification, coordination, and monitoring of patient services. This diversification has allowed for specialized handling of cases for women, children, and victims of human rights violations. Upon receiving a referral, a member of the team conducts a comprehensive clinical interview in order to begin assessment. If necessary, home, school, or work visits are conducted to complete the evaluation. Then a team discussion is conducted, during which the team makes a diagnosis and creates treatment plans. At that point, a case manager takes responsibility for the case, providing treatment, conducting follow-ups, making home visits, and carrying out evaluations.

With a combination of psychological, family, and community interventions, the GCMHP clinical team attempts to provide a supportive environment in which healing can take place. While performing classical psychological work, GCMHP firmly roots its therapy in a culturally sensitive, community based approach, adapting Western approaches to the needs of Palestinian society.

Community Day Treatment Program (CDTP) GCMHP is currently working to upgrade the Deir al-Balah clinic to a day treatment facility, serving the middle zone of the Gaza Strip. The major components of this new treatment program are:

• Crisis intervention services
• Treatment and rehabilitation
• Out reach and care management for patients and family
• Public meetings and public awareness campaigns about mental health

Occupational Therapy Unit

The Occupational Therapy (OT) Unit was established in 1991 at our Jabalia clinic. Occupational Therapy enables individuals to function as independently as possible in their daily life activities and working environment. During the OT sessions, clients develop disrupted skills through various therapeutic activities like painting, drawing, wood activities, and carpet weaving.

EEG Unit (Electo-Encephalo-Graphy)

The EEG Unit was established in 1991 in the Gaza City clinic to serve all the population in the Strip. Twenty percent of cases at the Gaza clinic receive EEG services free of charge and the remainder (80%) paid cost price only for the diagnostic tests.

Pharmacy:

Although GCMHP does not follow a medical-oriented approach, psychotropic drugs are proscribed to some clients, particularly chronic cases and patients requiring medication for a short period of time in the initial phase of therapy. To ensure that clients receive appropriate medication at an affordable price, each clinic has a pharmacy. Because of economic hardship, approximately 60% of clients receive medication free of charge. The remaining 40% pay the cost price only for medication.

Physiotherapy Unit:

The Physiotherapy Unit was established in March 1998 at the Gaza clinic to provide services for GCMHP clients, especially victims of human rights violations. The main goal of physiotherapy is to enable the individual to overcome his psychomotor dysfunction so that he can be reintegrated into the community.

Information Systems:

Clinical data is preserved in a computerized database. In June 1999, a special committee composed of the Medical Director, Medical Secretary, and a computer software expert startd working to upgrade the database management program in order to solve several problems experienced in several areas that include outcome, diagnosis, case management, and age. The new program started functioning in March 2000. Currently, a trained medical secretary who is supervised by a qualified computer programmer maintains the database. The database is highly confidential and access to the information is given only to qualified personnel.