Mental health of health professionals and their perspectives on mental health services in a conflict-affected setting: a qualitative study in health centres in the Gaza Strip during the COVID-19 pandemic

OBJECTIVES: To explore how primary care health professionals perceive their own mental health in a conflict-affected setting during and beyond the COVID-19 pandemic and to explore their perspectives on mental health services. METHODS: The Gaza Strip faces a chronic humanitarian crisis and is suffering from the consequences of the COVID-19 pandemic; United Nations Relief and Works Agency (UNRWA) health centres were used to recruit participants for this study. Semistructured interviews were conducted with 29 health professionals in UNRWA health centres who were sampled using maximum variation sampling. Transcripts were translated, double checked and analysed via thematic analysis. RESULTS: From the analysis, a thematic map was developed showing how health professionals perceive their mental health impacts. This included difficulties due to the COVID-19 pandemic, as well as the socioeconomic processes stemming from the on-going conflict. Another thematic map was developed showing the perceived strengths and challenges of the health services. The strengths included positive impact of the services to the service users and health professionals. In terms of challenges, health professionals identified socioeconomic processes and aspects of remote service provision during COVID-19. CONCLUSIONS: Based on the findings, we suggest that an improved signposting mechanism should be developed to address many of the challenges that emergencies bring about; in particular, this could support the health professionals’ mental health, as well as improve the response to patients’ socioeconomic challenges. We further suggest recommendations for improving mental health services when delivered remotely to increase their resiliency during various emergencies.