Barriers to treatment of mental health problems for Palestinian people in refugee camps in Jordan: a cross-sectional study

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Abstract Background About 2·1 million Palestinians live in Jordan, and 370 000 Palestinians live in Jordanian refugee camps. Conflict in their country of origin, poverty, unemployment, and squalid camp conditions are some of the environmental factors that render Palestine refugees susceptible to mental health problems. The aim of this study was to identify the barriers that contribute to the treatment gap in mental health-care services for Palestinian refugees in the Baqa'a refugee camp north of Amman, Jordan. Methods In this cross-sectional study, qualitative, semi-structured interviews of health-care professionals working at health centres for Palestine refugees in Jordan were done by a British researcher in the English language in the presence of an interpreter. All interviews were recorded, transcribed, and thematically analysed. Ethical approval was granted by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the University of Leeds. Written consent was obtained from all participants. Findings 16 health-care professionals were interviewed during a 3 week period in May, 2015. 14 participants were based in health-care centres at the Baqa'a refugee camp, and two participants were based at the Field Office of the UNRWA in Amman, Jordan. All (100%) participants reported that underfunding was the most common barrier to accessing treatment. Other major barriers were sex (reported by 15 [94%] participants), stigma and religion (12 [75%]), and culture (ten [63%]). Interpretation We suggest the following policy recommendations to overcome the barriers to accessing and using mental health-care services in Palestinian refugee camps in Jordan: (1) allocation of more resources for the provision of mental health-care services; (2) establishing a health and social care model that adopts a holistic approach to treating mental health problems in Palestinian refugees, incorporating a framework that facilitates enhanced communication and cooperation between faith leaders and health-care providers; and (3) launching anti-stigma campaigns that are culturally and religiously sensitive and specific. Funding None.