The Limitations of Deinstitutionalization: The Case of the Israeli-Occupied Palestinian West Bank
occupied Palestinian territories
West Bank
Gaza Strip
mental health disability
community care
deinstitutionalization of mental health services

This essay examines the concept and limitations of deinstitutionalization as a principle and practice derived from Western paradigms, and how it has been problematically implemented in non-Western settings, ­including the Israeli-occupied West Bank. It begins by reviewing the international literature on deinstitutionalization of people with mental health illnesses/disabilities. It then examines the Palestinian experience with deinstitutionalization in the West Bank with an eye to its many limitations, in order to propose alternatives to successfully relocate people with ­mental health disabilities from hospitals to their communities, and to ensure for them a dignified life. The essay ends with an emphasis on this need in the ­Israeli-occupied Palestinian territories given the ongoing daily reality of Israeli military occupation and apartheid, which have had dire effects on Palestinians’ mental health.

Author biography: 

Rita Giacaman is professor of public health at the Institute of Community and Public Health, which she founded in 1978 at Birzeit University, in the Israeli-occupied West Bank. As a researcher and practitioner, Giacaman played an important role in the development of the Palestinian primary healthcare model, in the establishment of the first women’s health program, and in building the Palestinian community-based disability rehabilitation network. Her ongoing work entails the development of measures to assess context-appropriate psychosocial health programs to generate capacity to endure and resist ongoing war-like conditions, especially among youth.