Vision and Framework A Concept Paper

Transcription

1 (Back to appeal 2004) Capacity Building for Psychosocial Services Vision and Framework A Concept Paper Written By: Mental Health Department September 2003

2 The Palestine Red Crescent Society The Palestine Red Crescent Society () is a national humanitarian society that provides a wide range of health, social and other humanitarian services for the Palestinian People throughout the Middle East. was established on 26 December In 1969 the Palestinian National Council (PNC) mandated the Society the responsibility for health and social services for Palestinian people inside and outside Palestine. To-date, continues its activities in Palestine (along side the Ministry of Health and other NGOs), Lebanon, Syria, Egypt, Iraq and other locations. The Society also maintains offices in Europe and North America. is an observer member in the International Federation of the Red Cross and Red Crescent Societies (IFRC). Palestine Red Crescent Society Al-Bireh P.O. Box 3637 Tel: (972) Fax: (972) The The provides psychological and psychosocial support services to various target groups throughout the West Bank and Gaza Strip. The Department has expanded over the past two years in order to meet the growing needs of the Palestinian community as they face the daily stress and trauma of continuous conflict. The consequences of the current (economic, political and social) conflict and occupation have both short and long-term impacts on the population at the levels of the community, the family and the individual. With conflict and occupation affecting every member of Palestinian society, the Mental Health Department has recognized the need for free, accessible and integrated community based psychosocial support services in all communities. The need for comprehensive capacity building and sustainability of mental health services is paramount to meeting community needs effectively. Contents Section 1: The Need for Integrated Psychosocial Services and Capacity Building: Challenges of Conflict and Occupation 1.2 Psychosocial Needs in the Palestinian Community 1.3 Palestinian Children- A special Consideration Section 2: Implementing Integrated Psychosocial Services: 2.1 Objectives/Strategy 2.2 Beneficiary Population and Geographic Range of the Programme. 2.3 Development Plan and Activity Description 2.4 Expected Impact 2.5 Conclusion The has Developed this Vision and Framework in order to build its capacity to deliver professional, accessible community-based psychosocial services to the Palestinian community in seven target locations.

3 Section 1: The Need for Integrated Psychosocial Service and Capacity Building to Improve Child Well-being in the Palestinian Community 1.1 Challenges of Conflict and Occupation: The psychosocial need in Palestine has been realized most acutely during the past three years of conflict, occupation and violence. Military incursions, curfews, movement restrictions, targeted killing, arrests, humiliation, spread of the terror acts, economic situation and poverty have affected every individual from children to the elderly. The impact has resulted in children being unable to attend school for weeks and sometimes months at a time; sick and injured persons have been denied hospital access while attempting to cross checkpoints; entire cities and villages being under virtual house arrest through military imposed curfews; security of the home violated by systematic searches; personal ownership is widely violated; restricted movement between cities; harassment and humiliation at checkpoints; as well as ongoing arrests and detentions. The unpredictability of the day-to-day situation further adds to the stress and anxiety felt by not having control over ones lives. This is the current situation in Palestine but it comes with the memories of the conflicts of the past and ultimately with the loss of land and identity. Methods of coping with chronic instability tie into religious beliefs, community lifestyle and cultural traditions. One of the most dominant effects of the continued conflict is the loss of hope. The affects on the individual, the family, the community will be long lasting finding ways to overcome the traumas of the past is the only way to a brighter future. 1.2 Psychosocial Needs in the Palestinian Community The combined impact of the elements of conflict has a deep influence on the psyche of the individual and the collective. Psychology and external social support is relatively new concept in Palestine. People are not accustomed to speaking to others about their problems and especially about their emotions. There are few consistent mental health, psychological and psychosocial services available to the public and numerous problems (such as sustainability, accessibility, professionalism and quality) associated with those that are available. Holistic psychosocial services and the focus on the family have been selected as the method of intervention according to the culture and existing support structures within the Palestinian Community. The family is one of the most important sources of strength and coping in Palestinian society working through the family is seen as the best way to support it and the larger community. Psycho-social combines psychological and social support methodologies recognizing that the individual must also be supported and integrated within social support structures. Psychosocial interventions empower the community to actively engage in supporting each other by giving them the knowledge and resources they need. Recognizing the large-scale of this capacity building effort, this proposal will focus on how plans to integrate psychosocial services, according to IFRC s psychosocial policy, through its; Primary Health Care (PHC), Rehabilitation Services (Rehab.), Youth and Volunteers (Y&V), Emergency Medical Services (EMS), Disaster Preparedness and Response (DPR), Social Welfare (SW), through the leadership of the Mental Health Department (MH). The Palestine Red Crescent Society s is currently in a stage of capacity building, expansion and development. The past three years have required the Department to expand to meet the prevailing psychosocial and psychological challenges faced by individuals, families and entire communities in the Palestinian Territories. In order to fulfill part of these needs, the Department has created a vision and framework that includes six Psychosocial Family Centers (PFC); four in the West Bank and two in the Gaza Strip. The widespread impact of conflict and occupation on all elements of Palestinian society are well known, affecting basic human security including mental well-being and normal opportunities for development. The aims to improve overall well being by providing free, accessible and professional psychosocial services through this network of PFCs. 3

4 1.3 Palestinian Children A Special Consideration: Article 39 of the UN Children s Convention on the Rights of the Child provides that if children are the victims of armed conflict, torture, neglect, maltreatment or exploitation, they have the right to receive whatever treatment is needed in order to become a full part of society again. This proposal is designed to give children the opportunity and means to exercise this right. Palestinian children experience many forms of violence from the current occupation and conflict. Those which are most likely to cause trauma among children are the death of a parent, relative or acquaintance, torture, witnessing an act of violence, separation from one or both parents for any period of time, injury, including those resulting in deformity or handicaps, engaging in violence, curfew (house arrest), poverty and severe depravation, and shelling or demolition of their house. Emotions and reactions of children are manifested in many ways including: Problems with speech, difficulty concentrating, learning difficulties, sleep related problems, bedwetting, loss of recently acquired skills, feelings of guilt, and variety of somatic complaints. Children must have safe places for healing and emotional support to be able to overcome these problems in order to continue to live normal, productive lives. Currently Palestine has no comprehensive mental health services for children, resulting in a high level of need of such services in the community. Section 2: Implementing Integrated Psychosocial Services 2.1 Objectives/Strategy: Objectives: Strategy: 1. Improved overall well being of Palestinian communities and their abilities to support themselves. 2. Improved existing social support networks. 3. Improved awareness of psychosocial issues and child well being in the community. 4. Improved ability of teachers to teach holistically through awareness and use of psychosocial approaches to teaching. 5. Improved ability of parents to address the psychosocial needs of their children and their families. 6. Improved community awareness of and Red Cross/Red Crescent Movement principles, services, facilities and IHL. The well being of people in Palestine cannot be improved by targeting individuals alone. In order for any intervention to be effective they must fit within the cultural, traditional and existing social support networks of the target society. In the Palestinian case, family and community (including the way it has been historically developed and organized) are key players and form the reference point for the individual - giving them a sense of identity. Taking into consideration these real societal and cultural values, psychosocial interventions in Palestine must fit within this social structure. The Mental Health Department has recognized that in developing a plan to improve the well-being of target groups who have been exposed to chronic crisis and prolonged occupation, a strong holistic community approach must be taken to improve the well-being of those structures. To accomplish these objectives the proposes to establish a network of six (6) Psychosocial Family Centers (PFCs): Four in the West Bank (Jenin, Tulkarem, Bethlehem and Hebron), and two in the Gaza Strip (Rafah and Jabaliya). The PFCs will offer psychological support services, awareness of psychosocial issues, social outreach and support programmes. envisions an initial five-year plan to support this capacity building effort and to ensure the programme s sustainability. 4

5 As this is an initiative that requires establishing physical resources through a network of Centres, the first year will see higher start up capital costs. This must be considered by any who wish to support and contribute financially to this Programme. The establishment of physical centres is central to the PFC concept as it provides a physical location, dedicated to psychosocial services, from which in-house and outreach services can be provided. As psychological and psychosocial interventions strongly involve human resources (psychologists, social workers, and trained volunteers), it must be emphasized that, for support services to be provided effectively, there must be support to and an investment in personnel. Fig. 1 Psychosocial Family Centres Ramallah Programme Office Hebron Psychosocial Family Centre Bethlehem Psychosocial Family Centre Tulkarem Psyhcosocial Family Centre Jenin Psychosocial Family Centre Rafah Psychosocial Family Centre Jabaliya Psychosocial Family Centre Cooperation with Departments and Branches: PFCs will further be linked to other services in the target areas such as PHC Clinics, Hospitals, Rehabilitation Services, Youth and Volunteers, Disaster Management and Branches. The aim of this effort is to strengthen s capacity and efficiency to provide holistic health and social services by improving facilities and delivery methods as well as integrating services to make them more easily accessible to the community. Cooperation with external Psychosocial Service Providers: psychosocial capacity will be supported by active cooperation with external organizations providing similar psychosocial support services in the target communities. Cooperation with external organizations will strengthen the ability of to provide comprehensive mental health services through the development of an effective referral system that will ensure primary level interventions can be strengthened by referrals to secondary and tertiary levels should there be a need among the beneficiaries. The aim of such cooperation is to succeed in meeting the overwhelming, widening needs working together to fill the gaps and to complement each other s works. Accomplishing this cooperation will require regular meetings and planning sessions nationally and within the target communities in order to map out services, highlight community needs and determine who can best serve which needs. hopes that the PFCs will provide an opportunity to take a lead in this cooperation effort. Note: Some of these external organizations include: WHO, MoH, MoE, Save the Children, Care International, UNICEF, UNRWA, PCC, WCLAC, YMCA, Child Secretariat, among others. Target Groups: In order to work effectively, the target groups will be limited to those within the seven PFC communities. Within these communities several target and high-risk groups have been identified. Though the entire populations within these target groups cannot be reached, the PFCs will aim to target as many as possible through in house, outreach and external organizational cooperation. The target groups are as follows: Children Parents Women Youth School (teachers and Counselors) Intifada affected families Men 5

6 EMS and Staff (Stress Management and Crisis Intervention Programme) 2.2 Beneficiary Population and Geographic Range of the Programme: The primary target group is families within the West Bank and Gaza Strip particularly those in the six target locations. The secondary populations are the communities who provide the social support structures for individuals in those communities. The aim of the network of six PFCs is to ensure that psychosocial support services and outreach activities are accessible to a high percentage of the community in order to have the widest direct and indirect impact. Through extensive awareness campaigns, it is hoped that a large portion of the target communities in the West Bank and Gaza Strip become aware of psychosocial issues, the support services available as well as how to access these services. For those who are unable to access these Centers, a national hotline is planned that would allow people in remote areas to speak to a trained counselor for advice and possible arrangement of a home visit by the nearest Centre s staff. Furthermore, the PFCs will coordinate, cooperate and hold regular meetings with other psychosocial services provides in their regions in order to facilitate comprehensive fieldwork, avoid duplication and establish a professional interagency referral system for the benefit of the community. (See figure 2). 2.3 Development Plan and Activity Description: The (MHD) plans to achieve the objective of improving child well being through the establishment of seven Psychosocial Family Centers (PFCs). These Centers will be established over a six-month period with the aim of being permanent structures within the target communities: West Bank Jenin, Tulkarem, Bethlehem, Hebron; Gaza Strip Jabaliya, Rafah. Establishment of PFC Network: 1. Community Assessments conducted in all six-target locations. 2. Procuring suitable facilities for the Centers in each area. In order to facilitate capacity building within the, locations of the PFCs will be investigated and where possible built within or near existing Branches. 3. Interdepartmental dialogue on cooperation, coordination and communication in terms of shared service, resources and referral systems to ensure maximum benefit and services to the community. 4. A wide-scale community awareness campaign will be developed and implemented utilizing the following communication methods: a. Pamphlets describing PFCs, their services, psychosocial issues particularly relate to children, and locations. b. Television and Radio media. c. Contact and meetings with community leaders (getting community involvement). d. Contact and meetings with schoolteachers and school counselors. e. Contact and meetings with local community groups and other psychosocial service providers in the target communities. f. Contact with the appropriate government Ministries for permissions including: Ministry of Education (MOE), and Ministry of Social Affairs (MOSA). 5. Hiring and Assignment of Qualified staff for all Centers. 6. Establishment of working plan and schedule of activities for each Centre. 7. Establishment of a national Psychological Support Hotline. 8. Needs Assessments to be completed in all seven (6)-target communities. 6

7 Figure 2. Target Group and Beneficiaries by Area (1 year) Note: these are estimated figures Target Group Jeni n Tulkarem Bethlehem Hebron Khan Younis Gaza City Direct Beneficiary TOTAL Indirect Beneficiaries TOTAL GRAND TOTAL 1. Children a. Schools (36) - (36) b. Classes (24) - (24) c. Children ,920* 30,240 d. Summer Camps ,000* 21,000 e. Child Well-being ,800* 12, Parents a. School-based ,600** 25, Women/Mothers a. Outreach groups ,800* 12,600 b. Safe Motherhood * Youth a. Manafez * Teachers/Counsellors a. School-based ** Intifada Affected Families a. Outreach * Men a. School-based * EMS and Staff a. Stress Management EMS and Volunteers b. Stress Management general staff c. Stress Management 4320* Families 9. PFC Staff a. PFC staff * b. staff and volunteers * GRAND TOTAL 22, , ,112 *Based on 6 member family size (6.1, PASSIA 2003). **Based on reaching out to at least 5 community members. PFC Programmes and Services: Once the Centers are established they will begin to provide a wide-variety of in-house and outreach services to the communities. These services will be community specific but will also integrate with the current projects and programmes offered by the as well as future projects that may be procured. The PFC s will carry out the following services, programmes and activities with the target groups: 1. Children: 1.1 The has experience in implementing two school-based psychosocial projects: Tubas School-based Psychosocial Project (based on CABAC-modality); and the Hebron Community-based Psychosocial Project (10 Messages for children). The MHD views school-based approached as effective in providing psychosocial support to children by training teachers in psychosocial skills and awareness. Utilizing our experience with these projects we plan to duplicate a similar school-based strategy in all seven-target communities. The PFC staff in each Centre will train 7

8 a specific number of teachers from identified target schools in psychosocial awareness, skills and workshops to be utilized with the children in their classrooms. The PFC will provide ongoing support and follow-up with these schools and assist with referrals, family discussion groups, and teacher support as needed. 1.2 The Mental Health and Rehabilitation Departments have experience of running a large-scale Child Well-being Programme in the Gaza Strip. This Programme has been extremely successful with children, providing an opportunity to play and received much needed support. Child Well-being activities include: Child Cinema, Child Theater, Animation, Open-Studio, Art Workshops and Playgrounds. With PFCs providing the required facilities to carry out these activities, the MHD plans to duplicate this Programme utilizing the experiences and personnel to ensure its success in the seven target communities. This programmes is recommended to be linked to the School-based Programme as well as outreach activities to make children and their families aware of the events and activities available through this Programme. 1.3 The PFCs will link up with the Youth and Volunteer Departments to assist with summer camp activities. The MHD has participated in and supported summer camps in the past. The Youth and Volunteer Department has been operating national summer camps for several years with great success. Linking with this effort, the staff of the PFCs will bring a psychosocial support element and assist the Youth and Volunteers in the camps. Efforts will be made to included the children in the target groups worked with by the PFCs (school-based Programme, child well-being and children). 2. Parents: 2.1 As part of the school-based psychosocial Programme, targeting parents is also crucial to ensuring a supportive and nurturing environment for children. The School-Based Programme will involve group discussion and educational sessions with parents in order to give information on the activities of the Programme, topics important for child well being, psychosocial issues, and discussions on the difficulties being faced within families. The aim of these groups is threefold: First to create psychosocial awareness; Second, to improve the family environment for children; Third, to provide support to mothers and families. 3. Women/Mothers: 3.1 The MHD experience in Bethlehem through its community Centre has shown that outreach and discussions groups with women are extremely successful. Discussion groups have focused on issues affecting pregnant women preparing for delivery; dealing with children; and family violence. Outreach to women s groups, community groups and women in refugee camps have provided the forum for this activity. The PFCs will provide the facilities and human resources to conduct outreach women s support activities, in all six localities, based on the experiences gained in Bethlehem. 3.2 The Primary Health Care (PHC) Department has been running a Safe Motherhood Programme that provides information, health, social and community support to expecting and new mothers in several target communities. The PFCs and their staff in these communities would be able to assist PHC in providing psychosocial awareness and support to their target beneficiaries as part of interdepartmental cooperation. 4. Youth: 4.1 The in partnership with the Youth and Volunteers Department has been operating a Youth Violence Prevention Programme called Manafez in Bethlehem and Khan Younis for the past three years. This programme aims to provide facilities for youth to learn to overcome their own violence, to gain career orientation and life-skills as well as receive support services from social workers. This Programme has become particularly relevant during the current Intifada (uprising), where youth have been particularly affected by lack of regular schooling, lack of 8

9 social activities as well as being main players in the current violence. The MHD plans to duplicate this Programme in each of the seven PFCs, offering facilities for youth utilizing the experiences of the Manafez Programme. 5. Teachers and School-Counselors: 5.1 As part of the School-based Programme, teachers are an essential part of providing support to children. The School-based Programme will train selected teachers in the seven target communities in psychosocial issues, workshop methods and needs of children. The staff of the PFCs, through mobilizing and utilizing other expert potentials in the field, will provide the training to the teachers along with regular follow-up and support. The aim is to improve the teachers ability to provide a supportive environment for children in the classroom, to help them identify children having coping difficulties, and children that may require further intervention. Referrals by teachers will first be made to the PFCs and then, if required further referred within referral network of other external psychosocial service providers. 6. Intifada Affected Families: 6.1 The MHD has had experience working with families affected by the current Intifada (uprising). Particularly with the Centre in Bethlehem, outreach activities have included: support to families who s homes have been destroyed, support to families who have lost a loved one to the violence, support to families who have a family member detained, and support to families who have been affected by intense conflict and violence (trauma). The PFCs will be able to reach out to similar families in their target communities, identifying those in need and working with other psychosocial service providers in the community. 6.2 The MHD, in responding to the past three years of crises, has established a Psychosocial Crisis Intervention Network utilizing psychologists, social workers and volunteers from the departments of MHD, PHC, Rehabilitation and Youth and Volunteers. This network is in place and ready to provide support according to crisis and emergency needs in communication and cooperation with the Disaster Management. The network of PFCs will provide a base in each of the seven communities from which crisis response activities can be planned and implemented when required. 7. Men: 7.1 The MHD recognizes that Palestinian men are an under-supported group in the community and are very rarely directly targeted for support services. However, when considering a holistic familycentered approach, the man is a key player and support figure. They bare most of the responsibility for the family and are directly affected by the poor economic situation (60% poverty and high unemployment) and are further those most affected by the current violence and aggression (main players in acts of violence, most subjected to humiliation at checkpoints, subject to detentions arrests and targeted killings). With all the stressors places of men in this context, it is often the case that these frustrations come out on the family in the form of violence, abuse and/or disassociation. The MHD would like to run a pilot Programme offering information and support to men. This pilot Programme would be run at first in conjunction with the school-based Programme. A small group of (agreeing participant) fathers would be selected from each of the classes targeted by the school-based Programme. A discussion group would be held with this group on a regular basis at each of the PFC facilities and run by PFC staff. 8. EMS and Staff: 8.1 The MHD has been running a psychological support and stress management Programme for all EMS personnel, EMS volunteers, staff and their families. This Programme was created to provide support services to these target groups who face the daily pressures of operating under conflict conditions to carry out humanitarian work in the field. The Programme also offered critical incident response within hours of events in order to provide support to this target group (death of a 9

10 colleague, injury, detention or violent/traumatic event). The Programme offers individual and group support, family support, physical well-being, social and motivational activities to achieve its objective. The PFCs will provide a place from which these services can be continued to the target beneficiaries. 9. Target Communities: 9.1 The network of PFCs will also operate a confidential, national psychosocial support hotline. Currently, the s office in Bethlehem operates a similar hotline with limited hours for the residents of the Bethlehem area. This hotline provides various kinds of psychological and social support to callers as well as a referral service to the Bethlehem office. The has also had experience operating a national medical hotline with a network of over 200 volunteer doctors. The medical hotline is linked to the current 101 emergency system which refers call to the volunteers in the callers area. The experience with these two hotlines will provide a base from which the psychosocial support hotline can be established. The psychosocial support hotline, as with the medical hotline, can be linked to the 101 service and calls referred to a network of trained psychosocial volunteers and PFCs. Establishing this hotline will be linked to a large awareness campaign that will give information on contact numbers, locations of PFCs, the hotline and psychosocial awareness material. Summary of PFC In-House and Out-Reach Services: PFC In-House Services: 1. On-site Counseling/Drop-In Centre. 2. Psychosocial Resource Centre 3. Community Trainings 4. Youth Centers and journal Clubs 5. Child Play/Drawing Workshops 6. Special Events 7. Awareness Material 8. Mentorship Programme 9. Hotline Service 10. Family Drop In and Social Days 11. Child Theater, Music Workshops and Cinema. 12. Child Playground (outside Centre). 13. Referral Service to other Health and Social Services. 14. Referral Service to external Psychological/Psychiatric Services when Required. 15. Dissemination of and training in and Red Cross/Red Crescent Movement principles, information and IHL materials. PFCs Outreach Services/Activities: 1. Teacher and School Counselor Training in Psychosocial Methods to Improve Child Well Being. 2. Family Visits. 3. Trainings for community groups (focus on high-risk groups). 4. Awareness Outreach Programmes of the PFCs and Psychosocial Issues including Child Well- Being. 5. Child Summer Camps with (Youth and Volunteers). 6. Youth Forums 7. Sports Events 8. Crisis Intervention Network. 9. Dissemination of and training in and Red Cross/Red Crescent Movement principles, information and IHL materials. PFC Cooperation and Coordination Activities: 10

11 1. On-going inter-departmental cooperation and resources sharing. 2. Regular meetings with other psychosocial/psychological service providers in the Palestinian community (Government, NGOs, and other institutions). 3. Open forum discussions on psychosocial issues in the community between departments and service providers. 4. On-going professional development of service providers including care-for-care givers Programme. 5. Strengthening cooperation, awareness and capacity of Branches in the six target locations. Long-term Vision: In order to ensure long-term sustainability for this network of PFCs, the is proposing it as a three-year initial strategy that would see inter-department integration, inter-agency cooperation, as well as integration within the communities themselves. 2.4 Expected Impact: The expected results of the establishment of Psychosocial Family Centers (PFCs) by the Mental Health Department are as follows: 1. Increased awareness of, access to and utilization of psychosocial and psychological support services by the Palestinian Community. 2. Increased awareness and knowledge of psychosocial issues and child well being in the general population. 3. Improved child well-being and well-being within the family. 4. Improved/Strengthened social support networks in the community. 5. Increased awareness and knowledge of psychosocial issues for teachers. Utilization of psychosocial methods in the classroom that address the holistic view of child needs in development (physical, social, cognitive, emotional and spiritual) with the aim of improving overall well-being. 6. Increased capacity for the to provide nation-wide access to psychosocial support services through the network of PFCs, its projects and a national support hotline. 7. Increased integration of health and social services through the PFCs and the cooperation and sharing of experiences between departments and facilities in the West Bank and Gaza Strip. 8. Increased professional capacity, knowledge and skills of psychosocial/psychological staff through ongoing development, education and training. (Improved professional skills lead to improved services to the beneficiaries and are seen as a priority to build the Palestinian capacity to help themselves). Monitoring and Measuring Progress, Achievements and Sustainability: The had experienced managing national and regional programmes. With this experience we have undergone numerous internal, external and donor evaluations. Ongoing Programme monitoring and regular evaluations are essential to maintain high performance, quality service delivery and to ensure that the programmes objectives are being met. For this reason, the Mental Health Department will conduct overall monitoring of the network of PFCs and will have an on-going evaluation for the first year of the project. The ongoing evaluation will evaluate the establishment of the PFCs from the beginning as well as the services and activities conducted by the Centers. Utilizing the ongoing evaluation method, any difficulties that arise can be dealt with in a timely fashion and new directions can be chosen. The evaluation will utilize a variety of investigative and evaluative methods including questionnaires, beneficiary interviews, meeting with community groups and persons involved with the Centers and measuring the overall impact of each if the programmes services and activities. Furthermore, the evaluation will investigate how the PFCs services are meeting the needs within the community, 11

12 determine those needs that are not being met, and propose solutions on how to address these needs. Furthermore, the impact of the network of will be reflected in the number of beneficiaries utilizing the services as well as the number of outreach activities conducted. Qualitative data, as with most psychosocial programmes, tends to be more relevant and indicative than the quantitative. Conclusion The Palestine Red Crescent Society () has developed this vision and framework for integrated psychosocial services in order to effectively meet the psychosocial needs of the Palestinian community. The need for psychosocial services has grown as the current conflict approaches its third year. The vision and framework are based on the belief that all Palestinians must have free access to professional psychosocial, psychological and psychiatric services and that the best way to achieve this goal is to provide services utilizing an integrated community-based approach. The has a large capacity currently serving general health needs throughout the West Bank, Gaza Strip and the Diaspora. The current mental health services lack integration, cooperation and coordination, functioning mostly on a project-to-project basis meaning that a comprehensive vision is not being met and services are not being provided effectively. These are the reasons behind s vision of a network of to service the psychosocial needs of seven target communities, improving overall service provision, awareness and cooperation among service providers. 12

13 ANNEX A Population figures in the West Bank and Gaza Strip. Statistics taken from PASSIA (Mid-2001): Locality Pop. In Governorate Pop. In City Only Jenin Tubas Tulkarim Qalquilya Salfit Nablus Ramallah/Al-Bireh Jerusalem Jericho Bethlehem Hebron TOTAL WEST BANK North Gaza Gaza City Deir Al-Balah Khan Younis Rafah TOTAL GAZA STRIP 225,711 41, ,188 81,942 54, , , ,003* 37, , ,781 2,102, , , , , ,120 1,196,591 30,836 13,727 39,253 37,585 8, ,872 21, ,041 17,580 25, , ,952 66,242 (Jabalia) 343,904 41, ,095 59, ,879 TOTAL 3,298,951 1,300,831 13

14 ANNEX B Psychosocial Family Centers: Budget for 6 Centers - 3 Years Unit Subline Category Code Category Quantity Unit Duration Unit CAPITAL EXPENDITURE 170, Computers & Telecom 128, Hardware & Software Office Computers 16 units 1,500 24, ,000 Youth Centre Computers 5 units 6 centres 1,500 45, ,000 Printers 8 units 600 4, ,800 CD RW 8 units 150 1, , Telephone 0 Telephones 10 units Telefax 0 0 Fax Machines 8 units 200 1, , Radio 0 0 Radio Mobiles 35 units 150 5, , Office Furniture 0 0 Desks 39 units 100 3, ,900 Computer Desks 16 units 90 1, ,440 Round Meeting Tables 16 units 200 3, ,200 Large Meeting Tables 8 units 400 3, ,200 Office Chairs 39 units 100 3, ,900 Meeting Chairs 130 units 40 5, ,200 White Boards 16 units Cork Boards 20 units 50 1, ,000 Rubbish Bins 16 units Filing Cabinets 25 units 60 1, ,500 Book Shelves 25 units 100 2, ,500 Drawing table (resource centre) 7 units Storage Cupboards 2 units 6 centres 150 1, ,800 Flip Charts 2 units 6 centres 100 1, ,200 Overhead Projectors 1 unit 6 centres 250 1, ,500 Year 1 Year 2 Year 3 GRAND

15 Unit Subline Category Code Category Quantity Unit Duration Unit Office Furniture (cont d) Child Chairs 140 units 30 4, ,200 Televisions 1 unit 6 centres 300 1, ,800 Video Player 1 unit 6 centres 200 1, ,200 Toys for Child Well-being 1 unit 6 centres 750 4, ,500 Small Fidge 1 unit 6 centres 200 1, ,200 Gas Stove Top 1 unit 6 centres Generators and Lighting 0 Desk Lamps 30 units Floor Lamps 12 units Other 18, Machinery/equipment 0 Child outdoor playground equipment 6 centers 1 unit 3,000 18, , Transportation & Vehicle 23, Fuel 2 cars 12 months 200 4,800 4,800 4,800 14, Insurance 2 cars 1 year 500 1,000 1,000 1,000 3, Car Rental (1 WB/ 1 GS) 2 cars 12 months ,400 14,400 14,400 43, Logistics Support 0 0 logistical support 1 units 12 months 300 3,600 3,600 3,600 10,800 PERSONNEL 662, Regional and National 329, Local Temporary Staff 0 Psychiatric Consultants (Fees) 2 persons 12 months ,000 12,000 12,000 36,000 Consultant Researcher 1 person 12 months 800 9,600 9,600 9,600 28, NS Staff - Salary Director 1 person 13 months* 1,500 19,500 19,500 19,500 58,500 Deputy Director 1 person 13 months* 1,000 13,000 13,000 13,000 39,000 Coordinator 1 person 13 months* 1,000 13,000 13,000 13,000 39,000 Psychologists 6 persons 13 months* 1,000 78,000 78,000 78, ,000 Field Mental Health Workers 18 persons 13 months* , , , ,200 Year 1 Year 2 Year 3 GRAND Mental 15 Health Department

16 Unit Subline Category Year 1 Year 2 Year 3 GRAND Code Category Quantity Unit Duration Unit NS Staff - Salary (cont d) Administrators/Secretaries 7 persons 13 months* ,400 36,400 36, ,200 Programme Accountant 1 person 13 months* 600 7,800 7,800 7,800 23, Workshops and Training 333, IFRC Organized Training 0 Local PSP training for MH Staff 2 trainings 35,000 70,000 35,000 35, , Distance Learning 0 0 MA Clinical Psychology** 10 persons 1 year 10, , , , , Training Material 0 0 MH Field Manual 1 manual 15,000 15, ,000 Training Manuals 40 Unit 100 4,000 4,000 4,000 12, Facilitator Fees 0 Quarterly MH Workshops 1 person 12 days 250 3,000 3,000 3,000 9,000 School-based Workshop Training for PFC staff 1 person 3 days ,250 Core Allocation: 6899 Workshops/Trainings 0 0 School-based workshop training for PFC staff 24 persons 3 days 75 5, ,400 10,800 Quartery MH Workshops 30 persons 12 days 45 16,200 16,200 16,200 48,600 Monlthy Supervision Meetings 30 persons 12 months ,000 36,000 36, ,000 Parents Meetings 6 centres 12 months 100 7,200 7,200 7,200 21,600 Women's Workshops 6 centres 12 months 100 7,200 7,200 7,200 21,600 Teacher Trainings 6 centres 12 months 100 7,200 7,200 7,200 21,600 Men Trainings/Groups 6 centres 12 months 100 7,200 7,200 7,200 21,600 Staff & volunteer trainings 6 centres 12 months ,400 14,400 14,400 43,200 Youth Training and Activities 6 centres 12 months ,000 18,000 18,000 54,000 Child Well-being Workshops 6 centres 12 months ,600 21,600 21,600 64,800 Mental 16 Health Department

17 Subline Category Year 1 Year 2 Year 3 GRAND Code Category Quantity Unit Duration Unit Unit GENERAL & ADMIN 407, Travel 28, International Travel 0 Foreign Conference/Convention 10 persons 1 airfare 1,000 10,000 10,000 10,000 30,000 Lebanon Assessment 2 persons 1 airfare 1,000 2, , Travel Per Diem 0 0 Foreign Conference/Convention 10 persons 1 unit 250 2,500 2,500 2,500 7,500 Lebanon Assessment 2 persons 1 unit Travel Accommodation 0 0 Foreign Conference/Convention 10 persons 5 days 100 5,000 5,000 5,000 15,000 Lebanon Assessment 2 persons 5 days 100 1, , Local Travel 0 0 MH field worker local travel 6 centres 12 months 100 7,200 7,200 7,200 21, Travel Visas 0 0 Foreign Conference/Convention 10 persons 1 unit 100 1,000 1,000 1,000 3, Information 132, Translations 0 Program Document Translations 1 unit 12 months 500 6,000 6,000 6,000 18, Photo Labs 0 0 Film and Developing 7 offices 12 months ,800 16,800 16,800 50, Printing 0 0 Pamphlets 6 units 10,000 copies ,000 15,000 15,000 45,000 Awareness Stickers 4 units 10,000 copies ,000 6,000 6,000 18,000 Manual 1 unit 500 copies 15 7, ,500 15,000 Newsletters 12 units copies ,000 30,000 30,000 90, PR Events 0 0 Community Awareness- Open Days 6 centres 4 units ,000 12,000 12,000 36, Publicity 0 0 Banners 4 units 21 copies 50 4,200 4,200 4,200 12,600 Mental 17 Health Department

18 Unit Subline Category Year 1 Year 2 Year 3 GRAND Code Category Quantity Unit Duration Unit Publicity (cont d) Newspaper Advertisements 4 units 1 unit 500 2,000 2,000 2,000 6,000 TV Spots (Production) 2 units 1 unit 5,000 10, ,000 20,000 TV Spots (Airing) 2 units 4 times 500 4, ,000 8, Books 0 0 Reference books (psychology, social work) 7,000 7,000 7,000 21, Periodicals/ subscriptions 0 0 MH Periodicals & Subscriptions 10 units 12 months ,000 12,000 12,000 36, Other General Expenses 216, Stationary 0 Stationary 7 units 12 months ,800 16,800 16,800 50,400 School-based program activity material 6 centres 1 unit 5,000 30,000 15,000 30,000 75, Photocopying 0 0 Photocopying 7 units 12 months 50 4,200 4,200 4,200 12, Office Rental 0 0 PFC Rent 6 centres 12 months ,200 43,200 43, , Building Maintenance 0 0 Building Maintenance 6 centres 12 months 100 7,200 7,200 7,200 21, Grounds Maintenance 0 0 Grounds Maintenance 6 centres 12 months 50 3,600 3,600 3,600 10, Cleaning 0 0 Cleaner 6 centres 12 months ,000 18,000 18,000 54, Utilities 0 0 Water, Electricity, Gas, Heating 6 centres 12 months ,400 14,400 14,400 43, Telephone 0 0 Telephone installation 8 units 1 unit Monthly Phone Bill 8 units 12 months ,400 14,400 14,400 43,200 Hotline Radio 0 0 Radio Mobiles 30 units 12 months ,000 54,000 54, ,000 Mental 18 Health Department

19 Unit Subline Category Code Category Quantity Unit Duration Unit 7408 Computer/Internet 0 0 Internet (Office) 10 units 12 months 50 6,000 6,000 6,000 18,000 Internet (Youth Centres) 6 units 12 months 50 3,600 3,600 3,600 10, Professional Fees 10, Other Professional Fees 0 Evaluation 1 unit 10,000 10,000 10,000 10,000 30, Core Cost/ Sundry Admin 20, Banking Charges 1 unit 12 months 100 1,200 1,200 1,200 3, Other Banking Charges 0 0 Annual Auditor 1 unit 1 unit 5,000 5,000 5,000 5,000 15, Gifts and Awards 0 0 Awards for staff, trainees & volunteers 6 centres 12 months ,400 14,400 14,400 43,200 Sub-total 1,242, ,950 1,040,850 3,281,820 Administrative Costs (5%) 63,541 49,948 52, ,531 Reserve 10,000 10,000 10,000 30,000 GRAND TOTAL 1,315,561 1,058,898 1,102,893 3,477,352 *13 months calculated on local emloyement insurance regulations **Dependent upon University chosen. Year 1 Year 2 Year 3 GRAND Mental 19 Health Department