In 1987, the first of the two intifadas that began in the State of Palestine brought significant changes in the development of the mental health services, with the lack of finances, management structure, and human resources inhibiting the quality of mental health services (Giacaman, 2004). However, there have been positive changes for the mental health services in Palestine. Giacaman (2004) explains that mental health services in the State of Palestine are primarily provided by three main types of organizations are governmental, non-governmental organizations (NGOs), and “the United Nations Relief and Works Agency” (UNRWA; Giacaman, 2004, p. 15).
The counselling profession also began to develop with the establishment of the Palestinian Counselling Center (PCC; Giacaman, 2004). Additionally, Giacaman (2004) stated that before the establishment of the PCC, mental health services were limited only to psychiatric treatment for mental disorders, and now some services are beginning to be offered in schools through the Ministry of Education and UNRWA, through which school counsellors serve as the first contact for students needing additional support or guidance regarding preventative services. In Palestine, there is little distinction between counsellors, psychologists, or social workers; mental health practitioners of all disciplines work in similar environments and have similar responsibilities and cases (Giacaman, 2004). Services offered and areas of expertise of a practitioner are determined by the type of organization that individuals work for as opposed to the type of training that practitioners have received. (Giacaman, 2004)
However, due to there being no formal system of referral between the NGOs and government sectors, the mental health services in the State of Palestine are fragmented (Giacaman, 2004). The mental health services in Palestine still need various improvements until counselling becomes a viable profession.