Bright red baubles adorn a tree at the entrance of a hospital in Nazareth, but Christmas celebrations will be muted in Jesus’s childhood home this year as doctors confront an increase in mental-health problems. From his office overlooking Nazareth’s old city, psychiatrist Nabil Geraisy summarised the full force of the coronavirus pandemic: “More anxiety, more phobia, more depression, and more suicidal thoughts and completed suicides.” Dr Geraisy recently returned to work as head of the mental health department at Nazareth Hospital EMMS, in northern Israel, after being infected with coronavirus. “We haven’t put up our tree in our house yet because I also infected my wife and she is recovering,” said Dr Geraisy, whose team decorated a Christmas tree outside his office. The patients, too, have been busy making festive ornaments to be sold at the hospital fair, where rules are in place to limit visitor numbers. Lydia Deek, the mental health department's head nurse, said such activities give her patients a sense of pride in an incredibly challenging year. “Even patients who weren’t scared before, they became scared. Or the patients who were a bit scared, their fear increased,” she said. “The cases deteriorated because of coronavirus.” There are 20 inpatient beds and five more for outpatients in the department, which treats all types of mental health disorders. While the patients are largely from northern Israel, some are from elsewhere in the country, as well as the occupied Golan Heights and West Bank. There has been an increase in emotional distress across Israel in recent months, Dr Geraisy said, more prevalent among Arab-Israelis, who make up about 20 per cent of the population. “The most probable reason is that the socioeconomic position of the Arab minority in Israel is lower than the Jewish majority,” he said. Nazareth, an Arab-majority city that usually draws throngs of Christian pilgrims, faced further coronavirus restrictions last month because of its high coronavirus infection rate. Although the measures have since been eased, infections are relatively high with 11 per cent of tests proving positive in Nazareth compared with 3.4 per cent nationwide. In addition to concerns about catching a virus that has killed more than 3,000 people in Israel, from a population of nine million, many residents are being hit hard by the economic fallout of two lockdowns and ongoing business closures. One of the hospital’s inpatients said he was apprehensive about being admitted to the facility a month ago, after experiencing mental health problems for six years. "In the beginning I was scared. Scared, firstly, because I was far from my family, and the idea of being hospitalised here," said the 25-year-old. Relieved to have found doctors who understand his problems, he said the onset of the pandemic had made life more difficult. "The shops are closed … there are no places to entertain yourself and ... there's also the economic situation," he said. A study published last month by Israel's Central Bureau of Statistics found that 57 per cent of Arab-Israeli familiesfinances worsened since the start of the pandemic, compared with 39 per cent of Jewish Israelis. Since March Israelhas barred tourists, which takes a particular toll on those in Nazareth who rely financially on the crowds of foreign pilgrims. While 17 per cent of Jewish Israelis assessed their mental health in negative terms in the November survey, the figure rose to 25 per cent among Arab Israelis. Jamal Daqduqi, a psychologist, said the pressure wrought by the pandemic was increasing. “Now it’s Christmas time and people should celebrate, but they are getting nervous,” said Dr Daqduqi, a member of Physicians for Human Rights Israel. “People are very sad and very angry and there is a lot of fear too.” In central Nazareth, the city’s Christmas tree was lit in a ceremony involving Santa Claus, singers and children playing bagpipes. But in a break from tradition, spectators stayed at home and the spectacle was streamed live online. In his home of Kafr Kanna, a village north-east of Nazareth, Dr Daqduqi predicted a modest and sad Christmas. “Usually we have a very nice celebration, on the streets and in the churches, and people are celebrating together,” he said. Large family gatherings over Christmas will be banned, as no more than 10 people are allowed to meet indoors under current Israeli measures. With infections rising, the government is expected to tighten existing restrictions within days. The start of Israel's public vaccination drive from December 21 brought hope that coronavirus will soon be curtailed. But Dr Geraisy said that the mental health effects would last far longer. “I think we are going to face more psychological and more emotional distress in the coming year.”
