Iraq: Overcoming security challenges to address mental health needs

October 6, 2010

Iraq: Overcoming security challenges to address mental health needs

Overall levels of violence may have decreased in Iraq, but highly volatile areas remain, and many people continue to die in bombings and assassinations. This unpredictable violence is the leading cause of trauma-related symptoms and psychological distress among Iraqis.

MSF teams determined that there were few counselling services available in areas of central and southern Iraq that had been hard hit by violence, and high needs for mental healthcare. But providing this care is complicated by the poor security situation, which forces MSF to manage its Iraq programs from Amman, in neighbouring Jordan.

In collaboration with the Iraqi Ministry of Health, MSF mental health officers trained 17 counsellors to work at three hospitals in central Iraq, beginning in September 2009. By August 2010, the counsellors had already conducted more than 2500 sessions. Sessions focus on everything from daily stressors, like inability to pay for school fees, to trauma connected to the violence.

MSF’s international teams are only able to visit the counselling programs in Iraq once a month, due to security restrictions. The rest of the time, the team relies on technology to connect the Iraqi counsellors with MSF mental health officers in Amman.

Originally forced to use unreliable instant messaging and mobile phones, in mid-2010 the team began using a videoconferencing system that has greatly improved supervision and collaboration.

“Using the videoconference, I am more connected to the counsellors,” says one of the MSF mental health officers. “I feel more in touch with the person. I am also able to get more ideas about the attitudes and skills of the counsellor ... I am able to have an emotional impact.”

The team plans to expand the reach of the program by working with local communities to increase awareness of mental healthcare, and to reduce the stigma associated with it.

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