MSF Background/media Briefing: Mental Healthcare in Iraq

December 12, 2012

MSF  Background/media Briefing: Mental Healthcare in Iraq Two Iraqi actors while filming “What are your complaints in Iraq @MSF

 “What are your complaints” is a short 7 minutes documentary Launched by Médecins Sans Frontières (MSF) that sheds light on the status of mental health and mental health services in Iraq. Through interviews with psychiatrists and therapy session scenarios by actors performing as patients and counselors, the film highlights different mental health illnesses, how such illnesses can develop, as well as the social stigma that is attached to mental health illness in Iraq.   This documentary is part of the community awareness campaign that MSF and Iraqi Ministry of Health (MOH) are implementing in order to help reduce that stigma and increase awareness of available mental health services.  This documentary is a joint production between Médecins Sans Frontières (MSF) and the Iraqi Ministry of Health (MOH).

Médecins Sans Frontières In Iraq

Following years of war, international sanctions and injustice, Iraqi people have suffered greatly. Even today, Iraq remains heavily affected by insecurity, violence, and uncertainty about the future. Bombings and assassinations continue in many regions of Iraq, killing or wounding dozens of people every month. According to some reports, over 4,000 civilians were killed in 2011. Fear of violence has driven many

people from their homes and resulted in their relocating elsewhere. This instability affected the social structure of their lives, with significant consequences for their physical and mental health.

Médecins Sans Frontières has worked intermittently in Iraq since 1992. Currently, MSF is providing medical care to Iraqis in different regions of the country, despite the ongoing violence, which has made it difficult for MSF expatriate staff to be present in Iraq.  Since 2006, MSF implemented programmes in Anbar, Baghdad, Najaf, Basra and in the northern governorates of Kirkuk, Hawijah and Dohok. MSF has developed activities in the field of surgery, dialysis, mental health, women and child healthcare. 

Although many health facilities inside Iraq are still functioning, the quality of care they provide has been undermined by a shortage of specialized staff and a lack of training. According to the Iraqi Ministry of Health, hundreds of medical staff have been killed in the course of the conflict and large numbers of skilled healthcare personnel have left the country. Iraq is critically short of certain medical specialists, including psychiatrists and psychologists.

Mental Health project in Iraq

In September 2009 Médecins Sans Frontières (MSF) opened a mental health counselling unit in Baghdad’s Imam Ali hospital in Sadr City, Baghdad. Three months later it opened a similar unit in Fallujah hospital in Anbar province. In 2010 MSF began supporting a third unit in Baghdad’s Yarmouk teaching hospital. All three units are in Ministry of Health hospitals, and are run by specially trained Ministry of Health staff. In these units, people traumatised by the violence receive psychological counselling.

Our mental health programmes target those affected by the violence, including domestic violence which often appears to be linked to the wider context of violence and insecurity.

The mental health project significantly matured in 2011. Patient numbers are increasing, with 15,348 patients treated in  24,300  counselling sessions over the course of the year and the Iraq Ministry of Health is starting to take steps to replicate the MSF model., including using the training modules developed to enable the use of non-medically trained counsellors.  A telephone helpline service has been established as a complementary action to counselling.

According to MSF Mental health officers, the main complain presented by the patients are anxiety, followed by physical complains and mood related problems.  Most of the symptoms reported by the patients are related to domestic and psychological violence.

Stigma related to Mental Health

Internationally and especially in the Arab region there is often stigma related to a mental health patient, with people judged on a personal behavior  Unfortunately, this is a common experience for people with a mental health condition. Stigma may be obvious and direct, such as someone making a negative remark about your mental illness or your treatment. Or it may be subtle, such as someone assuming you


could be unstable, violent or dangerous because you have a mental health problem. Therefore in the three mental health care units (MHCUs), there is also a strong focus on developing community awareness to help reducethe stigma attached to mental health illnesses and sufferers. Part of the treatment in the MHCUs focuses on mental health awareness for patients, their families and the wider community.

Even with the growing success of the MSF counselling model, knowledge of services is quite localised around the mental health care units; further activities are needed to raise awareness more widely and to ensure counselling is available for those who recognise their needs.

All patients, or clients as they are called in mental health care, are welcome in the MHCUs regardless of religion, ethnicity, gender, age, political or tribal affiliations, they are simply patients who are suffering, who need help. Clients are normal people who have developed unusual reactions to an extremely difficult situation.

MSF: What’s still needs to be done in the coming years.

In 2013, MSF will continue to work with the general public and the MOH to reduce stigma and reach more patients.  One element of this is promotion of the film that accompanies this briefing as well as other communication tools explaining what mental health care is. Focus on the quality of services will continue to be emphasised. The Ministry of Health of Iraq has plans to support the replication of innovative services in mental health in Iraq and that includes telephone help-lines, dedicated training facilities and trainers, in working on increasing the public awareness. 

As an international medical emergency organisation, MSF strives to provide free medical assistance to communities affected by natural disasters, armed conflicts and disease outbreaks, as well as those suffering from a lack of access to healthcare. MSF offers neutral and impartial assistance regardless of race, religion, gender or political affiliation. MSF is an independent, non-profit organisation founded in 1971. Today, it is a worldwide movement working in 65 countries around the world.

In order to ensure its independence, MSF does not accept funding from any government, religious committee or international agency for its programmes in Iraq, relying solely on private donations from the general public around the world to carry out its work.

Click here to read about Psychological Trauma in Iraq, and the Way to Help

Click here to watch the documentry What are your complaints

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