Rebuilding Iraq's Mental Health System

By Humphreys, Keith; Sadik, Sabah | Behavioral Healthcare, July 2006 | Go to article overview

Rebuilding Iraq's Mental Health System

Humphreys, Keith, Sadik, Sabah, Behavioral Healthcare

An international team is helping Iraqis repair damage done by decades of dictatorship, wars, and sanctions BY KEITH HUMPHREYS, PHD, AND SABAH SADIK, FRCPSYCH, DPM

The next time excessive paperwork, difficult managed care negotiations, and uncertain funding streams make you feel that you have the hardest job in the world, consider the situation of your colleagues in another country. Approximately 75 psychiatrists are available to care for 26 million people. Group homes, Assertive Community Treatment teams, and community-based care exist neither in reality nor in concept. Needed medications are in short supply, and many psychiatric facilities are understaffed and dilapidated. Some of your colleagues have been threatened or targeted by kidnappers. Meanwhile, daily bombings and economic insecurity continue to undermine the mental health of a people who already have endured decades of dictatorship, wars, and economic sanctions. Welcome to today's Iraq.

It was not always like this. What were probably the world's first medical schools and mental hospitals were established in what is now Iraq by the Sumerian and Abbasid civilizations. More recently, in the 1960s and 1970s, some of the best healthcare (including psychiatric care) facilities and training in the region were available in Baghdad. This same period witnessed the development of mental health centers, public awareness programs, school-based programs, and psychiatric units in general hospitals. Until the beginning of the IranIraq War in the 1980s, Iraq's spending on healthcare was on the upper end of nations in the developing world.

Saddam Hussein destroyed this healthcare system over the next two decades. He reduced healthcare spending to a thirdworld level for all persons not in his inner circle. He also undermined the confidence and skills of health professionals through intimidation, deprivation of control, and restrictions on travel and education. Many mental health professionals left the country; those that stayed saw their skills erode as their access to journals, conferences, continuing education, and colleagues was inexorably cut off.

Since the fall of the old regime, we have been privileged to work with a remarkable group of colleagues attempting to build quality mental health and addiction services in Iraq. One author (S.S.) was asked by the newly formed Iraqi government to serve as the lead mental health advisor to the Iraqi Ministry of Health in September 2003 and started extended work in Baghdad in March 2004 (after a preliminary visit in December 2003).

The other author (K.H.) joined the project in late 2004 as part of a growing network of professionals outside of Iraq who wished to aid the effort. Such individuals come from Italy, Slovenia, Sweden, the United Kingdom, and the United States; a number of them were born in and received some of their education in Iraq.

The international team's work has benefited from support from governments (e.g., a large donation from the government of Japan, as well as support for training from the U.S. Substance Abuse and Mental Health Services Administration, along with the Kent and Medway National Health Service and Social Care Partnership Trust in the United Kingdom). Professional societies (e.g., the U.K. Royal College of Psychiatrists and the American Psychiatric Association) also have provided support. And the team has benefited from strong collaborative relationships with the World Health Organization (WHO) and the World Bank.

Our work is coordinated through Iraq's National Council for Mental Health and Substance Abuse, which brings together representatives from a range of ministries to address mental health needs in thecountry. The challenges at the moment are, of course, considerable, not just because of the security situation but also because the mental health system was deprived of resources and of outside contact for several decades.

The current Iraqi mental health system has a "fly trapped in amber" quality, being like systems of another era in emphasizing long-term institutional care for many disorders and lacking developed mental health professionals outside of psychiatry, notably psychiatric nursing and clinical psychology. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • A full archive of books and articles related to this one
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)


1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

Cited article

Rebuilding Iraq's Mental Health System


Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.