May 2018
In 2014, the Islamic State of Iraq and the Levant (ISIL) took control of large areas in Iraq, including specific regions that are home to religious and ethnic minority groups. This resulted in an unprecedented scale of displacement and forced migration. Some individuals settled in camps and collective sites, where conditions are harsh and resources are scarce.
A camp for internally displaced persons (IDPs) in Iraq
Evidence shows that in emergencies like this, on average, the percentage of people with severe mental health problems (e.g. psychosis and severe mood and anxiety disorders) increases by one percent over the baseline of two to three percent (World Health Organization, 2017). In addition, the percentage of people with mild or moderate mental health problems may increase by five to ten percent above the set baseline of 10 percent. It’s further estimated that one in every five persons will experience mild or moderate psychological distress, a normal reaction to the stressors inherent in emergency contexts. (WHO, 2017).
To respond to this issue and further Heartland Alliance International’s (HAI) mission to provide healing and justice, HAI is implementing the Restoring the Future Project in Iraq, which aims to ensure religious and ethnic minority groups affected by ISIL are able to access their full political, social, and cultural rights. The project is supported by the United States Department of State’s Bureau of Democracy, Human Rights, and Labor (DRL).
The mental health and psychosocial support needs of religious and ethnic minority groups in Iraq is significant. There had been extensive physical and mental trauma from displacement, housing, land and property confiscation, violence, including sexual and gender-based violence, torture, and slavery. HAI’s Psychosocial Support Officers, working with HAI’s partner organizations, report that program beneficiaries frequently present with trauma-related symptoms including nightmares, flashbacks, anxiety, depression, and fear. In the past few months, staff have also witnessed a number of suicides and suicide attempts in the camps, including among women who have been tortured and forced into slavery by ISIL. Self-immolation (setting oneself on fire) has also become a way some choose to end their lives, particularly among women who survived ISIL captivity.
As suicide or suicide attempts is an indicator of serious psychological distress or mental health problems such as depression, the team in Iraq has helped organize support groups to combat the tendency of individuals going through such difficult times to isolate themselves and withdraw from social participation, which can contribute to or exacerbate suicidal thoughts.
Dr. Nashmeel, a psychiatrist, who serves as the Mental Health and Psychosocial Support Coordinator for this project, provides guidance and clinical supervision to partners working with religious and ethnic minority groups. She is pictured above (right) leading a case conference and providing clinical supervision to Psychosocial Support Officers.
In these support groups, participants receive information on the ways in which psychological distress manifests and on how to cope with these reactions as well as stressors associated with their displacement. They learn practical tools such as relaxation, meditation, mindfulness, and breathing techniques in a setting that is safe, comfortable, and that respects their confidentiality. The Iraq team and partner organizations we work with also help engage in awareness activities related to mental health in the communities we serve and in IDP camps to help reduce stigma related to mental illness and seeking help.
Sara* a Psychosocial Support Officer, says, “We have observed a decline in suicidal behavior in recent months compared to last year. The support groups have helped the women survivors of sexual violence to recover by affording them a safe space where they can share their experiences and receive support from their peers and a trained Psychosocial Support worker like me.”
*Some names have been changed to protect confidentiality.
