Iraq’s Problem in Addressing Suicide

A lack of mental health care professionals is contributing to inadequate care.

A relative kisses a Yazidi survivor boy following his release from Islamic State militants in Syria, in Duhok, Iraq, March 2, 2019. (photo credit: ARI JALAL / REUTERS)
A relative kisses a Yazidi survivor boy following his release from Islamic State militants in Syria, in Duhok, Iraq, March 2, 2019.
(photo credit: ARI JALAL / REUTERS)
A lack of properly trained personnel in Iraq has the county grappling with an increase in the number of suicides and suicide attempts, say Iraqi mental health professionals.
“We have thousands of victims of trauma, and already high rates of post-traumatic stress disorder (PTSD) are increasing. This results in depression and sometimes leads to substance and drug abuse,” Jan Kizilhan, dean of the Institute of Psychotherapy and Psychotraumatology at the University of Duhok in Northern Iraq, told The Media Line.
“The psychotherapist profession doesn’t exist in Iraq and there are not enough psychiatrists who can help people with depression or other mental illnesses. Therefore, there are no suicide prevention strategies in Iraq,” he said.
Recent figures from the Iraqi Ministry of Health count only 138 psychiatrists and 60 social/psychosocial workers in the entire country, Mohammed Abbas, a consultant psychiatrist and lead author of the research paper titled “The Iraqi national study of suicide: Report on suicide data in Iraq in 2015 and 2016,” told The Media Line.
The data from his study, which was published in 2017, indicates that there is “a trend which suggests an increase” in suicide, said Abbas.
Suicide does not affect the population equally.
“Our data suggest that half of the cases were not married and [were] unemployed,” Abbas said.
His research also found that two-thirds of suicide cases were of people below the age of 29.
According to Abbas, in 2017 there were two suicides per 100,000 people in Iraq, which he said was “relatively low” compared to the international rate of 11 per 100,000. Still, the rising number of suicides in Iraq has captured the attention of lawmakers.
Iraqi Members of Parliament Abdallah Al-Kharbeet and Mohammad Iqbal recently expressed concern about the suicide rate, and legislation is being proposed to put physical barriers at locations where people have been prone to jump in suicide attempts.
This does not address the underlying issue of mental health, which was exacerbated by the US-led invasion in 2003, noted the University of Duhok’s Kizilhan.
“We assume 50 percent of the Iraqi population is traumatized, and 20% of this segment needs urgent medical and psychotherapeutic treatment because they have post-traumatic stress disorder. Also, 30% of the country suffers from a depressive disorder, compared to 15% in the West,” he said.
Stigma surrounding mental health also stymies progress in addressing suicide, Kizilhan told The Media Line.
“Dealing with suicide is still strongly tabooed, as this is not provided for or rejected in Islam. Therefore, many suicide cases are registered as normal deaths,” he explained.
Emad Abdulrazaq, a mental health advisor for the Iraqi Ministry of Health, insisted to The Media Line that figures reported by the High Commission for Human Rights claiming that 132 people had committed suicide in Iraq between January and March of this year were erroneous. Rather, he said, those numbers were attempted suicides.
Dr. Eyad Yanes, a mental health officer for the Iraqi office of the World Health Organization (WHO), said the link between suicide and mental disorders was “well established.”
Despite this, Abdulrazaq contends that the Iraqi parliament’s commitment to mental health was better now than when Saddam Hussein was in power.
“Before 2003, the government had no commitment to mental health. Now, there is partial cooperation,” he said.
WHO’s Yanes agrees.
“Mental health was not among the Ministry of Health’s priorities in the last few years,” he told The Media Line. “However, the government has made some achievements in mental health, such as supporting the integration of mental health into primary health care, drafting a new mental health law, drafting a national strategy for addiction and drafting a national strategy for suicide – but much more still needs to be done.”
Kizilhan disagrees.
“The issue of suicide must also be made known to the public through campaigns. Unfortunately, this will not be such a high priority, as the government has other priorities and few qualified personnel,” he said.
Abdulrazaq argues that in order to improve mental health care in the country, the government needs to recruit more professionals and create more community-based support centers for victims of trauma. Legislatively, he feels that the government needs to change its approach to the way mental health is perceived.
“Mental health,” he stated, “needs to be covered as a human rights protection.”
(Tara Kavaler is an intern in The Media Line's Press and Policy Studies)
The Media Line