The Middle East’s Mental Health Crisis

National Minority Mental Health Awareness month is upon us in the U.S., and never has the scope and impact of mental health issues threatened to affect the long-term security of our country and world than now.

This year, the UN Office for the Coordination of Humanitarian Affairs estimates that 10.8 million people are affected by the conflict in Syria, with 4 million refugees having fled the country. This is the largest refugee population coming out of any one conflict in over a generation. Similarly, in early 2015, UNHCR estimated that the total population of concern, due to the conflict in Iraq, exceeded 3 million people. Millions of people have experienced the unimaginable trauma of political and religious conflict and persecution in the Middle East, especially women, whom the Iraqi Ministry of Health determined were disproportionately affected by mental health illness due to the recent conflict. The scale and depth of the trauma demands a multi-faith, multi-sector, multi-discipline response, before it is too late.

Within these populations, persecuted people are desperate for mental health care – first recounting difficulties with things like insomnia and domestic violence, but soon telling of their experiences of bombing, mass killing, and rape. The result of leaving traumatized populations untreated plays well into the hands of extremist groups, like ISIS, who exploit the emotional turmoil of refugees as a conversion and recruitment tool.

When refugees begin to question their identity and understanding of the world (i.e., when their faith is shaken by trauma), researchers call this a “cognitive opening.” It is during this time that refugees are most vulnerable to extremist ideologies and beliefs, according to Dr. Alexander Meleagrou-Hitchens, Head of Research and Information at the International Center for the Study of Radicalization. People who feel vulnerable and shattered will turn to whoever makes them feel safe. Offering refugees psychological care is one way to make civil society seem more like that safe haven, rather than the ever-welcoming arms of the world's extremist recruiters, according to Elizabeth Nicholas, a freelance writer examining the relationship between psychological trauma and conservatism.

The need is overwhelming. According to Doctors without Borders, there are currently only four psychiatrists for every 1 million residents in Iraq, and even fewer professionals are trained in related mental health professions such as psychological counseling. This has caused the Iraqi Ministry of Health to express the need to integrate mental health services into their health care facilities. Of the professionals working with Syrian refugees in Iraq, there are only four who do on average 70-100 counseling sessions per week with traumatized individuals. Similarly, in Jordan, there are a total of 31 psychiatrists and 24 psychologists for the entire population, including refugees from Palestine, Syria, and now Iraq. Unfortunately, most if not all of these professionals are strictly hospital-based and provide mainly biological care (provision of medicine), leaving no body of professionals to address the pervasive PTSD of these massive populations.

For this reason, it is critical that we respond to the trauma of refugees in the Middle East now. As stated by Hind Kabawat, Director of Interfaith Peacebuilding at the Center for World Religions, Diplomacy, and Conflict Resolution at George Mason University:

“If we wait until the war is over to begin addressing such widespread and systematic trauma, we will have lost an entire generation … who are now growing up amidst horror and war with no outlets for trauma healing or PTSD support. By guaranteeing social services beyond the mere basics of medical care and clean water, we not only position the local councils to surpass ISIS in terms of capability but also proactively work for the long-term good of the … people to ensure that the atrocities of the last four years do not color the future …”

In response, a few organizations have answered the call to come to the aid of traumatized refugees in Iraq, Syria, and their hosting countries within the Middle East. But their efforts have been small in comparison to the overwhelming need that now exists and daily increases. What’s more, these programs offer either direct trauma healing to refugees, or training modules to qualified helping professionals. Few, if any, have a model that serves to replicate trauma healing on a large scale in a way that is both religiously acceptable and accessible.

This is why major civil society organizations, governments, religious communities, and philanthropic institutions must collaboratively support trauma-healing efforts. Strategically treating the traumatized, especially religious minorities in the region ensures that the MENA region is more stable and less prone to growing extremism — meaning there is capacity to live with its deepest differences. The goal must be the creation of local nodal networks spanning faiths, sectors, and disciplines. Such a network would be equipped to provide sacred text-based trauma healing to populations affected by conflict, and could ultimately come together to collaborate and dialogue on this and other issues that threaten the vulnerable and persecuted in their midst.