With a population of more than 45 million, Iraq faces a severe shortage of mental health professionals. Only around 150 to 200 psychiatrists work across the country’s 36 psychiatric units. This is roughly one psychiatrist for every 10,000 people in need of care, pointing to the scale of the country’s shortage in specialist mental health care.
In a small room, Haider (pseudonym), 27, would often sit alone, staring at the cigarette burns on his fingers. His isolation carried the weight of a childhood marked by violence and fear. His mother’s voice echoed in his mind, “Don’t cry. Men don’t cry,”. Then his father’s, “Hold your head up or I’ll hang you by it.” As a child, Haider lived with repeated physical abuse, every corner of the house had become a stage for beatings, threats and questions he could never answer.
“Am I not his son? Why did he beat me? What did I do?”
Fear drove him into isolation which, in turn, led others to believe he was cursed or possessed. He began a long journey between spiritual healers. One surrounded him with incense. Another instructed him to remove his clothes to perform ritual practices. A third recited verses in a faltering voice.
Haider’s story is not an isolated one. It reflects the experiences of many young people in Al-Muthanna, where psychological suffering can be interpreted as madness or possession rather than as something requiring mental healthcare.
Mental health is one of Iraq’s most neglected areas of healthcare, despite its importance in a country shaped by decades of war, conflict, economic hardship, displacement, and poverty. According to Iraq’s Ministry of Planning, the entire country has no more than 200 psychiatrists, exposing a vast gap in availability and access to mental healthcare.
In Al-Muthanna, the gaps in mental healthcare are particularly visible. The governorate’s main psychiatric unit, located at Al-Hussein Teaching Hospital in Samawah, has just 12 beds and three psychiatrists serving a population of more than 1.25 million people. The shortage of specialised care, combined with the absence of dedicated psychiatric facilities and the widespread reliance on superstition, has left many people experiencing psychological distress without adequate support.
Two years passed between spiritual healers and rituals that offered no relief. Fear drove Haider into isolation. As he withdrew from those around him, he began to be described as “bewitched” or “possessed”, leading to a long period of visits to spiritual healers, from those who burned incense around him to those who stumbled over the religious verses they recited.
Then, hope came from an unexpected place: a comment on Facebook. A Tunisian psychiatrist named Khadija wrote to him: “I like the way you write about loneliness. Do you write often?”
For the first time, Haider told someone what he had never shared with anyone else. When he described the latest spiritual healer, he had visited, Khadija replied:, “You don’t need an exorcism or another healer. You need to hear yourself.”
Their conversation marked a shift in how Haider understood what he had been experiencing. From that moment on, Haider no longer saw himself as possessed. He began to understand himself as someone wounded in childhood, someone who was still bleeding from those wounds,yet someone who deserved to heal.
He held onto her words “You matter. You are here for a reason.”
The change was not immediate. Over the following two years, Haider gradually began to emerge from his isolation. He returned to writing, reconnected with other people, and left superstition behind. His experience points to the importance of changing how psychological distress is understood. It is understood not as possession or a source of shame, but as something that can be recognised and addressed.
Haider’s story is not unique. It reflects the reality facing many young people in Al-Muthanna, where psychological suffering is routinely mistaken for madness or possession In many cases, superstition replaces evidence-based treatment, deepening people’s pain and while isolating them from society.
A shortage of psychiatrists
Mental illness in Al-Muthanna is no longer an individual struggle but a silent epidemic. The scale of it is difficult to quantify, but the pressure on its limited mental health services is clear.Al-Muthanna remains one of Iraq’s most economically deprived governorates. Recent government figures place its poverty rate at 43.6%, the highest in the country, compared with 17.5% nationally, while UN data points to wider deprivation across the governorate.
Thousands live with psychological distress behind closed doors. Some ultimately die by suicide.
The psychiatric unit at Al Hussein Teaching Hospital in Samawah, the governorate’s capital, has just 12 beds to serve a population of more than 1.25 million people. It is staffed by only three psychiatrists, one of whom is retired and was brought back to work because of his experience.
Head of the unit, Dr. Adel Jaafar, tells Jummar that the department receives more than 200 patients every month, yet is staffed by only three psychiatrists. “Many patients refuse to have their names associated with the psychiatric unit because they fear the stigma,” he says.
Based on his experience working with patients in Al-Muthanna, Jaafar describes social stigma as one of the greatest barriers to treatment. “People would rather die by suicide than be labelled ‘mad’.” he says.
The small unit treats a wide range of conditions, including severe depression, hallucinations, schizophrenia, anxiety disorders, and episodes of violent behaviour. Jaafar explains that psychotic illnesses such as schizophrenia are among the most serious because they sever a person’s connection with reality. Conditions such as depression and obsessive –compulsive disorder are far more common and profoundly affect everyday life. These conditions exist against a backdrop of significant social and economic pressures in Al-Muthanna, although their causes vary from patient to patient.
Superstition in place of medicine
When patients are afraid to seek medical care, others step in to fill the void.
Families often turn to spiritual healers, fortune tellers, and self-proclaimed religious practitioners who invoke sacred texts to legitimise their claims. Unlike psychiatric treatment, seeking this kind of help does not necessarily require a person or their family to acknowledge their distress as a mental illness
The result is not treatment but false hope, while mental illness continues to worsen.
Dr. Issa Zahi, a psychiatrist in Al-Muthanna’s health directorate, says this reliance on superstition extends across Iraq, often cloaked in religious language despite having no basis in either science or religion. “We’ve seen many patients whose conditions deteriorated because of it,” he tells Jummar.
Those seeking out faith healers are not limited to poorer communities. Educated people and university graduates are equally vulnerable.
“Patients often begin with fortune tellers,” Zahi says. “They drain them financially through charms, talismans, and rituals. By the time they finally come to a psychiatrist, their condition has usually become much more severe.”
Reducing the phenomenon will not be easy, he argues. It requires legal action, public awareness, and a broader social effort to expose the harm these practices cause.
Exploitation
Many spiritual healers receive both men and women, but women seek their services more frequently. One Iraqi study of psychiatric patients found that women accounted for 56.6% of those who had visited faith healers
“Every patient receives the same diagnosis and the same treatment, something they call al-dawsa. ‘stepping’ or ‘treading’, referring to the stepping on “cursed” land. This diagnosis is sometimes given to women struggling to conceive, regardless of their symptoms. It has no scientific or religious basis,” Zahi says.
“Even more alarmingly, some tell women they are possessed and then sexually exploit them. Unfortunately, we’ve received numerous complaints of this nature.”
Nour Hamed, who holds a master’s degree in psychiatric nursing, says women make up most of the mental health patients in Al-Muthanna.
Housewives are more likely to experience mental health problems due to social isolation and the pressures of daily life, she explains, often living with chronic depression or obsessive –compulsive disorder.
She also points to the prevalence of postpartum depression, driven by hormonal changes and social pressures, warning that without treatment it can become a long-term condition.
School students are another overlooked group. Mental illnesses often emerge early in life, specialists say, with depression and schizophrenia among the most common conditions. For some students, displacement and exposure to conflict add another layer of psychological strain. Early intervention through school counsellors could make a significant difference, yet most schools lack both adequate counselling services and properly trained staff.
Ali Al-Qaisi, head of the Sama, an Iraqi organisation providing psychological and social support and documenting the mental health impacts of conflict and human rights violations, says the stigma surrounding mental illness prevents many students and their families from seeking support. Alongside documenting these problems, Sama provides psychological and social support to people affected by conflict and violence and works to raise awareness around mental health.
“The most common disorders among students are depression, anxiety, and post-traumatic stress disorder (PTSD), particularly among displaced children and those from conflict-affected areas,” he says. “Sleep disorders and drug addiction are also increasingly common.”
The consequences are visible across classrooms and communities with students dropping out of school, declining academic performance, and increasingly aggressive behaviour.
The organisation has documented cases of suicide among young people under the age of 20. This is a stark reminder of the absence of meaningful psychological support in Iraq’s schools and communities.
The data gap
The Ministry of Health does not publish comprehensive mental health statistics. However, the Sama Organisation estimates that around 18% of Iraq’s population, approximately six million people,are living with a mental health disorder.
Al-Qaisi says Iraq has only three specialised psychiatric hospitals: Al Rashad Hospital in Baghdad’s Al-Shama’iya district, Ibn Rushd Hospital, also in Baghdad, and Soz Hospital in Sulaymaniyah. Beyond these facilities, mental healthcare is provided through 36 small psychiatric units attached to general hospitals, all operating with limited resources.
Iraq’s Mental Health Law No. 1 of 2005 was intended to guarantee adequate mental healthcare, but its implementation has been undermined by a chronic shortage of psychiatrists, deteriorating infrastructure and insufficient public funding.
In most cases, services are confined to prescribing medication, including antidepressants and antipsychotics. Psychotherapy and behavioural treatment remain largely unavailablebecause of the shortage of trained specialists. Limited staffing is compounded by low levels of funding: Iraq’s mental health sector receives no more than 2% of the Ministry of Health’s overall budget.
The country’s infrastructure is also under severe strain. Al Rashad Hospital was built to accommodate 1,200 patients but currently houses around 1,440. Ibn Rushd Hospital continues to struggle with shortages of both medication and essential equipment.
In April 2025, Iraq’s parliament completed the first reading of proposed amendments to the Mental Health Law. The proposed changes include building new psychiatric hospitals and improving specialist training, measures intended to strengthen a system struggling with shortages in both facilities and qualified staff. However, the legislation has yet to advance to its second reading.
For communities already facing poverty, displacement and the lasting effects of conflict, access to mental healthcare remains limited. For Haider, change began with something more immediate: understanding his distress as something that could be addressed rather than feared. His experience cannot resolve the wider gaps in Iraq’s mental health system, but it shows what can change when psychological suffering is met with understanding rather than stigma.
