Iraqi mental health professionals visit Philadelphia

A delegation of Iraqi mental health professionals is visiting Philadelphia this week to learn more about American approaches to treatment. The six-week session is offered by the federal Substance Abuse and Mental Health Service Administration.

A delegation of Iraqi mental health professionals is visiting Philadelphia this week to learn more about American approaches to treatment. The six-week session is offered by the federal Substance Abuse and Mental Health Service Administration.

(Photo: Dr. Jamal Omar discusses mental health treatments with a representative from SAMHSA) [audio:101006msiraq.mp3]

Decades of brutal dictatorship and war have exposed much of Iraq’s population to suffering and loss, leaving wounds both physical and mental.

The focus of the delegation’s U.S. visit is understanding the impact of trauma. It’s a very familiar topic to Dr. Jamal Omar, a psychiatrist in Sulaymaniyah in Iraqi Kurdistan:

Omar: Kurdish people is exposed to trauma for a long time, under Saddam’s regime, evil Saddam regime, chemical bombardments and also mass displacement of the people

One of the stops on the delegation’s packed Philadelphia schedule is a program called “Healing Hurt People,” which works with young people who have been shot or stabbed. The program’s research director, clinical psychologist Linda Rich, explains that trauma is a lens that provides a deeper understanding of their clients:

Rich: By being trauma informed, what we really do it take into account that individuals and communities have had distressing and emotionally painful events, chronically and really over the course of their lives and that this impacts their health emotionally and physically.

Traumatic events, says Dr. Sandra Bloom Co-Director of Philadelphia’s Center for Nonviolence and Social Justice, alter mechanisms in the brain, like the fight or flight response:

Bloom: Lots of people don’t realize that it changes your biology, and the way your brain works, not just emotionally. So people are much more ready after a traumatic event, not because they want to be but because their biology is changed, to respond to minor provocation with a major, often violent response.

This concept will be a tough sell back in his region, says Dr. Jamal Omar. People there focus on physical symptoms such as headaches, or backaches, but don’t see a connection between past events and behavior:

Omar: Sometime, some of them tortured for a long time, and then, after that now he is not working, he has not family, no job, nothing. if you try consider this – it’s not related to that, they don’t know, what is that, trauma.

During the training session, Healing Hurt People staffer Dionne Delgado gives an example of how trauma can affect her clients’ behavior:

A lot of them smoke marijuana, which is maladaptive, but when you talk to them they explain it as calming themselves down, it’s how they soothe themselves, it’s their solution and they say you don’t want to have to deal with me if I’m not calm, if I’m agitated, nobody in my family wants to deal with me.

What about clients who refuse treatment after a life-changing injury, asks one of the members of the Iraqi delegation:

Iraqi delegation member: I have an example, people say I don’t want to receive medication, I want to die, what do you want from me.

Delgado responds that a first step is to explain to the medical staff that the patient is severely traumatized, and then start with behavioral health interventions. She says often, once patients begin to understand and address their emotional wounds, it changes their outlook on life.

Omar estimates that over 40 percent of people in his region deal with mental health issues. He says one problem is that the suffering has been going on for so long that symptoms like sleeplessness, anger, aggression, or depression feel normal to people. He says raising public awareness about mental health issues will be the first major step.

Omar: For example, we can go through the community, through the teachers, we can teach or tell them awareness about mental health, what are abnormal behaviors among the students, if they found this, they must know, so we we begin slowly slowly.

Another big issue, says Omar, will be to reduce the stigma associated with visiting a psychiatrist or crisis center.

The delegation concludes its Philadelphia visit later on today.