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Training Iraqis to Treat Victims of Torture
FrontLines - October 2009
In northern Iraq’s Kurdistan region, U.S. mental health researchers are assisting local professionals and trainees to provide mental health services to survivors of Saddam Hussein’s regime of torture and genocide.
A network of newly-trained community mental health workers
interviewed torture and genocide
survivors and identified a list of priority mental health problems.
These included: depression, anxiety, post-traumatic stress disorder, and grief.
USAID has invested close to $4 million in this program through its Victims of Torture Fund.
The Applied Mental Health Research (AMHR) group from Johns Hopkins University’s Bloomberg School has assisted torture and trauma victims worldwide. But Paul Bolton, a member of the AMHR team, said the torture in Iraq was the worst of which he was familiar. Not only were people arrested and tortured but, at times, their families were brought in to watch.
"This was torture at a different
level, very much both mental and physical torture," he said.
One Iraqi doctor described the need for mental health services
in his country as grave.
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To learn more about the AMHR’s work to address mental health issues in the developing world, read "Mending Wounded Minds" published in the magazine of the Johns Hopkins Bloomberg School of Public Health, summer 2009 issue, at http://magazine.jhsph.edu. |
In Iraq, the AMHR program
improves the ability of torture survivors to function. Community mental health workers are trained to interview people in affected communities
in order to understand local priorities and concepts of mental distress. That information is used to address major mental health issues.
The team then works with local medical officials to set up treatment programs.
The team identified and adapted two promising interventions,
neither of which have been implemented outside the West—behavioral activation and cognitive processing therapy—and trained local health care workers in their use.
Behavioral activation is a therapy designed to treat depression, based on the premise that people’s mental states improve if they do things that make them happy and avoid things that are distressing.
Cognitive processing therapy helps people suffering from depression, anxiety, and post-traumatic stress disorder. Individuals suffering from those disorders exhibit distress by avoiding things that remind them of the original trauma. During treatment, counselors encourage patients to talk about their traumatic experiences and to try to respond differently in stressful situations.
Torture survivors who participate
in an evaluation of the therapies receive 12 weeks of treatment and will have their symptoms and ability to function in daily life assessed before and after treatment.
The most effective therapies will form the basis of future aid for torture survivors in Kurdistan and possibly other community-based mental health programs around the world, USAID and AMHR officials said.
★
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