Transition: Al-Rashad Mental Hospital
When Muhmmad R. Lafta, M.D., took over as Director of
Baghdad's Al-Rashad Mental Hospital 2 years ago, the
situation was so dire many of the patients didn't even
have clothes. "They were naked," he said.
The lack of clothing was not the only evidence of serious
neglect. "Just a few weeks before the war, the ex-regime
released the convicted criminal patients into the streets,"
Dr. Lafta explained. "And during the war, almost
all the patients ran away." Two-thirds of them were
returned by families, neighbors, or police, but a third
never returned. "We lost them."
The hospital itself has been bombed and looted of its
equipment and drugs. Patient records have been destroyed.
Located on the outskirts of Baghdad, the hospital now
has the Americans on one side and insurgents on the other.
"When there's fire between them, the patients start
to cry and try to run away," said Dr. Lafta. "It's
Even without a war raging outside, the hospital would
have a hard time. Iraq's main psychiatric institution,
the hospital offers both inpatient and outpatient services.
Its 1,200 beds, including 250 forensic beds in a secure
unit, are always full. There are only eight psychiatrists
to serve these patients, very few allied health professionals,
and barely any medications available.
The intense stigma attached to mental disorders and
the lack of rehabilitation and government support make
families reluctant to take back patients even once they've
stabilized. Some of the psychiatrists at the hospital
are ashamed to admit where they work.
Now that Dr. Lafta has seen community-based services
in England and the United States, he's convinced that's
the model to use. He envisions patients living in group
homes staffed by nurses or even in their own families'
homes. The government could provide small salaries to
family members, who would serve as patients' case managers.
Psychiatrists could visit weekly or monthly. And Al-Rashad
would be transformed into an institution serving only
Trained in Iraq, Dr. Lafta began his studies hoping
to be a physician specializing in neurology. Because
such specialized training was unavailable, he shifted
to the next closest thingpsychiatry. Before coming to
Al-Rashad, he served as a psychiatrist and officer in
Iraq's army, treating patients in military hospitals
and lecturing at the military medical school. "The
old regime focused on the army and neglected civilian
patients," he explained. What will he do once the
hospital closes? "Iraq needs hundreds of psychiatrists,"
he laughed. "I'm not worried."
« See Part 1Helping Iraq Restore Its Mental Health System
« See Part 2Helping Iraq Restore Its Mental Health System
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