Helping Iraq Restore Its Mental Health System (Part
By Rebecca A. Clay
When the idea of closing Baghdad's Al-Rashad Mental
Hospital first arose, Director and Consultant Psychiatrist
Muhmmad R. Lafta, M.D., didn't believe it was possible.
But after exploring the idea further at a recent conference,
he's now committed to closing the hospital as soon as
possibleeven though it means putting himself out
of a job. (See In Transition:
Al-Rashad Mental Hospital.)
"It's not unusual for patients to spend 20 years
in the hospital," explained Dr. Lafta. "These
are people without rehabilitation, without goals, without
human attachments. They have nothing to do. They spend
their days waiting for pills. I'm now convinced that
a better way to treat patients is to let them live in
the community. Instead of just being left in the hospital,
they should be treated like human beings."
The event that changed Dr. Lafta's mind was the Action
Planning Conference for Iraq Mental Health held in Amman,
Jordan, in March. The conference brought together 30
Iraqisalong with more than 20 American and British
experts serving as resourcesto figure out how to
go about rebuilding the country's mental health system.
SAMHSA organized and funded the event.
"The fact that the Iraqis recognize the centrality
of mental health bodes well for their country's recovery,"
said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W.
"We're committed to doing what we can to help."
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The conference came about when SAMHSA asked Sabah Sadik,
MBCHB, FRCPsych, DPM, National Advisor for Mental Health
at the Iraqi Ministry of Health, if he needed any help
restoring Iraq's mental health system (see SAMHSA
News, January/February 2005). Dr. Sadik is a psychiatrist
who also serves as Medical Director of the West Kent National
Health Service and Social Care Trust in England. In response
to that offer of assistance, Dr. Sadik explained that what
he needed most was help organizing an action planning conference.
Dr. Sadik and his colleagues were ready. Iraq's National
Mental Health Councila group comprising representatives
from several government ministries including the Ministry
of Health, as well as other interested persons outside
the governmenthad already developed an initial
plan with an ambitious agenda. "The purpose of the
conference was really to consider that plan carefully
and figure out what was missing and what was most urgent,"
explained conference organizer Winnie Mitchell, M.P.A.,
International Officer at SAMHSA.
Another conference goal was to help build a team to
take on that work. Developed by a Planning Group on Iraq
Mental Health chaired by SAMHSA, the conference brought
together Iraqis from all parts of the country. It also
brought together Iraqis from all sectors of society,
including mental health professionals, government officials,
judges, educators, human rights advocates, and religious
leaders from the Muslim (including both Shiite and Sunni)
and Christian faiths.
"Many of them had never met each other," said
Ms. Mitchell. "Dr. Sadik really meant the conference
to be a team-building exercise."
Joining the Iraqis were representatives from the United
States, the United Kingdom, and international entities
such as the World Health Organization and the World Bank.
These experts, including Mr. Curie and other SAMHSA representatives,
served as resources during the didactic sessions that
began the conference.
Mr. Curie and Dr. Sadik, for example, gave a joint presentation
on leadership and team building in mental health services.
Anita Everett, M.D., Senior Medical Advisor at SAMHSA,
summarized the history of deinstitutionalization and
the creation of community-based services in the United
States. Other topics included the integration of mental
health services and primary care, health care financing,
and staff and professional development.
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