The psychological profile of Iraq: A nation haunted by decades of suffering

List of abbreviations

ISIS

Islamic State of Iraq and Syria

PTSD

Post-traumatic stress disorder

1 Background

Iraq, a country plagued by a turbulent history, has experienced numerous traumatic events in recent decades. The psychological profile of Iraq presents a tragic and complex narrative of a nation experiencing decades of hardship, from the Iraq–Iran war to the rise of the Islamic State of Iraq and Syria (ISIS) to the COVID-19 pandemic. These events have left deep emotional scars to the collective trauma of the nation, affecting the population and generations [1].

Iraq has confronted formidable challenges due to prolonged warfare, including the Iran–Iraq War, the Kuwait War, USA special operations in 2023, terrorist warfare, and sectarian civil conflicts. Particularly from 2003 to 2011, these conflicts resulted in the significant loss of at least 116,903 Iraqi non-combatants and over 4,800 coalition military personnel. The health-supporting infrastructure suffered extensive damage, leading to numerous injuries, illnesses among Iraqi civilians, and the displacement of about 5 million individuals [2]. Finally, the emergence of ISIS in 2014, along with its occupation of significant parts of the country, introduced a new layer of trauma, leaving the population grappling with psychological distress, helplessness, and grief.

The wounds inflicted on various Iraqi communities are deep and long-lasting. Yazidis, who suffered cruelly at the hands of ISIS, faces an unimaginable trauma that will persist for generations [3]. The people of Nineveh, Salahaddin, Anbar, and Kirkuk bear the psychological burden of living through ISIS-led terror wars that have ravaged their homes and communities. Kurds, survivors of the Anfal genocide and chemical attacks, continue to grapple with the trauma that reverberates through their daily lives [4].

Additionally, the Sunni and Shia communities have historically been involved in struggles that have left lasting psychological impacts on their collective identities. The interplay of sectarian divisions has further added to the nation’s psychological distress, creating divisions and deep-rooted mistrust among the people. Finally, Iraq faces significant environmental challenges and is considered the fifth most vulnerable country to the impacts of climate change [5]. It faces severe climate extremes, water scarcity, and rising temperatures, making it uninhabitable within the next two decades [6]. These factors include low rainfall, depleting surface and groundwater, intensified dust storms, drought, and desertification, leading to agricultural decline, disrupted food chains, and the influence of the psychosocial well-being of people [7].

Tragic events do not end there. Socioeconomic challenges, including poverty, unemployment, inadequate infrastructure, water scarcity, environmental pollution, increased suicide, and addiction, exacerbate the mental health crisis in Iraq [8]. Faced with such adversity, the mental health of the Iraqi population has been under immense strain. The prevalence of psychological disorders and suicide behaviours is expected to be alarmingly high with substantial impacts on diverse communities, according to two systematic reviews focusing on mental health problems and suicide by self-immolation, revealing a 45.5% depression rate among junior physicians, a 70.5% prevalence for parents of children with cancer, and a 68.9% rate for infertile women. PTSD rates range from 20.8 to 67% among internally displaced persons, and university students exhibit a prevalence of 22.9%. Anxiety affects physicians 47.9% and junior physicians 50.8%, with older people experiencing a significant anxiety rate of 58%. In addition, self-immolation significantly contributes to burn admission, which is 26.38% overall, with 16.02% in the middle and southern provinces and 36.75% in the Kurdistan region [1,9].

The enduring series of disasters has unquestionably left a profound mark on the mental well-being of Iraqi communities. Yazidis, Kurds, Christians, Sunnis, and Shias collectively bear the burden of their historical challenges, giving rise to a shared experience of trauma, fear, depression, and anxiety. Younger generations, especially Yazidi young people, have been particularly affected, growing up surrounded by violence and instability, leading to widespread feelings of hopelessness and despair [10]. This article aims to shed light on the psychological profile of Iraq in recent decades and emphasises the critical need to prioritise mental health within health and education policies. It underscores the pressing need for inclusive mental health programmes, interventions, and awareness initiatives to effectively address the ongoing psychological challenges facing the Iraqi population. Table 1 outlines the major events in Iraq’s recent history and their impact on the psychological profile of the country.

2 Addressing the psychological crisis

The psychological profile of Iraq requires critical attention and comprehensive interventions to rebuild a resilient and cohesive society. Key steps to address this crisis include:

1. Mental health infrastructure: Iraq must invest in a robust mental health infrastructure to offer accessible and affordable mental health services to its citizens. This includes training more mental health professionals and establishing and prioritising more mental health and psychology programmes at universities and mental health clinics and centres throughout the country.

2. Trauma-informed care: Given the widespread trauma experienced by various communities, it is crucial to provide trauma-informed care and support to survivors. Psychosocial support programmes should be developed to aid in the healing process.

3. Reconciliation efforts: Acknowledging the historical events and grievances faced by different communities is vital to fostering reconciliation. National dialogues and initiatives to promote understanding and empathy among groups can play a pivotal role in this regard.

4. Socioeconomic development: Addressing socioeconomic challenges is paramount in alleviating stressors that contribute to mental health issues. Job creation, poverty reduction, and improved infrastructure can foster a sense of stability and hope for the future.

5. Combating extremism: Efforts to combat extremist ideologies must include targeted counter-messaging campaigns on social media platforms and promoting critical thinking to prevent the spread of hatred and radicalisation.

6. Building climate resilience: Iraq should prioritise climate resilience by investing in infrastructure and policies that help communities adapt to the changing climate. This includes measures such as building climate, resilient agriculture systems, improving water resource management, and implementing sustainable land use practices to mitigate the impacts of climate change and improve long-term sustainability.

Investing in mental health resources and implementing trauma-informed care are crucial to address the psychological wounds that generations carry. Empowering communities, encouraging dialogue, and promoting reconciliation initiatives contribute to a more cohesive and stable society [10]. International support is equally important in recognising and acknowledging the consequences of past interventions in Iraq’s history. Cultivating empathy and understanding can bridge divides and aid in collective healing. Addressing Iraq’s socioeconomic challenges is essential, including creating employment opportunities, improving infrastructure, and investing in sustainable development. These efforts lift communities and instil hope for a better future. Together, we can help Iraq overcome its traumatic past and build a brighter, more stable future. Despite challenges, Iraqis have demonstrated resilience and strength, showcasing the ability of the human spirit to endure, adapt, and rebuild in the face of overwhelming odds. Recognising this resilience underscores the importance of prioritising mental health support and interventions for the Iraqi people.

3 Conclusion

The psychological profile of Iraq portrays a nation deeply affected by a history characterised by trauma and hardship. However, recognising and addressing these issues present an avenue for psychological recovery and transformation. Collaborative efforts between the international community and the Iraqi government are crucial to supporting initiatives that prioritise mental health, foster reconciliation, and address the documented challenges and socioeconomic issues confronting the nation. Through the cultivation of psychological resilience, understanding, and optimism, Iraq can initiate a trajectory towards a more positive and resilient future for its populace.