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Mental Health

According to the International Rescue Committee (IRC), Iraqi refugees arrive in the United States with more emotional and mental health issues than many other refugee groups, and the IRC has documented a high prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) among recently arrived Iraqis 30. In a 2012  CDC survey of Iraqi refugees who had lived in the United States 8-36 months, 50% of participants reported anxiety, 49% depression, and 31% a need for further assessment for PTSD 8. This finding is consistent with data collected on Iraqis in their host countries. In Syria, 89.5% of interviewed Iraqi refugees reported depression, 81.6% anxiety, and 67.6% PTSD 6. Reasons reported for mental health issues among Iraqis in Syria included air bombardments, shelling, or rocket attacks (77%); witnessing a shooting (80%); interrogation or harassment by militias (68%); and knowing someone close to them who had been killed (75%) 6.

A 2009 study estimated the lifetime prevalence of any mental disorder at 18.8% for Iraqi adults 34. Anxiety disorders were the most common (13.8%) class of disorders in the cohort studied, and major depressive disorder (MDD) was the most common (7.2%) single disorder 34. Iraqi refugees are aware of their psychological disturbances and describe their feelings of anxiety and depression in terms such as “Dayij” (uncomfortable), “Ka’aba” (melancholia), “al Zillah” (humiliation), “Kalak” (anxiety), “Inziaaj” (uneasiness), “Ihbat” (frustration), “Khawf” (fears), “Daghet” (pressure), “Ta’ab” (tiredness), “Sadma” (shocked), “Insilakh” (uprooting), and “Hasbiya Allah wa ni’ma l wakil” and “Allah y’in”, which both refer to the hope in God’s assistance to face trouble and injustice 17. Iraqi refugees may not seek mental health care due to cultural stigmatization of mental health patients; lack of access to mental health services in countries of asylum (especially Jordan); and lack of outreach and education about mental health issues 17. Iraqi refugees may manifest mental health problems as physical symptoms, such as headaches, backaches, body aches, or gastrointestinal problems with no physical underlying reasons.

Summary

Iraqi refugees have been coming to the United States for a short time compared with some other refugee groups. Iraqi refugees have a high burden of non-communicable disease such as hypertension, diabetes mellitus, and malnutrition. The information provided above is intended to help resettlement agencies, clinicians, and health care providers understand the cultural background and health issues of greatest concern pertaining to resettling Iraqi refugee populations.

References

  1. United Nations High Commissioner for Refugees. UNHCR Iraq Fact Sheet. 2010. Accessed November 2013. http://www.unhcr.org/pages/49e486426.html
  2. Queensland Health Multicultural Services. Community Profiles for Healthcare Providers: Iraqi Australians. Queensland Health. [Online] July 8, 2011. [Cited: September 13, 2011.] www.health.qld.gov.au/multicultural.
  3. Giese, Amanda. An Assessment of the Health of Iraqi Refugees in Chicago. Heartland Alliance. 2010.
  4. Harper, Andrew. Iraq's Refugees: Ignored and Unwanted. 869, 2008, International Review of the Red Cross, Vol. 90, pp. 169-190.
  5. Doocy, Shannon, et al. Food Security and Humanitarian Assistance Among Displaced Iraqi Populations in Jordan and Syria. 2, 2011, Social Science & Medicine, Vol. 72, pp. 273-282.
  6. Ghareeb, Edmund, Ranard, Donald and Tutunji, Jenab. Refugees from Iraq: Their History, Cultures, and Background Experiences. Center for Applied Linguistics. 2008. COR Center Enhanced Refugee Backgrounder No. 1.
  7. Women's Commission for Refugee Women and Children. Iraqi Refugee Women and Youth in Jordan: Reproductive Health Findings, A Snapshot from the Field. 2007.
  8. Taylor, Eboni et al. Physical and Mental Health Status of Iraqi Refugees Resettled in the United States.  Springer, Journal of Immigrant and Minority Health, August, 2013. Web. August, 2013.
  9. Iraq Family Health Survey 2006/7 (World Health Organization). Accessed 2012, at http://www.emro.who.int/iraq/pdf/ifhs_report_en.pdf).rm
  10. Terrazas, Aaron. Iraqi Immigrants in the United States. Migration Information Source. [Online] March 5, 2009. [Cited: September 9, 2011.] http://www.migrationinformation.org/USfocus/display.cfm?id=721.
  11. O'Donnell, Kelly and Newland, Kathleen. The Iraqi Refugee Crisis: The Need for Action. Migration Policy Institute. 2008.
  12. Wisconsin Department of Health Services. Tips for Health Care Providers about Iraqi Refugees. 2010.
  13. Stratis Health. Iraqis in Minnesota. Stratis Health. [Online] 11 1, 2009. [Cited: September 13, 2011.] http://www.stratishealth.org.
  14. Saadi, Altaf, Bond, Barbara and Percac-Lima, Sanja. Perspectives on Preventive Health Care and Barriers to Breast Cancer Screening Among Iraqi Women Refugees. 2011, Journal of Immigrant & Minority Health. PMID 21901446 .
  15. IRC Commission on Iraqi Refugees. A Tough Road Home: Uprooted Iraqis in Jordan, Syria and Iraq. New York : International Rescue Committee, 2010.
  16. Frelick, Bill. "The Silent Treatment": Fleeing Iraq, Surviving in Jordan. [ed.] Peter Bouckhaert, Christoph Wilcke and Sarah Leah Whitson. Human Rights Watch. November 2006, Vol. 18, 10.
  17. Schinina, et al. Assessment on Psychosocial Needs of Iraqis Displaced in Jordan and Lebanon. International Organization for Migration. 2008.
  18. Centers for Disease Control and Prevention (2012), Electronic Disease Notification System (EDN).
  19. US Department of State, Bureau of Population, Refugees, and Migration (PRM), Worldwide Refugee Admissions Processing System (WRAPS).
  20. Joint Appeal by UNFPA, UNHCR, UNICEF, WFP, and WHO. Meeting the Health Needs of Iraqis Displaced in Neighbouring Countries. 2007.
  21. World Health Organization/UNICEF/Johns Hopkins University. The Health Status of the Iraqi Population in Jordan: 2009
  22. United Nations High Commissioner for Refugees; United Nations Children's Development Fund; World Food Program. Assessment on the Situation of Iraqi Refugees in Syria. 2006.
  23. Women's Refugee Commission. Baseline Study: Dcumenting Knowledge, Attitudes and Practices of Iraqi Refugees and the Status of Family Planning Services in UNHCR's Operations in Amman, Jordan. 2011.
  24. Chynoweth, Sarah. The Need for Priority Reproductive Health Services for Displaced Iraqi Women and Girls. 31, 2008, Reproductive Health Matters, Vol. 16, pp. 93-102.
  25. World Health Organization, Regional Office for the Eastern Mediterranean (EMRO) website. Accessed September, 2012. http://www.emro.who.int/
  26. Ramos, M, et al. Health of Resettled Iraqi Refugees–San Diego County, California, October 2007-September 2009. 2010, Morbidity and Mortality Weekly Report, Vol. 59, pp. 1614-1618.
  27. World Health Organization. Tuberculosis Profile: Iraq. World Health Organization. [Online] January, 29th 2013. [Cited: January 29th, 2013] www.who.int/tb/data.
  28. Yanni, E, et al; The Health Profile and Chronic Diseases Comorbidities of US-Bound Iraqi Refugees Screened by the International Organization for Migration in Jordan: 2007–2009.    Journal of Immigrant and Minority Health; DOI 10.1007/s10903-012-9578-6
  29. World Health Organization. Non-Communicable Disease Profile: Iraq. World Health Organization. [Online] September 12, 2011. [Cited: September 12, 2011.] http://Infobase.who.int.
  30. International Rescue Committee. The Health of Refugees from Iraq. 2009. http://www.rescue.org/iraqi-refugees.
  31. Darwish-Yassine M, Wing D. Cancer epidemiology in Arab Americans and Arabs outside the Middle East. Ethn Dis. 2005;15 (1 Suppl 1):S1-5–S1-8.
  32. 32. Michigan Department of Community Health. Color me healthy: a profile of Michigan’s racial/ethnic populations, May 2008. 2011. Accessed on 22 Jan 2011 at http://www.michigan.gov/documents/mdch/ColorMeHealthyProfileMay2008_2362457.pdf
  33. Shah SM, et al. Arab American Immigrants in New York: health care and cancer knowledge, attitudes, and beliefs. J Immigr Minor Health. 2008;10:429–36.
  34. Alhasnawi, Salih, et al. The prevalence and correlates of DSM-IV disorders in the Iraq Mental Health Survey (IMHS). 2, 2009, World Psychiatry, Vol. 8, pp. 97-109.
  35. United Nations High Commissioner for Refugees. 2013 UNHCR country operations profile – Iraq. http://www.unhcr.org/pages/49e486426.html

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