Needs Assessment Report: Mental Health and Psychosocial Conditions in Anbar - Republic of Iraq, Al-Anbar Governorate, Fallujah and Al-Qaim Districts, October 2020

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Iraqis living in Anbar Governorate experienced a myriad of atrocities during the occupation of Islamic State of Iraq and the Levant (ISIL). Although the ISIL has fallen, both returnees and others continue to suffer from consequences of the conflict, including mental and psychological symptoms.
This Mental Health and Psychosocial Support (MHPSS) assessment outlines causes of these stressors and necessary steps to improve their mental health and psychosocial well-being. The report also details coping strategies of returnees and current gaps in MHPSS services, particularly in the Al-Qaim and Fallujah district centres of Anbar Governorate.

Both qualitative and quantitative methods were used for this assessment. The findings are based on 121 activities, reaching 197 respondents through Key Informant Interviews (KIIs) that also included surveys and Focus Group Discussions (FGD). Out of the nearly 200 respondents, 55 were youth aged 14 -17 years (33 girls and 32 boys) and 131 were older than 18 years (67 women; 64 men).

Overall, this assessment found that 83 per cent of respondent in Al-Qaim and 90 per cent of respondent in Fallujah reported having emotional distress in the range of moderate to very high (from 5 to 10).

Leading causes of emotional distress differ between the two locations. While displacement, traumatic experiences in the area of origin, and loss of loved ones were the most commonly stated causes of emotional distress in Al-Qaim, displacement, COVID-19 pandemic, living situations/conditions, and lack of job opportunities were the most frequently reported causes of emotional distress in Fallujah.

In terms of resilience building factors, the majority of the KII respondents felt supported by their families in both districts (95% in Al-Qaim and 85% in Fallujah), but more than half of the respondents reported that they do not feel supported by other community members and neighbors (59,53% in Al-Qaim and 57% in Fallujah).

The assessment reveals several notable findings. In Al-Qaim, the most urgent needs were provision of psychosocial support services, including awareness raising sessions; awareness raising activities regarding harassment against women and girls; recreational activities, such as building parks and kindergartens; opening educational and vocational courses and other courses to build computer and literacy skills; and improved access to basic services, such as food, electricity, medicine, and education. The most urgent needs for respondents in Fallujah were addressing mental health conditions, such as depression, anxiety, suicide, addiction, and drug abuse; addressing other psychosocial related issues such as marital conflicts, daily stress, and addiction to technology; restoring hope and establishment of peacebuilding in the community; addressing issues of injustice, inequality, and corruption in the community; and addressing protection-related problems, including gender-based violence (especially domestic violence and child marriage), child neglect, and child labor. The need to enhance the provision of services to persons with special needs was also highlighted.


Psychological and Psychosocial Needs

  • Address MHPSS related gaps in governmental service provision through providing both specialized and focused non-specialized MHPSS services, ranging from psychological first aid to psychiatric treatment.

  • Advocate for the provision of basic services that are safe, accessible and protect the dignity of the community members; encourage humanitarian actors to deliver these services in a safe and socially appropriate way.

  • Establish safe areas for recreational activities.

  • Establish link between MHPSS and livelihoods through integrated programming which includes support to community members to access livelihood opportunities and become economically self-reliant.
    MHPSS Capacities and Resources

  • Establish and/or increase spaces to create peaceful and inclusive atmosphere for community members to gather and engage in activities.

Protection Related Needs

  • Ensure MHPSS and protection services are integrated. Neither should take place without consideration of the other. Effective referral pathways should be established to address needs in a holistic manner.

  • Address MHPSS needs while considering protection concerns, such as through the provision of psychosocial support to gender-based violence survivors.

MHPSS Service Providers

  • Design holistic and complementary MHPSS programmes that are more accessible and diverse ,addressing the various MHPSS related needs of the community while ensuring coordination with other providers to avoid duplication of services.

  • Support local authorities in customizing services according to the specific contextual needs of their communities.

  • Advocate for a better implementation of the Mental Health Policy of Republic of Iraq.

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