Shafaq News

In a country weighed down by decades of wars, conflicts, and mass displacement, millions of Iraqis live with deep psychological scars. Within this reality, a pressing question arises: how does Iraqi legislation protect citizens’ mental health and provide the care they need?

Law on Paper

The Iraqi Mental Health Law No. 1 of 2005 was designed to answer that question. It provides the legal framework for safeguarding psychiatric patients and regulating the work of mental health institutions.

The legislation defines psychiatric patients and outlines their basic rights, including humane treatment, respect for privacy, and involvement in medical decision-making. It also introduces rehabilitation programs aimed at helping patients reintegrate into society.

Involuntary hospitalization is tightly regulated. Admission without consent requires either a judicial decision or a request from relatives, backed by a medical report confirming the patient poses a danger to themselves or others. To ensure protection, a legal representative must be appointed to safeguard the patient’s rights.

Cracks in Care

Despite the law’s importance, implementation has remained limited due to insufficient human resources and infrastructure, compounded by the psychological consequences of long-term conflicts.

According to Majid Shankali, chairman of the parliamentary Health and Environment Committee, Iraq has no more than 200 psychiatrists, far below the roughly 4,500 needed to adequately serve a population of 45 million. This equates to one psychiatrist per 10,000 people, compared with an actual density of just 0.34 per 100,000, highlighting a significant gap between demand and availability.

Specialized facilities are also scarce. Iraq has six psychiatric hospitals—two in Baghdad and four in the Kurdistan Region—with a total bed capacity of 5.4 per 100,000 people. Nearly all beds, 97%, are concentrated in major cities, leaving residents of other provinces with very limited access to treatment.

Hospital records indicate 3,220 patients are currently admitted, corresponding to 12 per 100,000 population, with an average stay of 338 days. This heavy reliance on institutional care underscores the limited reach of community-based rehabilitation programs.

Financial resources pose another challenge. The Ministry of Health has not allocated a dedicated budget for psychiatric services; instead, it folds mental health funding into the general health budget. The annual operating cost of a single psychiatric hospital is estimated at $1.08 million, insufficient to cover essential medications, equipment, and infrastructure expansion.

Although government hospitals provide medications free of charge, frequent shortages force some patients to turn to the private market, adding financial strain on low-income families.

Primary health care centers, meant to serve as the frontline of mental health care, offer only limited services. Fewer than 20% of clinics follow psychiatric treatment protocols, only 7% of doctors have received basic mental health training, and just 1% of nurses have relevant training.

Moreover, restrictions on prescribing psychiatric medication further limit the capacity of primary centers, particularly in remote areas. The upcoming revision of the law is expected to strengthen the role of primary care centers in delivering mental health services, seen as a crucial step toward expanding coverage nationwide.

Read more: A nation in trauma: Iraq's mental health crisis deepens

A Law Awaiting Passage

The Health and Environment Committee is currently preparing an updated version of the law, which has been repeatedly placed on the parliamentary agenda but has not yet been voted on due to an incomplete quorum.

The proposed amendments aim to close the gaps in the 2005 law by strengthening patient rights and protections and integrating mental health services into primary care centers. They also seek to expand psychiatric clinics across all provinces, improve the regulation of psychiatry and mental health facilities, and enhance oversight of involuntary admissions.

Obstacles Ahead

If enacted, the updated Iraqi Mental Health Law is expected to provide a more comprehensive framework for psychiatric care by expanding personnel and facilities and improving access to services. Yet its implementation faces significant obstacles.

Parliament has struggled to maintain quorum during debates, slowing the legislative process. Even if passed, success will depend on sustained funding, training programs to expand Iraq’s psychiatric workforce, and campaigns to reduce stigma around mental illness that deters many from seeking treatment.

Without these steps, the law risks remaining a framework on paper, unable to deliver the protection and care millions of Iraqis urgently need.

Read more: Iraq's psychological wounds: A generation scarred by conflict

Written and edited by Shafaq News staff.