HAVING MENTAL HEALTH CARE BE COMPULSORY IN PHC IN SYRIA:

A RISKY YET NEEDED MOVE

World Health Organization Committee
Topic B
The Syrian Arab Republic
Thai Bao Tran
“In Syria, 75% of people with mental health conditions receive no treatment at all, and
the current pandemic is further aggravating the situation.”[1]The ongoing war in Syria has
engendered damage that may not be understood for years, particularly on the three
million Syrian children born since the start of the war. Available data indicates that
nearly half of all Syrian children display symptoms of post-traumatic stress disorder
(PTSD) and a quarter face intellectual and developmental challenges.[2] The result is an
entire generation susceptible to everything from depression and anxiety to behavioral
dysfunction and radicalization. Children become highly susceptible to depression,
anxiety, and other forms of mental illness in the short term when living in conflict
zones[3]. Higher still were the results of Mohammed Bahaa Aldin Alhaffar’s study on oral
health and the prevalence of severe PTSD among children, which showed that 91.5% of
children in the city of Damascus suffered from PTSD[4], the highest rates being
concentrated in eastern and south-eastern areas of Damascus,
namely Dwelah, Nahr Aisha, Tabbaleh and Jaramana. From here, we can imagine
the magnitude of the psychological damage that those living through the crisis are
experiencing.

Before the conflict, Syrian society had reasonably well-developed medical facilities,
although the quality and quantity of mental health facilities were low. MHPSS (Mental
Health and Psychosocial Support) services in Syria have been disrupted and destroyed by
the conflict, and suffer from a critical shortage of qualified staff[5]. Although mental
health services in Syria have been largely institution-based, several demonstration
projects, focused on Iraqi refugees in Syria a few years ago, proved successful in
reaching people with mental health problems and providing access to care through
community-based psychosocial activities, community outreach, and mental health care
integrated into primary health care. In addition, as part of the humanitarian response to
the Iraqi refugee crisis and the Syrian conflict, humanitarian agencies have supported
psychosocial services in some areas, and to a lesser extent, mental health services. In an
international aspect, to help thousands of people, WHO’s a hub in Gaziantep, Turkey
rolled out the Mental Health Gap Action Programme in northwest Syria and trained more
than 250 Syrian health care workers and mental health professionals. WHO also trained
more than sixty psychologists in cognitive behavioral therapy, using external trainers, and
followed up on their field training[6].Besides, WHO continues to support health partners
to ensure that medicines and health services for mental health patients are available[7]. In
addition, UNICEF has supported the development of a mental health guide for children in
emergencies and the creation of child-friendly spaces,16 while the International
Organization for Migration has worked at the anthropological level and carried out
training on non-violent communication, conflict resolution, and refuge center
management. In terms of national programs, a report written by Amnesty International in
2006 shows that 117,000 Syrian refugees living in Jordan camps have access to
education, health care, food, and water provided by the government.[8] The Syrian Arab
Red Crescent (SARC) has played a major role in mental health – it was the first to open
polyclinics with a psychiatrist, psychotherapists and a speech therapist, as well as mobile
psychosocial support teams that traveled between the worst affected places and evaluated
psychosocial support activities for children. Several organizations are currently
developing methods to reach victims remotely using social media and modern
technology. For example, the Syrian Association of Psychiatrists has developed an
application for carrying out audiovisual psychiatric consultations and interviews
electronically.

However, the problem cannot be fully solved since people who perceive the origins of
psychological distress as somatic usually expect their treatment to follow medical lines.
As a result, many Syrians may be reluctant to speak in detail about their memories and
experiences, because they do not see the relevance of such information to their current
diagnoses. Besides, there are many others challenge such as Complicated language used
when clients diagnose, Gender and help-seeking behaviors can be seen as weak or
unstable and Stigma around psychological distress and mental illness can
be misunderstood.

To convince our country government about the need of making mental health care
mandatory, MHPSS programs must engage with the many qualified and educated Syrian
refugees who are already working hard to improve community mental health and
psychosocial wellbeing through grassroots networks. And for clinical mental health
professionals, such as psychiatrists and clinical psychologists, it is critical to realize that
their clients’ understanding and the manifestation of mental illness and psychosocial
(un)wellbeing is rooted in social, cultural, and religious contexts. Moreover, clinical
assessment should not only look for symptoms but also access whether the person has
social dysfunction, as well as assess strengths and coping abilities.

1
Syria: WHO-supported mobile teams deliver mental health care in Syria. (2020, October 14).
Who. Int
2
Hussain, I. (n.d.). Mind the Gap: Why Mental Health Care Matters for Rebuilding Syria.

Center for Strategic and International Studies.

4
Hedar, M. (2017). Mental health during the Syrian crisis: How Syrians are dealing with the

psychological effects. International Review of the Red Cross.

[5]
Syria: WHO-supported mobile teams deliver mental health care in Syria. (2020, October 14).

Who. Int
[6]
Randolph, K. (2021, January 26). The Syrian Mental Health Crisis. The Borgen Project.
[7]
Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians. (2015).

UNHCR.ORG. https://www.unhcr.org/55f6b90f9.pdf