Many pundits have criticized the Bush administration for not having a robust postinvasion plan for Iraq. The military obviously did not anticipate the resistance and Iraqi infighting that have intensified years after the President declared “mission accomplished,” and the incredible toll on Iraq's citizens mounts daily. In a country where death squads roam the streets of the capital, overwhelming fear and stress certainly must be leading to a tremendous rise in mental health issues.
But Iraqis have few behavioral health professionals to turn to for help. As Keith Humphreys of Stanford University and Sabah Sadik, national advisor for mental health in Iraq, explain on page 34, Iraq has approximately 75 psychiatrists for a population of 26 million. I bet that the rates of untreated depression, anxiety, and PTSD are off the charts. Even when fighting dies down, the undoubtedly high rates of mental illness will be a serious burden to healing—both emotional and economic—for decades to come. Behavioral health disorders don't heal overnight, and a competent workforce is needed to help mend many emotional wounds. Yet as we know all too well in the United States, workforce development takes a long time.
The United States could face its own mental health crisis in the near future if fears of a bird flu pandemic come true. Widespread panic certainly would ensue as areas are quarantined, and rates of depression could skyrocket as the death toll mounts. News coverage 24/7 on every channel won't make the situation any easier for weary minds (remember 9/11?). And the many needs of existing behavioral health consumers must be anticipated in advance. On page 43 Ron Manderscheid details the role of behavioral health organizations in such a crisis. Although our country's mental health system is certainly more robust than Iraq's, planning now for the behavioral health needs during a national crisis—whether it's bird flu, small pox, or something else—is certainly worth our time and effort.
As Iraq rebuilds its healthcare system and we continuously reevaluate our own, we must remind lawmakers that the best way to anticipate and treat behavioral health disorders is to ensure that everyone has access to affordable mental health and substance abuse care. As Elizabeth Funk explains on p. 10, Massachusetts is taking steps to meet this goal. She points out that Massachusetts' decision to require healthcare for all is not a “liberal” concept from a state known for John Kerry, Edward Kennedy, and gay marriage; it's a practical solution to a problem that is draining economic resources and costing human lives. I hope national leaders—both in the United States and Iraq—take notice.
P.S. I'd like to know your thoughts. Send your comments to me at firstname.lastname@example.org.
Douglas J. Edwards, Editor-in-Chief