The July issue of Kurdistan Chronicles, issue 16, featured a story about a mental health training project led by the Oxford Cognitive Therapy Center (OCTC), a part of Oxford University. This story reports on the experiences of the trainers.
The first 30 Kurds trained to deliver Cognitive Behavior Therapy (CBT) are set to finish the first major element of their course in November 2024. CBT is the main ‘go to’ therapy treatment used in the UK and by the World Health Organization to treat depression, anxiety, and a range of other mental health issues. Following the completion of the full CBT training, the Kurdish therapists should be able to treat patients with these issues.
The project, the brainchild of an Anglo-Kurdish non-governmental organization based in the UK, is the first major year-long CBT training project in the Kurdistan Region of Iraq and includes an added year of supervision.
The two main Oxford trainers for the Kurdistan Region are Dr. Kevin Meares and Amandeep Soomal.
“Everyone involved in the project at OCTC has been absolutely enthralled by meeting people from the Kurdistan Region and working with them,” Meares says. “Even though this is a society that has suffered multiple instances of trauma, they are the most generous, kind-hearted people, with a huge appetite for learning. And it is this that makes this project an absolute joy to be a part of.”
A local lens
Throughout the early months of training, the trainees have overcome significant barriers and stigmas around mental health. In particular, Soomal admires the trainees’ “ability to take on that challenge, their openness to new learning, and their readiness to challenge us and say, ‘I don’t think that this works for us.’ And then we set about finding new ways of working.”
“We are working with this cohort to build something really beautiful,” Soomal explains. “And these are just the seeds. I’m hoping it is going to grow into a huge tree that will weather many storms.”
Although standard in many countries, CBT is new to Kurdistan. The Oxford trainers acknowledge that there have been challenges and learning opportunities for them as they work to adapt CBT to the region – which, in general, has a more collectivist culture than the UK.
Soomal says that they have had to think about how CBT helps the system and the whole family, in order to help the individual. “That’s something that the cohort has taught me,” she explains. “We did a ‘get to know you’ exercise during induction and asked: ‘What is your favorite thing about Kurdistan’? The resounding answer was ‘community’ and ‘we rely upon each other.’”
The Oxford trainers have adapted their teaching in another surprising way. For the training on treating suicide risk, the Oxford team brought in Dr. Anne Garland, a specialist who was able to use Kurdish poetry to talk powerfully and movingly about difficult issues.
The Oxford trainers are also mindful of gender issues and have made space for women-only groups in some cases, which has led to more openness. Soomal notes that the team has been workshopping how to support patients who are survivors of gender-based violence.
Along these lines, there have been discussions about mental health disparities between genders and the different pressures and expectations that society places on them.
International expertise
Tackling mental health issues is a challenge across every society, but there are opportunities for countries to learn from each other’s experiences.
In this vein, the Kurdistan Region project has drawn upon the expertise of Anglo-Kurdish mental health practitioners, including Dr. Ava Doski. Doski, whose family is originally from Duhok, lives and works in the UK and received a doctorate in clinical psychology. In order to give back to her community, she has helped shape, create, and develop the project from day one.
“Kurdistan should prioritize mental health because of the profound impact it has on the well-being and future prosperity of its people,” Doski emphasizes. “The Kurdish population has endured significant trauma, including decades of violence, displacement, and oppression. These collective experiences have left significant psychological scars, not only for individuals, but for entire communities.
“Mental health care is essential for breaking the cycle of generational trauma, where unresolved psychological wounds are passed from one generation to the next. By addressing these issues, Kurdistan can build a more resilient and mentally healthy population, allowing its people to live more fulfilled lives.
“Healthy minds lead to higher levels of productivity, creativity, and social cohesion, which are critical for the long-term prosperity of the region,” she adds.
“There is a strong global consensus that there is no health without mental health,” Doski says. “If mental health is ignored, physical health initiatives alone won’t be sufficient to create a thriving society. By investing in mental health care, Kurdistan can ensure a healthier, happier, and more productive population capable of contributing to the region’s development and growth.”
Having worked on the project as a supervisor, Doski says that she is struck by the extent to which awareness of mental health is on the rise. People in the Kurdistan Region, she notes, are becoming more open to discussing mental health, which is a critical shift.
For her, Kurds should continue to talk about mental health and normalize it – whether through advertising, TV shows, or public discussions. The more we bring it into everyday conversation, the more we can break the stigma and encourage individuals to seek help without fear.
The project has private funding through 2025, and the OCTC says it is looking forward to building the next generation of CBT therapists in the region.
“We want to provide the right level of support for the right amount of time and then phase ourselves away and out,” Meares says. “But we want to help our new CBT colleagues within Kurdistan for as long as they need us. This is just the beginning.”
Chris Bowers is the former UK Consul General in the Kurdistan Region and has been working on KRI for more than a decade.