Published: June 29, 2021

Exploring Cultural Idioms of Distress and Other Factors that Limit and Enhance Mental Health Practitioners’ Work with Iraqi Refugees

By Nadyah Spahn


There are approximately 80,000 Iraqi refugees in the United States, many of whom report severe mental illness but face barriers to treatment. Thus, to improve the mental health outcomes of Iraqi refugees, I interviewed mental health practitioners who work with this population. Based on a qualitative analysis of these interviews, I found two main themes in their responses. First, through a focus on cultural idioms of distress, I found that many practitioners misunderstood cultural phrases, while other practitioners demonstrated greater understanding due to their shared Iraqi background. Second, I found that practitioners who relied on the biomedical framework struggled to develop rapport, diagnose clients, and suggest interventions while the practitioners who utilized a holistic viewpoint were more effective in those domains. To address the limitations in cultural knowledge and clinical practices, I created a two-phase intervention based on the findings of this study which may help to make mental health services more accessible and sensitive to the needs of Iraqi refugees.