By: Dr. Alborz Bahador, Clinical psychologist, Researcher and practitioner
Note: FISN research reports and papers may be used freely with proper referencing and credit to the authors and the Free Iran Scholars Network.
This article is the first in a series of scholarly investigations into the state of mental health and medical resources in the Islamic Republic of Iran. The series aims to dissect how Iran’s mental health infrastructure, access to care, and societal well-being have been systematically eroded under decades of corruption, mismanagement, and repression.
Introduction
Iran is facing a mental health crisis of staggering proportions. One in four Iranians is currently affected by a diagnosable mental disorder [1]. Yet even these figures underestimate the depth of the crisis, because so many suffer in silence, uncounted and untreated. Behind these statistics lies a much darker truth: Iran’s health system, once among the most robust in the Middle East, has collapsed under the weight of an authoritarian regime more interested in survival and enrichment than in serving its people. From underfunded psychiatric services to the use of psychiatric institutions for political repression, the Islamic Republic has turned what should be a system of healing into yet another instrument of decay and control.
A Nation in Psychological Distress
Iran’s mental health burden is among the highest in the region. According to Iran’s Ministry of Health, roughly 25% of the population suffers from some form of mental disorder [1]. For women, the numbers are even more alarming: mental health disorders account for over 12% of the total disease burden among Iranian women, compared to 8.4% for men [2]. Adolescents and young adults are especially vulnerable, with staggering rates of anxiety, depression, and suicidal ideation [3].
The depth of the crisis becomes more apparent when examining regional data. In provinces like Khuzestan and Sistan-Baluchestan—areas historically marginalized and under-resourced—mental health disorders are even more prevalent, driven by poverty, violence, and environmental degradation. A 2023 study conducted by the Iranian Psychiatric Association found depression rates exceeding 40% in several southern provinces [12].
Case Study 1: Suicides in Ilam Province
Ilam, a western province with high unemployment and limited access to education, has recorded one of the highest suicide rates in the country. In 2022, over 400 suicide attempts were reported in Ilam alone, with many involving young people and women [13]. One widely publicized case involved a 19-year-old woman named Mina, who took her life after repeated attempts to escape an abusive home environment and forced marriage. Despite reaching out to local health officials, she was denied shelter and psychological support due to “resource constraints.” Her story, shared widely on Persian social media, underscores the catastrophic failure of the mental health safety net.
An Abandoned System
Iran’s mental health infrastructure is grossly inadequate. According to a recent report published in Frontiers in Public Health, the country lacks a cohesive mental health policy, suffers from low government prioritization, and is plagued by fragmentation across services [4]. Access to trained professionals is woefully insufficient. As of 2020, Iran had fewer than 1,000 licensed psychiatrists for a population of over 80 million [5]. In rural and underserved urban areas, mental health services are nearly non-existent.
The problem is not merely one of numbers. There is a complete absence of a coordinated referral system, resulting in patients bouncing between general practitioners, emergency rooms, and spiritual advisors without receiving proper psychiatric care. Furthermore, there is no mandatory continuing education for mental health professionals, meaning that treatment standards are outdated and inconsistent.
Political Weaponization of Psychiatry
Beyond neglect, the regime has actively weaponized psychiatry to punish dissent. Numerous human rights organizations have documented cases where protesters, especially women, are forcibly admitted to psychiatric institutions under the pretense of “delusion” or “anti-social behavior.” In one notorious case, a woman arrested for undressing in public as a protest was forcibly institutionalized, raising alarms from Amnesty International and Human Rights Watch [7].
This tactic is chillingly reminiscent of the practices used by the Soviet Union, where psychiatry was routinely used to silence political dissidents. In Iran, it reinforces the message that any deviation from state-imposed norms is not just criminal but pathological.
Case Study 2: Student Activist Subjected to Forced Psychiatric Evaluation
During the 2022 Mahsa Amini protests, a university student named Pouya was arrested for organizing a student sit-in at Tehran University. Rather than face a formal trial, Pouya was sent to a psychiatric facility under the claim that his activism was a sign of mental instability. According to leaked testimony from a fellow patient, Pouya was denied legal representation, administered sedatives, and interrogated under surveillance.
This abuse underscores how psychiatric institutions have become extensions of the regime’s security apparatus. Far from treating mental illness, these centers are used to delegitimize activism and terrorize those who dare speak out.
Structural Causes: Theft, Corruption, and Authoritarianism
The Islamic Republic has siphoned away Iran’s wealth to fund proxy wars, enrich ruling elites, and sustain a bloated security apparatus. Meanwhile, public services including mental health care have withered. According to estimates by independent economists, billions of dollars have been funneled into the coffers of the Revolutionary Guards and clerical networks, leaving little for basic health infrastructure [8].
Sanctions have compounded these issues, but they are far from the root cause. Even prior to the re-imposition of sanctions in 2018, Iran’s health system was already in free fall due to internal mismanagement and structural looting. Medication shortages, including for psychiatric drugs, are the result of a corrupt pharmaceutical procurement system that favors insiders and hoards supplies [9].
Numerous reports indicate that imported medicines are often redirected to black markets controlled by regime-connected actors, forcing ordinary patients to either pay exorbitant prices or go without. This criminalization of access has turned mental health treatment into a luxury only available to the elite.
Cultural Stigma and State Complicity
Mental illness in Iran remains a taboo topic. Cultural stigma leads many families to conceal mental disorders, and many individuals suffer alone. Yet rather than launch public education campaigns or normalize treatment, the regime has reinforced silence. Officials routinely downplay mental health statistics, and clerical authorities often frame mental illness as a spiritual failing or lack of faith [10].
This cultural suppression is compounded by a lack of legal protection. Iran has no mental health act or legal framework to protect patients’ rights or ensure ethical standards of care. This legal vacuum enables abuse, neglect, and state manipulation of psychiatric institutions without consequence.
Clerics have also undermined scientific medicine by promoting so-called “Islamic healing” as an alternative to professional mental health treatment. State media frequently airs programming that suggests prayer, fasting, and allegiance to the Supreme Leader as cures for depression and anxiety, effectively pathologizing dissent and deflecting from material causes of psychological distress.
Women and Youth: The Hardest Hit
Among the most affected are Iran’s women and young people. Women face systemic gender discrimination, limited legal protections, and persistent threats of violence and moral policing. Many suffer from post-traumatic stress, depression, and anxiety, exacerbated by their daily experiences of repression and exclusion [2, 11].
A 2021 study found that more than 60% of female respondents in Tehran exhibited moderate to severe symptoms of anxiety, with economic instability, harassment, and family pressure as key drivers [14].
For youth, the trauma is both psychological and existential. In a society that offers little hope and criminalizes self-expression, many young Iranians experience chronic despair. Suicide rates among youth are rising, and studies show alarming levels of depressive symptoms even in school-age children [3].
Case Study 3: Self-Immolation in Kurdistan
In 2021, a 22-year-old woman named Shilan set herself on fire in the city of Sanandaj after being denied the right to attend university and marry a partner of her choice. Her death was recorded by neighbors and shared widely online, sparking protests that were quickly suppressed. Shilan had previously sought counseling but was turned away due to lack of documentation and funds.
Her tragic end exemplifies the hopelessness that so many Iranian women face. It also shows how lack of access to even basic psychological support can turn personal suffering into public outrage—and sometimes into irreversible tragedy.
The Way Forward: A Post-Islamic Republic Framework
It is clear that the Islamic Republic is incapable of reforming the mental health system. A functioning, ethical, and responsive mental health infrastructure requires transparency, accountability, and investment—none of which are possible under a regime that survives by crushing freedom and hoarding wealth.
Any future transition in Iran must prioritize rebuilding mental health and medical services from the ground up. This includes:
- Creating a national mental health act to safeguard patient rights
- Integrating mental health into primary care
- Training a new generation of ethically grounded mental health professionals
- De-stigmatizing mental illness through public education
- Building modern, accessible facilities across the country
Transitional justice must also include an accounting of how psychiatric institutions were misused for political control. Mental health reform in Iran must be both forward-looking and rooted in truth-telling about the past. Survivors of psychiatric abuse deserve restitution, public acknowledgment, and institutional reform.
Iran’s people deserve more than slogans and broken promises. They deserve healing, dignity, and the right to a full life.
References
[1] Iran Ministry of Health, 2024 Report on Mental Health Trends. Report summary via Iran International. https://www.iranintl.com/en/202412212738
[2] Afshari, M. et al. (2022). Gender Disparity in Mental Health Burden in Iran. BMC Public Health.
[3] Suicide in Iran. Wikipedia summary and citations. https://en.wikipedia.org/wiki/Suicide_in_Iran
[4] Sarrafi, M. et al. (2022). Barriers to Effective Mental Health Policy in Iran. Frontiers in Public Health. https://www.frontiersin.org/articles/10.3389/fpubh.2022.1027002/full
[5] WHO Mental Health Atlas, Iran Profile, 2020.
[6] Iranian Parliamentary Health Committee, 2021 Budget Review.
[7] The Guardian. (2024). “Woman arrested in Iran for protest forcibly institutionalized.” https://www.theguardian.com/global-development/2024/nov/08/woman-arrested-iran-undressing-protesters
[8] Alfoneh, A. (2019). The Revolutionary Guards and Economic Capture. Atlantic Council Issue Brief.
[9] Financial Times. (2024). “Iran faces medicine shortages amid economic crisis and corruption.” https://www.ft.com/content/012e9dbf
[10] Khabar Online. (2024). “Mental Health in Iran Below Global Average: One Third of the Population Suffers.” https://www.khabaronline.ir/news/1971829
[11] Human Rights Watch (2023). “Iran: Systematic Discrimination Against Women.” https://www.hrw.org/middle-east/n-africa/iran
[12] Iranian Psychiatric Association, 2023 Provincial Mental Health Survey.
[13] Ilam Province Health Authority. Annual Suicide Report, 2022.
[14] Tehran University School of Social Sciences, Women’s Mental Health Survey, 2021.