Syrians in Istanbul, seeking mental healthcare to cope with the wounds of eight years of war and displacement, say they are increasingly encountering a new form of injustice: fake psychiatrists seeking to exploit them by cashing in on their pain.
In recent years, unlicensed clinics have mushroomed, run by individuals practicing without training or qualifications. Many young refugees suffering from anxiety, trauma, post traumatic stress disorder (PTSD), and depression have become easy targets for fake counselors.
Dalal, a 27-year old Syrian who has been living in Istanbul since 2016, says she was shocked to discover that her psychiatrist, who posed as a mental health professional, was an untrained impostor.
“It was the first time in my life to see a psychiatrist, because I was so depressed. After a few sessions with the doctor, I felt major relief,” she told Asia Times.
Over weeks of sessions, the man convinced Dalal to leave her fiancé, whom he blamed for her psychological problems. Dalal was so convinced by his counseling that she later accepted an offer of a job at his office.
Then, the harassment began.
She recounts: “Immediately after I left my fiancé, his behavior changed. He started making sexual innuendos and using vulgar language, and sometimes he jokingly put his hand on my leg.”
Dalal decided to put up with her therapist’s bizarre shift until one day, when a friend of his brought alcohol into the clinic and the conversation shifted to his training.
He began bragging about how he became a psychiatrist with no formal education, and how he had trained himself by reading books on the topic.
“I was shocked,” Dalal said. “He even gave me a book to read so I could become a doctor like him.”
After her disturbing discovery, Dalal decided to investigate her employer by befriending his patients and chatting with them. She discovered that he prescribed the same antidepressant, Lustral, to nearly all of them. The depressant, she says, is available over-the-counter.
“What disturbed me most is that I had been so convinced by his competence at the beginning. He knows how to talk to women, and most of his patients are women,” she said.
To verify Dalal’s account, this reporter and two others, including one woman, visited the self-professed psychiatrist individually, each describing different symptoms. After each of the separate 45-minute sessions, which cost 100 Turkish Lira ($17), the “doctor” prescribed the same medication: Lustral. And the woman walked away with several packs of cigarettes that he gave her as a gift. They were all diagnosed with general anxiety, despite them describing varied symptoms.
Sherine, a 35-year-old Syrian woman living in Istanbul, told Asia Times she has also suffered from individuals passing themselves off as psychiatrists in the city.
She says she was initially happy with a counselor whom she believed to be a psychiatrist when she moved to Turkey four years ago. However, the medication he prescribed began causing her seizures.
When she went to another doctor for a second opinion, he told her that the medication was unsuitable for her case and could have caused dangerous ramifications.
Newly-vigilant, Sherine began to notice posts on a Syrian Facebook group, where people were warning one another about her previous doctor, saying that he had aggravated their psychological ailments.
The ongoing war in Syria has had serious effects on the psychological health of the population, especially children and young adults.
A report released in 2017 by Save the Children titled “Invisible Wounds” estimated that 89% of Syrian children suffer increased fear and nervousness, 81% have become more aggressive, and 71% suffer from frequent bedwetting and involuntary urination.
A study by Marmara University in Turkey concluded in April 2018 that 60% of refugee children in Turkey suffer from psychological disorders due to the traumas they sustained during the war in Syria, manifested in PTSD and depression. The study found that the majority of adults also suffer psychological ailments.
Therapist Aya Mehana describes mental healthcare in Turkey as “catastrophic.” She told Asia Times that there are a number of fake doctors who have been making money through unlicensed practices in Istanbul, as well as in the city of Gaziantep in the east and the city of Kaş in the southwest.
Often, she says, they prescribe the same medicine to all patients, regardless of their symptoms or diagnosis, which aggravates the problem.
“The biggest problem that we’re facing is that most psychiatrists diagnose all Syrian patients with PTSD, although some could be suffering from other ailments,” she said.
Mehana, who offers basic training to Syrian youth on how to help individuals suffering from PTSD, says she once discovered that two of her trainees, despite having no formal education on the subject, had turned that limited knowledge into a business, opening a self-described psychiatric center for suicide prevention, which they have since promoted on a Facebook page.
“They even started offering training to mental health care volunteers,” she said.
Badr al-Din al-Ahmar, a psychological counselor with a volunteer social services team in Istanbul, says he knows of several practicing fake psychiatrists in Istanbul.
“One of these people opened two mental health centers, with no experience in the field. He seems to have a great capacity for manipulation,” Ahmar said.
Until now, these alleged clinics have managed to operate under the radar within the refugee community.
“The Turkish government is not taking any measures against these people, which is causing their numbers to increase,” Ahmar said.
Other than the damage caused by unsuitable treatment, the counselor says that women often suffer doubly, when they face sexual harassment at the hands of fake psychiatrists.