Summary
A study published in Frontiers in Psychiatry reveals that for displaced Muslim women traumatized by war, faith is not merely a comfort but a fundamental pathway to psychological well-being and resilience. Researchers from Queen Margaret University conducted an extensive mixed-methods study among 160 Sunni Muslim women living in an internally displaced persons (IDP) camp in Iraq, all of whom had survived the brutal occupation by the Islamic State of Iraq and Syria (ISIS). The findings are striking: these women face immense daily stressors, with an average Kessler Psychological Distress score of 31.43, indicating rates of severe anxiety and depression.
However, the study’s central discovery is the profound role of faith in coping and recovery. Women who perceived God as caring and responsive experienced significantly lower distress levels. Conversely, those who felt disconnected from God or believed their faith was inadequate reported the highest levels of psychological suffering. Self-appraised “low” faith was associated with an average Kessler score of 40, far higher than the study’s average.
The research also uncovers a critical gap: humanitarian and mental health responses often overlook or fail to accommodate the spiritual needs of displaced populations. Gender-blind approaches in the camp—such as providing prayer spaces only for men and excluding faith from psychosocial assessments—compounded distress by creating barriers to coping resources for women.
Distress Levels and Faith Perceptions
| Faith Self-Appraisal | Percentage of Women | Average Kessler Score (Distress Level) |
|---|---|---|
| High/Very High | 78% | 31 (Severe) |
| Average | 16% | – |
| Low/Very Low | 6% | 40 (Very Severe) |
| Overall Study Average | – | 31.43 (Severe) |
Source: Rutledge, Frontiers in Psychiatry, 2025
Belief in God’s Care and Distress Levels
| Response to “God cares about my life and situation” | Percentage of Women | Average Kessler Score (Distress Level) |
|---|---|---|
| Very True | 80% | 31 (Severe) |
| Usually True | 13% | 32 (Severe) |
| Usually Not True | 4% | 39 (Very Severe) |
| Not at All True | 3% | 43 (Very Severe) |
Source: Rutledge, Frontiers in Psychiatry, 2025
The Silent Suffering of Displaced Women
Imagine losing your home, witnessing unspeakable violence, and then living for years in a cramped tent with your children, struggling daily for food and water. This is the reality for millions of displaced people worldwide. For the Sunni Muslim women in this study, who fled the ISIS conflict in Iraq, this nightmare is compounded by a profound spiritual struggle.
The research, conducted in 2019, paints a stark picture of life in the camp. Women had experienced an average of eight different conflict-related traumatic events, from combat exposure to the loss of family members. Daily stressors were relentless: lack of food, poor health without access to medicine, and the despair of being unable to return home. These “daily stressors,” as the study terms them, were often cited as the primary cause of current distress, creating a constant state of hopelessness and fatigue.
The researchers used two local idioms of distress to capture the women’s suffering: “Tired Soul” (Nafseetak ta’bana), reflecting depression, and “Heart Squeezed” (Qalbak Maqbood), reflecting anxiety and anguish. An alarming 68% of women reported being quite a bit or extremely bothered by a “Tired Soul,” while 56% said the same for a “Heart Squeezed.” These figures underscore the severe mental health crisis unfolding in displacement settings, a crisis that is often invisible to the outside world .
The Power of Faith: Coping and the Quest for Paradise
Despite their immense suffering, the study reveals a powerful source of resilience: faith. For these women, Islam is not simply a religion but a comprehensive way of life that shapes their understanding of suffering, wellbeing, and the very purpose of existence. The term “diyana,” used locally to describe faith, encompasses one’s internal orientation toward Allah, their beliefs, and their religious practices. Crucially, it is tied to the ultimate goal of achieving Paradise after death .
The women reported high levels of religiosity. A vast majority performed the five daily prayers (salat), fasted during Ramadan, and read or listened to the Qur’an frequently. These practices were not just rituals but active coping mechanisms. They were described as conduits for comfort, stress relief, and a way to invoke divine protection and provision.
For women like Jinan, a 51-year-old widow who lost three sons in the Mosul bombings, faith was the only thing keeping her alive. She explained that prayer, reading the Qur’an, and fasting were “just like pouring water on fire,” bringing comfort and the strength to face another day. This aligns with research showing that positive religious coping, where a believer feels a secure attachment to a caring God, is associated with lower anxiety and greater resilience .
However, the study reveals a crucial nuance. The benefit of faith practices is not automatic. It is profoundly mediated by the individual’s perception of their relationship with God. Women who felt a sense of “nearness” to Allah and believed He cared for their situation reported lower distress. Conversely, those who felt their faith was “inadequate” or that God was unresponsive experienced the highest levels of psychological suffering.
For example, Hosa, a 30-year-old woman, wept as she explained her distress: “Why before the events I felt God near me and now when I need him, I do not feel this? It adds sadness on my sorrow.” This loss of a perceived connection to God was identified as a primary source of distress, surpassing even the grief of displacement and loss. This finding underscores a critical point for mental health professionals: for many, the spiritual crisis is the crisis.
The Gender Gap in Faith and Healing
One of the most significant findings of the study is how gender-blind humanitarian responses can inadvertently exacerbate suffering. Despite the women’s high prioritization of faith-related coping, camp management and aid agencies had largely overlooked their spiritual needs.
For instance, although a prayer space (mosque) existed in the camp, it was exclusively for men. Women were prohibited from attending, despite 65% expressing a desire for a women-only prayer space. This left many feeling excluded from a key source of community and spiritual solace. As Tamara, a 39-year-old mother of four, lamented, she had attended her local mosque regularly before displacement, and it helped her feel “nearer to God.” Not having access to it now was a source of deep sadness.
Furthermore, while external religious actors had coordinated with the male imam to distribute materials, this approach failed to recognize that gender norms in the community prevent women from making contact with men outside their families. Consequently, women-headed households—which constituted 34% of the camp—were largely excluded from these efforts. Women also felt they could not discuss their faith-related anxieties with mental health providers, fearing judgment or that such topics were inappropriate.
These access barriers are not just inconveniences; they are harmful. They compound feelings of disempowerment and helplessness. The study argues that ensuring access to gender- and faith-sensitive coping resources is not a luxury but a necessity for boosting mental health outcomes in such contexts. This is consistent with broader research calling for MHPSS programs that are sensitive to cultural and gender norms to be truly effective .
The Struggle Between Punishment and Care
A profound internal struggle for many of the women was the question of why they were suffering. Was it a test from God, a punishment for their sins, or simply a random act of fate? The way the women answered this question had a direct impact on their mental health.
Many found comfort in viewing their suffering as a “test” from Allah—a trial to be endured with patience, with the promise of reward in Paradise. This appraisal, rooted in Islamic teachings, fostered resilience and strengthened resolve. For others, however, the suffering was interpreted as a punishment for inadequate faith practice. This “Punishing Allah Reappraisal,” as researchers call it, was strongly associated with higher distress. Believing that God was punishing them for not being “good enough” added a crushing layer of guilt and anxiety to their grief.
This ties directly to the concept of “secure attachment” to God. When the divine is seen as caring and responsive, faith is a resource. When the divine is seen as harsh and judgmental, it exacerbates stress. The study found that women who felt “God cares about my life and situation” had significantly lower distress scores than those who felt He did not. This highlights a crucial task for helpers: to support individuals in strengthening or restoring a sense of a caring, benevolent connection to their faith.
Practical Implications for a More Effective Humanitarian Response
This research is a powerful call to action, urging humanitarian organizations and mental health providers to rethink their approaches. The current system often overlooks the spiritual dimension of wellbeing, leaving a critical coping resource untapped for many, particularly women. The study offers concrete recommendations that could dramatically improve mental health outcomes.
First, agencies must comply with existing international mandates that call for faith-sensitive aid. This means proactively assessing whether individuals want faith supports to be part of the response and then providing them. It is not about proselytizing but about respecting and enabling the coping strategies that are central to a person’s identity and worldview.
Second, responders need to develop context-specific religious literacy. This does not mean becoming theology experts, but it does mean understanding the basics of the faith, its practices, and its potential role in both causing and alleviating distress. As one study participant noted, she wished aid workers would talk about religion because “it is very important” . This literacy helps providers know what questions to ask and how to recognize spiritual distress.
Third, gender barriers must be removed. Creating safe, segregated spaces for women to pray, gather for social support, and access spiritual guidance is essential. Furthermore, MHPSS interventions must be multi-layered. They must address the overwhelming “daily stressors” of camp life (like food and shelter) and also provide support for spiritual and emotional concerns. This could involve connecting women with informal female faith leaders within the community—”hidden” women of faith who can offer counsel and consolation in culturally appropriate ways.
A Path to Healing That Honors Whole Persons
The study on displaced Muslim women in Iraq reveals a simple but profound truth: you cannot heal the mind without also considering the spirit. For many, faith is not a separate compartment of life; it is the very lens through which they see the world, understand their suffering, and find the strength to endure. Recognizing and enabling this reality is not just respectful; it is effective.
The women in this study have survived unimaginable horrors. The study’s findings show that for them, hope and resilience are sustained through a powerful, personal relationship with God. By failing to honor and support this spiritual lifeline, the humanitarian sector is missing a critical opportunity to provide truly comprehensive and compassionate care.
Reference: Rutledge K (2025) Rethinking pathways to well-being: the function of faith practice in distress alleviation among displaced Muslim women affected by war. Front. Psychiatry 16:1335640. doi: 10.3389/fpsyt.2025.1335640
