High on a hill in Kabul, shielded by a steel gate crowned with barbed wire, lies an often-overlooked women’s mental health center run by the Afghan Red Crescent Society (ARCS). Commonly referred to as Qala, or the fortress, this facility is home to 104 women, many of whom face dire circumstances linked to domestic violence and societal stigma.
Among its residents, Mariam* has spent nine years within Qala’s walls, bearing the scars of a troubled past that included abuse and neglect by her family. Now in her mid-20s, Mariam recounts a history filled with violence, leading to her homelessness and eventual rescue by a concerned stranger. Despite her rosy demeanor and desire to help within the center, her path to freedom is obstructed; she has nowhere to go and cannot envisage returning to her abusive family. “I want to marry someone here in Kabul,” she expresses, highlighting the desperation that shackles her fate.
Habiba, another patient aged 28, found refuge in the facility after her husband left her when he remarried. With no support from her widowed mother or any means of contacting her three sons, Habiba also longs for reunion but remains confined by her circumstances. “I want to be reunited with my children,” she laments.
The situation at Qala is not uncommon. Many women have languished in mental health facilities for decades, abandoned by families who deem them unworthy of care. “Some have been completely abandoned by their families. No one comes to visit, and they end up living and dying here,” psychotherapist Saleema Halib reveals, accentuating the grim reality within the center. The consequences of Afghanistan’s long-standing conflict linger heavily on the mental health of its citizens, particularly women, who often carry the brunt of both societal pressures and psychological trauma.
Official responses downplay the real struggles faced by Afghan women. Taliban deputy spokesperson Hamdullah Fitrat assured the BBC that the government condemns violence against women and secures their rights. Nevertheless, a 2024 UN report sheds light on the increasing mental health crisis, revealing that 68% of surveyed women reported feeling “bad” or “very bad” mentally, a stark contrast to the Taliban’s assurances.
The mental health crisis continues to expand as more patients seek care, often with insufficient resources to accommodate the swelling numbers. “Mental illness, especially depression, is very common in our society,” remarks Dr. Abdul Wali Utmanzai, who serves women patients from across various provinces. The complexities of accessing help are intensified by restrictions on women’s mobility without male supervision, making it nearly impossible for them to overcome their struggles.
Inside Qala’s fortified walls, the urgency intensifies. One family's desperate attempt to admit their 16-year-old daughter, Zainab, highlighted the dire lack of resources as they learned there was no available space for her condition. Previously confined to her home and bound by physical restraints to prevent her from escaping, the young girl represents a painful reality faced by many. Zainab’s mental health deteriorated following traumatic experiences during school bombings, a reflection of the broader crisis affecting Afghan youth.
As women like Mariam, Habiba, and Zainab navigate the harrowing labyrinth of mental health care in Afghanistan, the future remains bleak. If the conditions do not change, the cycle of vulnerability may only deepen, with many becoming permanent residents of Qala or other facilities, trapped by society’s failings.
*The names of patients and their families have been changed to protect their identities.