Women trapped in the mental health system

At the top of a hill west of the Afghan capital, Kabul, behind a steel door surmounted by barbed wire, is a place that few premises speak, and even fewer visits.

The wing of women from a mental health center led by Afghan Red Crescent Society (ARCS) is the largest of only a handful of facilities in the country dedicated to helping women with mental illnesses.

The inhabitants call it Qala or the fortress.

The BBC has acquired exclusive access to the crowded center where staff have trouble dealing with the 104 women currently within its walls.

Among them, women like Mariam * who say that she is the victim of domestic violence.

Thought is in mid-Vingta, she has been here for nine years, after having endured what she describes as abuses and negligence of her family, followed by a period of roaming.

“My brothers beat me whenever I visited a neighbor’s house,” she said. Her family did not want to let her get out of the house alone, she said, because of a cultural belief that young girls should not leave the house without supervision.

Finally, her brothers seemed to have expelled her, forcing her to live in the street at a young age. It was here that a woman found her and, apparently concerned about her mental health, brought her to the center.

Despite her story, Mariam’s smile is constantly radiant. It is often seen to sing and is one of the few patients authorized to get around the building, volunteering to help cleaning.

It is ready – and willing – to be released.

But she can’t leave because she has nowhere to go.

“I don’t expect to go back to my father and my mother. I want to marry someone here in Kabul, because even if I go home, they will abandon me again,” said Mariam.

As she cannot return to her abusive family, she is indeed trapped in the establishment.

In Afghanistan, the strict Taliban regulations and deeply rooted patriarchal traditions make it almost impossible for women to live independently. Women are legally and socially required to have a male tutor to travel, work or even access many services, and most economic opportunities are closed to them.

The generations of gender inequality, limited education and restricted employment have left many dependent women financially from family supports, strengthening a cycle where survival often depends on the part of male parents.

Habiba is sitting on a bed in one of the dormitories.

The 28 -year -old said that she was brought to the center by her husband, who forced her to leave the family home after her marriage.

Like Mariam, she now has nowhere to go. She too is ready to be released, but her husband will not resume it, and her widowed mother cannot support her either.

His three sons now live with an uncle. They visited him at the start, but Habiba did not see them this year; Without access to a phone, she can’t even get in touch.

“I want to find my children,” she said.

Their stories are far from unique at the center, where our visit, including conversations with staff and patients, is supervised by officials of the Taliban government.

Some patients have been here for 35 to 40 years, explains Saleema Halib, psychotherapist at the center.

“Some have been completely abandoned by their families. No one comes to visit, and they end up living and dying here.”

Years of conflict have left its mark on mental health of many Afghans, especially women, and the problem is often misunderstood and subject to stigma.

In response to a recent United Nations report on the aggravation situation of women’s rights in Afghanistan, Hamdullah Fitrat, deputy spokesperson for the Taliban government, told BBC that their government had not authorized violence against women and that they had “assured women’s rights in Afghanistan”.

But the United Nations data published in 2024 indicate an aggravation of the mental health crisis linked to the repression of the Taliban against women’s rights: 68% of women interviewed have had “bad” or “very bad” mental health.

Services are struggling to cope, inside and outside the center, which has increased patients several times in the past four years, and now has a waiting list.

“Mental illness, in particular depression, is very common in our society,” said Dr. Abdul Wali Utmanzai, main psychiatrist in a neighboring hospital in Kabul, also managed by Arcs.

He says that he sees up to 50 external patients per day of different provinces, most of them: “They are faced with strong economic pressure. Many have no male sex to provide them – 80% of my patients are young women who have family problems.”

The Taliban government says it is committed to providing health services. But with restrictions on the movement of women without male hood, many cannot ask for help.

All this makes more difficult for women like Mariam and Habiba to leave – and the more they stay for a long time, the less there are for those who say they are desperately needing help.

A family has been trying for a year to admit their 16 -year -old daughter, Zainab, in the center, but they were told that there were no available beds. She is now one of the youngest patients there.

Until then, she had been confined to her house – her chained ankles to prevent her from fleeing.

We don’t know what mental health problems have experienced, but she has trouble verbalizing her thoughts.

A Feda Mohammad visibly in distress said that the police had recently found her daughter for kilometers from her house.

Zainab had disappeared for days, which is particularly dangerous in Afghanistan, where women are not allowed to travel long distances from their home without a male guardian.

“She climbs the walls and fled if we unleash her,” explains Feda Mohammad.

Zainab is based in tears from time to time, especially when she sees her mother cry.

Feda Mohammad says they noticed his condition at the age of eight. But that worsened after several bombings hit his school in April 2022.

“She was thrown against a wall by the explosion,” he said. “We helped make the wounded and recover the bodies. It was horrible.”

What would have happened exactly if the space had not been found is not clear. Zainab’s father said that his rehearsal attempts to escape him, and he argued that it was better for her and her family that she was confined to the center.

It remains to be seen if she – like Mariam and Habiba – will now become one of the abandoned women of Qala.

* The names of patients and their families have been modified throughout