Women trapped in the mental health system

High on a hill to the west of the Afghan capital, Kabul, behind a steel gate, garnished with a barbed wire, lies a place to be recorded about, for which the locals are talking about a few more and less visit.

The women’s wing of the Mental Health Center, run by Afghan Society of the Red Crescent (ARCS), is the largest of only a handful of facilities in the country dedicated to supporting women with mental illness.

The locals call it Kala or the fortress.

The BBC has gained exclusive access to the crowded center, where employees make it difficult to deal with the 104 women who are currently in its walls.

Among them are women like Mariam*who says she is a victim of domestic violence.

It is believed to have been in the mid-1920s, it has been here for nine years after withstanding what it describes as abuse and neglect by its family, followed by a period of homelessness.

“My brothers were beating me whenever I visited a neighbor’s house,” she said. Her family did not want to let her go out of the house, she says, because of a cultural conviction that young girls should not leave the house unattended.

In the end, it seems that her brothers expelled her, forcing her to live on 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 that he sings and is one of the few patients allowed to work around the building will voluntarily help with cleaning.

She 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 back home, they will just abandon me again,” Mariam says.

As she cannot return to her violent family, she is effectively trapped in the facility.

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

The generations of gender inequality, limited education and limited employment have left many women financially dependent on male yields, enhancing a cycle in which survival often depends on relatives of men.

Sitting on a bed in one of the hostels is a habiba.

The 28-year-old says she was brought to the center by her husband, who forced her to leave the family home after he got married again.

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

Her three sons now live with uncle. They first visited her, but Habiba did not see them this year; Without accessing a phone, she can’t even make contact.

“I want to reunite with my children,” she says.

Their stories are far from unique in the center where our visit, including staff and patient conversations, is controlled by officials from the Taliban government.

Some patients have been here from 35 to 40 years, says Salema Khalib, a psychotherapist at the center.

“Some were completely abandoned by their families. No one comes to visit and eventually live and die here.”

The years of conflict have left their imprint on the mental health of many Afghans, especially women, and the question is often poorly understood and subordinate to the stigma.

In response to a recent UN report on the worsening situation of women’s rights in Afghanistan, Hamdula Fitrat, deputy speaker of the Taliban government, told the BBC that their government did not allow violence against women and “guarantee the rights of women in Afghanistan.”

But the UN data, published in 2024, according to a worsening crisis of mental health related to Taliban’s repression of women’s rights: 68% of women surveyed report “bad” or “very bad” mental health.

Services are struggling to cope, both inside and outside the center, which has been observed several times an increase in patients in the last four years and now has a waiting list.

“Mental illnesses, especially depression, are very common in our society,” says Dr. Abdul Wamasai, a senior psychiatrist at a nearby hospital in Kabul, also managed by ARCS.

He says he sees up to 50 outpatient patients a day from different provinces, most of them women: “They face heavy economic pressure. Many do not have a male relative to provide them – 80% of my patients are young women with family problems.”

The Taliban government says it is committed to providing health services. But with the restrictions of the women’s movement without a male chaperon, many cannot seek help.

All this makes it difficult for women like Mariam and Habiba to leave -and the longer they remain, the fewer there are places for those who say they desperately need help.

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

Until then, she was closed in her home – her ankles shook to prevent her from running.

It is unclear what problems with mental health he has experienced Zaynab, but she is struggling to verbalize her thoughts.

Apparently difficult Feda Mohammed says that police recently found his daughter Miles from home.

Zaynab had disappeared for days, which was especially dangerous in Afghanistan, where women were not allowed to travel long distances from the home without a male guardian.

“She climbs the walls and runs if we release her,” explains Feda Mohammed.

Zaynab breaks down from tears from time to time, especially when he sees his mother crying.

Feda Mohammed says they noticed her condition when she was eight years old. But it worsened after multiple attacks hit her school in April 2022.

“She was thrown to the blast,” he says. “We helped do the wounded and collect the bodies. It was horrifying.”

Exactly what would happen if the space had not been found is not clear. Zaynab’s father said her repeated attempts to escape were discouraging him, and he claims that she was better for her and her family, that she was limited to the center.

Whether she – like Mariam and Habiba – will now become one of Kala’s abandoned women, remains to be seen.

*Patients’ names and their families have been changed all the time