By: Ellaha Rasa
At least a fifth of people who access mental health support from the Herat regional hospital are university educated women, a significantly higher number than before the Taliban takeover in August 2021, according to sources at the hospital.
The mental health department statistics show that of an average 250 daily clients, 20 percent of them are educated women who were employed before the Taliban rule.
A senior staff member, who does not want to be named in this report, says that women are suffering from an adjustment disorder due to their exclusion from work, education, parks, and gyms. Some cases are more serious than others and result in the women needing urgent treatment and care.
“Adjustment disorder” refers to a state in which a person cannot adjust to new conditions and therefore suffers from mental illnesses and needs medical treatment, the staff says.
“Most of the people who come for treatment are educated people who were working before, but now they are unemployed,” the staffer says. “These are women with undergraduate, postgraduate degrees and PhD’s who cannot adapt to the restrictions of the Taliban era.”
Herat University student Fereshta*, 23, was an employee in a private institution before the Taliban takeover. Her office closed when the Taliban took Herat and she has been unemployed since then. Now she spends most of her days in isolation at home and suffers from a deep depression.
Fereshta says that every day her depression increases, comparing a woman’s life in the shadow of the Taliban to being in a prison with no hope of a way out.
“When I think about how I don’t have any freedom and rights, life becomes really difficult for me,” she says. “I feel like I’m in prison and I’m just waiting for my death.”
She says even often thinks about how to end her own life.
Fereshta’s life is a microcosm of a story playing out for millions of women and girls in Afghanistan under the rule of the Taliban.
Coupled with the rising levels of acute mental health challenges, there is a rising level of poverty and many women who need support are unable to afford private clinics, even if they were permitted to do so. This issue has compounded the pressure on staff in Herat Hospital’s mental health department.
Aasi*, 24, also suffers with severe depression. She worked in a Herat private company up until the Taliban takeover, and has been unemployed ever since – for 15 months now. She says that she has been contemplating suicide regularly as she doesn’t want to live under the Taliban rule.
“Life has become very difficult for me. All women understand this difficulty. I became unemployed. I don’t have money for my expenses. I have become mentally ill because of staying all the time at home. I wish we could go back to where we were before so we did not see these difficult days under the rule of the Taliban,” she says.
The Taliban have imposed many restrictions on women’s freedom. Closing girls’ schools above grade six, banning women from working in government offices, blocking fun parks and gardens for women, restrictions on traveling alone, and mandatory hijab rules are some of the Taliban’s enforced restrictions only against women. They have issued more than 30 restrictive decrees to date.
Richard Bennett, the UN Special Envoy for Human Rights in Afghanistan, says some of the restrictions against women are worse than the Taliban’s first rule in the 1990s.
Herat regional hospital expects the number of mental health patients to increase as these restrictions become the norm and hope for change is lost. But the capacity of the hospital is low.
The mental health department only has 25 beds and is available to all patients in Afghanistan, not only Herat. The department only has seven doctors and four psychologists who are working around the clock to treat and advise patients.
One of the hospital officials believes a dedicated mental health hospital needs to be built with at least 250 beds and more extensive treatment and counselling for mental health patients.
“Even standard services are not provided to most mental patients due to the fact that we have little resources,” he says. “We are not able to meet the mental health needs of the people of the western provinces.”
“We provide individual and group primary counselling services in urgent cases, but the people need to be followed up in order to really cure their illness. However, we can’t do it properly,” he says.
Save the Children Fund warned in a report released on World Mental Health Day that Afghanistan is on the brink of a disaster in terms of mental health with poverty, conflict, and Taliban restrictions considered the main factors driving the deterioration.
According to the organization’s report, one in four girls has depression or anxiety. Exclusion from school, an increase in domestic violence, and forced or early marriage of girls, are considered the main causes.
* The names have been changed at the request of the interviewees