Struggling for Freedom: Women Trapped in Afghanistan's Mental Health System

A troubling report highlights the dire conditions faced by women at a mental health center in Kabul, where societal and legal restrictions deny them independence. Patients like Mariam and Habiba illustrate a heartbreaking cycle of abuse, abandonment, and confinement, exacerbated by the Taliban's oppressive regime.

High on a hill in Kabul, behind formidable barbed wire, lies a mental health center that serves as a refuge—and a prison—for women in dire need. Known locally as Qala, or the fortress, this facility is run by the Afghan Red Crescent Society (ARCS) and is among the very few dedicated exclusively to the care of women with mental illnesses. A recent visit by BBC journalists revealed not only the overwhelming number of patients, currently 104, but also the heartbreaking stories of the women confined within its walls.

Among the patients is Mariam*, a woman in her mid-twenties who has endured nine years of institutional life, fleeing a cycle of domestic violence that forced her into homelessness. "My brothers used to beat me whenever I visited a neighbor's house," she recalls, a reflection of the cultural belief that young girls require constant supervision. Eventually, her family cast her out, leaving her to fend for herself. Fortunately, she was rescued by a concerned stranger who brought her to the mental health facility. Despite her cheerful demeanor, evidenced by her willingness to help with chores, Mariam faces a grim reality: she cannot leave the center because she has nowhere to go. "I want to marry someone here in Kabul," she declares, rejecting the notion of returning to an abusive family.

Mariam is not alone. Habiba, age 28, was institutionalized after her husband abandoned her for a new spouse. Now, separated from her three sons, she too longs for release but is trapped due to societal constraints. The conditions in the center force these women to confront the harsh truth that, in a country dominated by patriarchal regulations, independence is an elusive dream. In Afghanistan, women must have male guardians for most activities, making financial independence and basic freedoms virtually unattainable.

Staff at the facility, such as psychotherapist Saleema Halib, report that some patients have lived there for decades without any family visits. The stigma surrounding mental health issues in Afghanistan further complicates their plight, as chronic underfunding and lack of resources limit the help they can provide. In a recent UN report, it was noted that 68% of women surveyed reported experiencing "bad" or "very bad" mental health—an alarming statistic revealing a nationwide crisis fueled by the Taliban’s oppressive regime.

The increase in demand for mental health services has left local resources overwhelmed. Dr. Abdul Wali Utmanzai, a senior psychiatrist, sees as many as 50 patients a day, most of them women burdened by the stress of familial obligations and economic hardship. Such stressors compound the difficulty of seeking help, especially under restrictive regulations that confine women's movements.

This systemic oppression, compounded by a lack of shelter and support, leads to tragic cases like that of Zainab, a 16-year-old girl recently admitted to Qala after being confined at home for years. Her mental health struggles intensified after experiencing violence in her school, prompting a desperate father to seek help after finding her missing for days.

While the Taliban government insists it upholds women’s rights, the reality in places like Qala tells a different story—one marked by despair, confinement, and a desperate fight for freedom. As these women wait for a chance to reclaim their lives, the number of those in need continues to grow, highlighting a critical gap in Afghanistan’s mental health services amid the cultural and institutional barriers that keep them trapped.

*Names of patients and families have been changed for privacy.*