As Afghanistan grapples with a humanitarian crisis, protecting and supporting people’s mental health has never been so important.
One in two people living in Afghanistan suffer from psychological distress. Devastated by decades of war, political violence, instability and poverty mental health problems affect every household. With the ongoing crisis in Afghanistan, many people have become displaced, losing their homes, possessions and loved ones. Uncertainty for the future and the loss of a way of life can lead to mental health illnesses. As the health system is being pushed to the brink of collapse due to the loss of funding from international donors, access to mental healthcare has been severely cut off.
“The current political situation, displacement of people, unemployment and a threatening crisis in Afghanistan have all impacted the mental health and psychosocial wellbeing among Afghan people. Health services, including mental health services are all restricted due to a loss of funding by international donors”. – Dr. Zalmai Sinwari, mental health professional, Afghanistan.
Access to care
Mental health services are scarce across the country – most people who live with a mental health problem are not able to access the care they need, or do not dare to seek it. It is estimated that only 3% of people visiting health centres are offered help for their mental health. This is very low compared to the recommended target of 10-15%.
This is significant because most Afghans have experienced violence, losing loved ones, being injured or becoming displaced. All these traumatic experiences are scarring and can deeply affect mental health. Post-traumatic stress disorder (PTSD) is frequent among Afghan people because of their high exposure to trauma with 86% of respondents either having personally experienced or witnessed at least one traumatic event in their lives. 47% have experienced psychological distress with women suffering more than men on average . Children also have a high level of mental health concerns, with 11.5% of children struggling with their daily thoughts and feelings.
Mental health services
Integrating mental health services in to basic health care packages has been a focus for HealthNet TPO for the past 2 decades. With support from donors including the EU, remarkable progress has been made in ensuring that mental health disorders and psychosocial problems are recognised and managed by healthcare workers at the first point of call. The training of healthcare workers on mental health assistance has been a crucial step for this progress. Through this training, over 260 doctors and 265 midwives and nurses are now able to identify mental health issues and provide mental health services or refer to specialised support if needed. To date we have trained 325 psychosocial counsellors to deliver psychosocial counselling support to community members and patients in health facilities. Now 190 psychosocial counsellors have received additional training to become Health Social Counsellors through a diploma training programme.
Saima’s story
At the young age of 20, Saima was rushed to Asad Abad Provincial Hospital in a critical condition after attempting to take her own life. After receiving emergency life-saving treatment she was referred for mental health and psychosocial counselling with a psychiatrist and psychosocial counsellor within the hospital where she was diagnosed with depression. They created a comprehensive care plan to improve Saima’s mental health and wellbeing and through several individual and groups sessions, Saima’s began to notice improvements. She felt more enabled to manage and reduce her stress through positive coping mechanisms and her family, who also received group sessions, learned to support Saima in her recovery. “I am so thankful to the Asad Abad Hospital team and the psychosocial counsellors for their kind and continued support. I continue to meet with my counsellor every week and I am seeing huge improvements.”
Challenges to treatment
Afghanistan faces many challenges for the treatment of mental health problems. There is still the need for additional mental health professionals (psychiatrists, psychiatric nurses, psychosocial counsellor, and social worker and other trained health staff) to improve access to services for those suffering with their mental health. Inadequate financing of mental health and psychosocial interventions; increasing alcohol and drug abuse among the young; limited monitoring of services; and poor community mental health awareness all impact the ability to access treatment.
Stigma remains another huge barrier for people to reach out to mental health support. Mental health is considered a taboo topic, and people often hide their mental health problems and avoid seeking help from their families or from a professional. Recognising and seeking support is also influenced by someone’s personal beliefs, cultural and structural barriers, gender discrimination, poverty and ongoing conflict within the country.
The current situation in Afghanistan has further deteriorated access to mental health services. The loss of funding from international donors has pushed the health system – reliant on the international community – to collapse. Hospitals and health centres are not only running short on medicines and medical supplies, but health professionals have not been paid for months causing many to leave their medical work behind so they can provide for their families. The delivery of even basic healthcare is threatened – meaning mental health services are often the first to be pushed aside.
HealthNet TPO continues to be commitment to the health of the Afghan people. But to do this, we need your support. By donating to HealthNet TPO today, your gift will directly fund the doctors and healthcare workers to continue providing health, and mental health, care today.
