They're known by many names across Afghanistan.
Whether they're called "haunted," "crazy", "stupid", or "idiots", people suffering from mental illness have few options for treatment. In the Afghan city of Jalalabad, for example, families often leave their mentally ill relatives at the Amyali shrine on the outskirts of the city. Such shrines often act as makeshift sanctuaries for the mentally ill across many Islamic countries, largely due to the reports of miraculous cures that take place there.
During their stints at the Amyali shrine, the "haunted" are chained up for much of the day and are rarely allowed to leave the room in which they are kept. All that they get each day is one piece of bread, a red chili, and a glass of water. While many locals insist that the people who leave the shrine after forty days are cured, the reality is very different.
And the incidence of mental illness in Afghanistan has been rising steadily in recent years, largely as a result of decades of warfare that shows little sign of ending. According to Afghanistan's Health Ministry, as much as fifty percent of the population reports experiencing significant psychological stress. As well, many people suffering from posttraumatic stress disorder (PTSD), schizophrenia, bipolar disorder, and other serious psychiatric conditions often go undiagnosed and untreated due to the lack of proper mental health resources even in the larger cities.
Depression is especially prevalent and the latest United Nations World Happiness Survey places the country as the third most unhappy globally. Only South Sudan and the Central African Republic score lower overall. Hospitals are called on to treat cases of attempted suicide on a daily basis though suicide statistics remain incomplete due to the stigma that causes many families to conceal actual cause of death to investigators.
In a recent interview with Global Media, Bashir Ahmad Sarwari, director of the Department of Mental Health and Substance Abuse at the Afghan Ministry of Public Health, states that the problem is getting worse. “People do not know about mental health illness and come up with various names for sufferers — idiots, crazy, stupid, or haunted. The stigma toward mental health illness is everywhere, not only among ordinary Afghans but also among doctors, staff, politicians, and policy-makers.”
That means that many of Afghanistan's hospitals are ill-equipped to handle cases of mental illness. Kabul's Mental Health and Addiction Recovery Hospital is widely considered to be the best facility for the mentally ill in the country but can only handle 100 to 150 patients at a time. But critics of the hospital insist that the treatment there falls well below international standards. Many patients are released after only a few days with no real options aside from returning to their homes and the stigma that makes their problems worse.
Though many people try to get psychiatric help in Pakistan and India, usually because of the better services there, poverty often forces them to return home. In the meantime, the ongoing political and military crisis in Afghanistan means more people than ever needing mental health services that are already strained to capacity - and beyond.
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