“She would hit her head on the wall continuously”: Afghanistan on the brink of mental health catastrophe as children pushed to the limit

Children are under increasing emotional and psychological pressure as they bear the brunt of the worsening crisis in Afghanistan. Many go to bed hungry night after night, drop out of school to work to support their family, have lost loved ones due to a lack of healthcare and have very little hope for the future.  

There are an estimated 4,460,000 children and adults who need mental health and psychosocial support in Afghanistan, but so far this year, only 1,308,661 people have been able to access services and treatment, according to new data.  

A recent Save the Children report also found that one in four girls were showing signs of depression or anxiety, and that two thirds of children said they felt negative feelings – including feeling more worried, more sad and more angry. 

Parents have told Save the Children that, due to the violence and the current financial pressures on their families, they have seen concerning changes in their children’s behaviour, including uncontrollable crying, nightmares, aggressiveness and self-harm.  

The majority of children and adults who need psychosocial support services cannot access them because the services don’t exist in their communities. Afghanistan’s healthcare and child protection systems have long been under resourced, and facilities often lack qualified staff and resources. Families also struggle to pay for treatment and for the transport to and from facilities.  

Although conflict in Afghanistan has reduced over the past year, children are still dealing with the violence they have witnessed in the past – including the loss of loved ones – and are still exposed to deadly attacks targeting students and education facilities.  

New restrictions imposed by the Taliban have also had an impact on children’s mental health, especially for girls. The restrictions mean many girls have been excluded from school, socialising and going to parks and shops. The economic crisis has also forced some girls into early marriage as their parents need the money to feed the other children in the family.  

Rahima*, 17, was top of her class and loved going to school before her parents were forced to arrange her engagement to an older man. The family were desperate for money as they were surviving on bread and rarely ate a proper meal. Her mother, Marzia*, had already lost five babies in the past because they couldn’t afford healthcare, so she was determined that her other children would survive.  

Shortly after the engagement, Rahima dropped out of school and stopped talking to her family and friends.  

“Before life was OK. We worked on the land and my husband and son worked as casual labourers. But now it’s hard to get jobs and the cost of food has increased and now due to the poverty and because of the economy, we’ve engaged our daughters,” Marzia* said. 

“Before the engagement she was completely well, and she did all her tasks well and was interested in life. After the engagement, everything changed…she became disengaged in life and school and argued with her siblings. When I used to ask her about school, she would hit her head on the wall continuously and then she would get a headache.”  

Rasheeda, a Save the Children counsellor, said Rahima used to cry continuously and hit herself. She provided psychosocial support to Rahima and helped encourage her to go back to school. Rasheeda also negotiated with the families to delay the marriage until Rahima is an adult and has finished school. 

Rahima said: “I was lost and there was pressure from every side - the conflict and pressures from my family - and I became disillusioned about continuing my education. Now I’m slowly improving, and this has happened because of Save the Children’s support. Rasheeda is like my teacher, and she has helped me a lot.” 

Nora Hassanien, Acting Save the Children Country Director in Afghanistan, said: 

“The current crisis in Afghanistan is pushing children to their absolute mental and emotional limits. What these children are experiencing – the bombings, watching as their siblings die from hunger, being banned from school and separated from their parents – is having a fundamental impact on their mental and psychosocial wellbeing. 

“Save the Children is extremely concerned because the support networks and psychosocial services that should be helping the most vulnerable children simply do not exist in most communities in Afghanistan. And if children are not given the support and treatment they need, it can lead to long-term health and psychological impacts. These long-term impacts may exacerbate and maintain conflict, perpetuate cycles of poverty and reinforce family and community instability. 

“This World Mental Health Day, Save the Children is calling on the international community to provide critical humanitarian aid to help families survive this economic crisis and long-term funding for mental health and psychosocial support. The future of Afghanistan’s children – and their country – depend on it.” 

Save the Children is providing mental health and psychosocial support for children in one-on-one and group counselling sessions and helping children to build their resilience and coping strategies via youth groups and children friendly spaces. The organisation is also providing cash grants to families to help them avoid resorting to desperate measures to survive, such as selling their children into marriage.  

*Names changed to protect identities  

NOTES TO EDITORS:  

• Rahima’s story, along with the stories of other children impacted by the crisis (photos and written case studies), are available at: www.contenthubsavethechildren.org/Package/2O4C2SDWU0C5 

• UNICEF estimates 4,460,000 children and adults need mental health and psychosocial support (MHPSS), but so far this year only 1,308,661 children and adults accessed MHPSS services, thus an estimated 1 in 4 people are receiving support.  

• Save the Children has worked in Afghanistan since 1976, including during periods of conflict, regime change, and natural disasters. We have programmes in nine provinces and work with partners in an additional six provinces. Since the Taliban regained control in August 2021, we’ve been scaling up our response to support the increasing number of children in need. We’re delivering health, nutrition, education, child protection, shelter, water, sanitation and hygiene and food security and livelihoods support. Save the Children has reached more than 3 million people, including 1.7 million children since September 2021.  

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For further enquiries please contact: 

• Sacha Myers – Sacha.myers@savethechildren.org (based in Kabul) / +93 7947 66407 

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