An activist's journey: Successes and roadblocks in mental health advocacy
By Ahmad, a young mental health advocate from Afghanistan and recent graduate of Orygen's Global Youth Mental Health Advocacy Fellowship.
Imagine you are illiterate, living in poverty, exposed to violence from your family and community, and have been emotionally drained for years. You have no one to hear or understand what you’re going through and are thinking of substance abuse or self-harm to escape your pain. Where would you begin to find support?
The impact of life today in Afghanistan on mental health
For decades, mental health has been a foreign and taboo term to Afghans. Despite the widespread impact of ongoing war, violence, poverty, and low standard of living on the mental health of most of the population, you will find people whispering “oh, he’s going crazy. I saw him at a mental hospital yesterday”.
Not long before the political upheaval in Afghanistan, politicians were cutting corners and hesitant to leverage implementation plans for the unexecuted National Mental Health Programme. People were hopeful for an end to their untiring financial, social, and emotional sufferings; however, prolonged armed conflict, terrorism, illiteracy, and government corruption blindfolded the public to consider mental health as a solution and need.
Additionally, migration and internal displacement, poverty, hunger, and the approach of an unwelcoming winter caused the death of dozens of children and propelled some families to sell their children to survive the starvation. Fifty percent of Afghan families had already forced their children to work during COVID-19 pandemic, and this figure has considerably increased. Despite the desperate need for mental health support during such horrendous moments, nonexistent resources and illiteracy have blocked any chance to propose recovery plans for our future.
Escalating financial burdens means drastic violence in homes as well. A local 16-year-old banana seller shared with me that his father often beats him when he doesn’t bring home a hefty sum. My mother, a teacher in a public school, says her students are mostly depressed because of domestic violence and inappropriate behaviour from teachers. Just recently, a student was beaten so intensely by his teacher that he bled for 10 minutes straight, and cases of suicide are plentiful, with two people dying by suicide every two hours.
These stories are a good demonstration of the underlying factors that need to be addressed using an intersectional lens and rights based approach. All these burdens significantly contribute to poor mental health, which forces people out of educational attainments. This costs society in economic terms as well, with an estimated 16.3 trillion USD loss expected to the global economy by 2030 due to mental ill-health.
Signs of hope
Personally, I experienced mental suffering in school, and yet found virtually no resources for support. This was not only because the cause isn’t supported by law, but also because of the lack of mental health literacy of my teachers and peers. In 2021, I was offered a Fellowship with the Orygen Global Youth Mental Health Advocacy Fellowship, learning necessary skills and tools to advocate for systematizing mental health literacy within broader educational avenues. As part of my small research project, I visited five schools to give short-term training to students and teachers on mental health. The training provided respectful teaching and parenting strategies, including how to appropriately communicate with mentally unwell students.
In comparison to other schools without this mental health literacy training, the performance and potential of students and teachers was as much as 1.5 times better: 80% of students stated that they felt motivated to study and participate in class activities, and 75% felt comfortable talking to a teacher about their personal challenges. This small-scale research demonstrates how effective inclusion of psycho-education in the curriculum could be the catalyst for widespread positive change.
In addition, I led a program supported by Women Deliver with the aim to educate women and children about mental health, comprehensive sexuality education, and natural disaster management. The program educated 70 women, boosting their confidence, autonomy and state of mind. All because of being introduced to a term they had never heard before: ‘mental health’. And I have been able to collaborate with the Deputy Minister of Literacy and the Minister of Education to develop a policy proposal that includes mental health and comprehensive sexuality education in the formal school curriculum.
However, these hopes and aspirations died when the Taliban outpowered the government. There were no words left to speak in this new world. Instead, silence and solitude were the order of the day. After some weeks, the economic crises made education a distant dream for most children. Regrettably, the million dollars of aid to Afghanistan was snatched by incapable leaders who not only caused a humanitarian crisis but also deprived millions of citizens from their basic rights.
A chance for something better
The silver lining for an Islamic country like Afghanistan is that mental health is supported by Sharia in the holy Quran and Hadith of the Prophet Muhammad (PBUH). Specific verses promote mental health and discourage self-harm: ‘And be patient, [O Muhammad], and your patience is not but through Allah. And do not grieve over them and do not be in distress over what they conspire.’ plus “And do not kill yourselves [or one another]. Indeed, Allah is to you ever Merciful.”
Afghans desperately need help. We cannot confront the massive challenge of poverty, hunger, disease and environmental destruction unless we address mental health. We need the government, non-government organizations, civil society organizations, schools, universities and health clinics to unite and reinforce mental health through law, program implementation, and partnerships with multiple sectors.
Inaction doesn’t only cost the country itself, but the whole globe. A stable society with stable citizens drives positive changes within the country, stopping the need to receive humanitarian aid and force people to flee to other countries. With proper systemization of mental health in the Afghan context, we can instill hope and reframe people’s perspectives to foster prosperity and development. This will only be possible with help from the international community in placing mental health at the forefront of the global agenda. If the Taliban can reach a mutually beneficial deal with the international community to integrate mental health into educational contexts, we can take a step forward towards a brighter future and a more sustainable society.