Perched atop a hill in western Kabul, Afghanistan, a facility shrouded in discretion lies behind a steel gate fortified with barbed wire, rarely acknowledged or visited by locals.
The women’s wing of a mental health center, operated by the Afghan Red Crescent Society (ARCS), stands as the most extensive among a limited number of facilities nationwide dedicated to aiding women grappling with mental illness.
Known locally as “Qala,” or the fortress, this institution remains largely out of public view.
The BBC secured exclusive access to the overcrowded center, where staff face considerable challenges in caring for the 104 women currently residing within its walls.
Among these women is Mariam*, who identifies herself as a survivor of domestic violence.
Believed to be in her mid-20s, she has resided at the center for nine years, following what she describes as abuse and neglect by her family, compounded by a period of homelessness.
“My brothers used to beat me whenever I visited a neighbor’s house,” she alleges, attributing her family’s restrictions to cultural norms dictating that young girls should not leave the house unsupervised.
Eventually, she claims her brothers evicted her, forcing her to live on the streets at a young age. It was there that a woman, concerned about her mental health, brought her to the center.
Despite her history, Mariam maintains a consistently radiant smile. Often seen singing, she is one of the few patients permitted to assist with cleaning and other tasks around the building.
Mariam is ready—and eager—to be discharged.
However, her lack of a safe and stable place to go prevents her departure.
“I don’t expect to return to my father and mother. I want to marry someone here in Kabul, because even if I go back home, they’ll just abandon me again,” Mariam explains.
Unable to return to her abusive family, she remains effectively trapped within the facility.
In Afghanistan, stringent Taliban regulations and deeply entrenched patriarchal traditions severely limit women’s ability to live independently. Legal and social norms require women to have a male guardian for travel, employment, and accessing many essential services, while most economic opportunities remain inaccessible.
Generations of gender inequality, limited educational access, and restricted employment have left many women financially dependent on male breadwinners, perpetuating a cycle where survival often depends on male relatives.
Habiba, a 28-year-old woman, sits on a bed in one of the dormitories.
She recounts being brought to the center by her husband, who forced her out of the family home after remarrying.
Like Mariam, Habiba now has nowhere else to go. She too is ready for release, but her husband refuses to take her back, and her widowed mother lacks the resources to support her.
Her three sons now live with an uncle. While they initially visited her, Habiba has not seen them this year and lacks the means to contact them.
“I want to be reunited with my children,” she expresses.
Their stories are not unique within the center, where our visit, including conversations with staff and patients, was overseen by officials from the Taliban government.
Some patients have resided here for 35 to 40 years, according to Saleema Halib, a psychotherapist at the center.
“Some have been completely abandoned by their families. No one comes to visit, and they end up living and dying here.”
Years of conflict have profoundly impacted the mental health of many Afghans, particularly women, an issue often misunderstood and stigmatized.
In response to a recent UN report highlighting the worsening situation of women’s rights in Afghanistan, Hamdullah Fitrat, the Taliban government’s deputy spokesperson, told the BBC that their government does not condone violence against women and has “ensured women’s rights in Afghanistan.”
However, UN data released in 2024 indicates a deepening mental health crisis linked to the Taliban’s crackdown on women’s rights: 68% of women surveyed reported having “bad” or “very bad” mental health.
Services are struggling to cope, both within and outside the center, which has experienced a significant increase in patients over the past four years and now maintains a waiting list.
“Mental illness, especially depression, is very common in our society,” notes Dr. Abdul Wali Utmanzai, a senior psychiatrist at a nearby hospital in Kabul, also operated by ARCS.
He reports seeing up to 50 outpatients daily from various provinces, predominantly women: “They face severe economic pressure. Many have no male relative to provide for them—80% of my patients are young women with family issues.”
The Taliban government asserts its commitment to providing health services. However, restrictions on women’s movement without a male chaperone hinder their ability to seek help.
All of this makes it more difficult for women like Mariam and Habiba to leave—and the longer they stay, the fewer spaces remain for those who desperately need help.
One family had been attempting for a year to admit their 16-year-old daughter, Zainab, to the center, only to be told that no beds were available. She is now one of the youngest patients there.
Until then, she had been confined to her home, her ankles shackled to prevent her from running away.
While Zainab’s specific mental health challenges remain unclear, she struggles to articulate her thoughts.
A visibly distressed Feda Mohammad recounts that the police recently found his daughter miles from home.
Zainab had been missing for days, a particularly perilous situation in Afghanistan, where women are prohibited from traveling long distances without a male guardian.
“She climbs the walls and runs away if we unchain her,” Feda Mohammad explains.
Zainab frequently breaks down in tears, especially when she sees her mother crying.
Feda Mohammad says they first noticed her condition when she was eight. However, it worsened after multiple bombings struck her school in April 2022.
“She was thrown against a wall by the blast,” he recounts. “We helped carry out the wounded and collect the bodies. It was horrific.”
The potential consequences had a space not been found remain uncertain. Zainab’s father indicated that her repeated attempts to run away were dishonoring him, arguing that her confinement to the center was better for both her and her family.
Whether she—like Mariam and Habiba—will become one of Qala’s abandoned women remains to be seen.
*The names of the patients and their families have been changed throughout
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