Devastated by decades of war, instability and poverty, many Afghans suffer from mental health and psychosocial problems. Despite significant need, healthcare facilities attending to mental health issues are scarce. Mental health is one of the components in the existing framework of the Basic Package of Health Services (BPHS). Inclusion of mental health and psychosocial care into BPHS is an important step towards ensuring that psychosocial problems and mental disorders are recognized and managed by primary healthcare personnel. Currently, psychosocial counselors provide services in most comprehensive health centres (CHCs). The lack of trained psychiatrists, psychiatric nurses, psychologists and social workers presents a serious challenge for mental healthcare service delivery. Nationwide, only 320 hospital beds in the public and private sector are available for people suffering from mental health problems.
Decades of conflict have left an estimated 800,000 Afghans (2.7% of the population) with a range of severe disabilities. The main categories of disability are physical (37%), sensory (26%) and multiple disabilities (46%). Between 60-80% of people with disabilities live in rural and informal urban settlements.The provision of rehabilitative services to people living with disabilities is hindered by a lack of institutional expertise, trained practitioners and skilled teachers, and by weak community knowledge and physical barriers to treatment. The remoteness of services and lack of funding often hampers access to services for vulnerable groups. Only 21 out of 34 provinces have physical rehabilitation services within both the BPHS and EPHS. The majority of services for people with disabilities are provided by international and national NGOs.
Achievements:
§ Gender-based violence (GBV) unit conducted Training of Trainers on mental health care for survivors of intimate partner and sexual violence with the technical assistance from HQ/EMRO.
§ Emergency Health Unit facilitated training of psychosocial counsellors on psychosocial first-aid.
§ Supported the revision of Afghanistan’s Mental Health Strategy.
§ Supported the development of the National Suicide Prevention Strategy for Afghanistan.
Programme Risks and Challenges:
§ People with mental health and substance abuse disorders are not the only ones who experience stigma and human rights violations: mental health care providers in the formal and informal sectors also report this.
§ Despite the high number of people suffering from mental health problems in the country, the mental health services available are limited and of low quality.
§ Inadequate financing of mental health and psycho-social interventions.
Way Forward:
§ Support the rolling out of integrated mental health services in BPHS/EPHS, including substance use prevention and treatment up to the PHC level.
§ Support the monitoring and supervision of mental health services and activities by BPHS implementers.
§ Develop mental health IEC/BCC materials to increase community awareness of mental health problems.
