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Afghan mental health and psychosocial well-being: thematic review of four decades of research and interventions
- Qais Alemi, Catherine Panter-Brick, Spozhmay Oriya, Mariam Ahmady, Abdul Qawi Alimi, Hafizullah Faiz, Nadia Hakim, Sayed A. Sami Hashemi, Muhammad Amin Manaly, Roman Naseri, Khesraw Parwiz, Sayed Javid Sadat, Mohammad Zahid Sharifi, Zalmai Shinwari, Sayed Jafar Ahmadi, Rohullah Amin, Sayed Azimi, Atal Hewad, Zeinab Musavi, Abdul Majeed Siddiqi, Martha Bragin, Wataru Kashino, Michalis Lavdas, Kenneth E. Miller, Inge Missmahl, Patricia A. Omidian, Jean-Francois Trani, Sarah Kate van der Walt, Derrick Silove, Peter Ventevogel
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- Journal:
- BJPsych Open / Volume 9 / Issue 4 / July 2023
- Published online by Cambridge University Press:
- 10 July 2023, e125
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- Article
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Background
Four decades of war, political upheaval, economic deprivation and forced displacement have profoundly affected both in-country and refugee Afghan populations.
AimsWe reviewed literature on mental health and psychosocial well-being, to assess the current evidence and describe mental healthcare systems, including government programmes and community-based interventions.
MethodIn 2022, we conducted a systematic search in Google Scholar, PTSDpubs, PubMed and PsycINFO, and a hand search of grey literature (N = 214 papers). We identified the main factors driving the epidemiology of mental health problems, culturally salient understandings of psychological distress, coping strategies and help-seeking behaviours, and interventions for mental health and psychosocial support.
ResultsMental health problems and psychological distress show higher risks for women, ethnic minorities, people with disabilities and youth. Issues of suicidality and drug use are emerging problems that are understudied. Afghans use specific vocabulary to convey psychological distress, drawing on culturally relevant concepts of body–mind relationships. Coping strategies are largely embedded in one's faith and family. Over the past two decades, concerted efforts were made to integrate mental health into the nation's healthcare system, train cadres of psychosocial counsellors, and develop community-based psychosocial initiatives with the help of non-governmental organisations. A small but growing body of research is emerging around psychological interventions adapted to Afghan contexts and culture.
ConclusionsWe make four recommendations to promote health equity and sustainable systems of care. Interventions must build cultural relevance, invest in community-based psychosocial support and evidence-based psychological interventions, maintain core mental health services at logical points of access and foster integrated systems of care.
7 - The Journey to Europe: A Young Afghan’s Experience on the Migrant Route
- Edited by Md. Azmeary Ferdoush, Reece Jones
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- Book:
- Borders and Mobility in South Asia and Beyond
- Published by:
- Amsterdam University Press
- Published online:
- 12 December 2020
- Print publication:
- 23 April 2018, pp 167-186
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Summary
Abstract
This chapter tells the story of Akbar, a young Afghan man who left Kabul during the summer of 2015 to escape war and poverty. Three months later, after a torturous journey that included abuse by both smugglers and the authorities, Akbar arrived in Frankfurt, emotionally, physically, and financially broken. The authors frame a harrowing, first-person account of Akbar's journey across Western Asia and Central Europe: first, recounting his parents’ refugee experiences during the Soviet-Afghan War; later, describing the circumstances that convinced his family to support Akbar's journey; and finally, explaining his family's thoughts about Akbar's future in Germany. The chapter concludes with speculations about the potential political ramifications of the forced repatriation of (perhaps) tens of thousands of Afghans from Europe. This story of one young man and his family's history helps to humanize the confusing and often impersonal accounts of the global migration crisis and provides necessary historical context for grasping the contemporary Afghan refugee crisis.
Keywords: refugee, Afghanistan, migration crises, human smuggler, Germany, oral history
At 11 PM on a hot summer night in the first week of June 2015, after weeks of delay, the call finally came. ‘The game is on’, the smuggler announced. Akbar was told he had an hour to get across town to the Kabul central bus station. With US$250 hidden in the folds of his shalwar kameez and a knapsack containing two pairs of clothes, a sewing needle his mother had taught him to use in preparation for the journey, dried fruit, hard-boiled eggs, naan, and an old Samsung phone, Akbar set off to begin a new life anywhere far from Afghanistan.
Akbar rushed emotional goodbyes with his mom and two sisters. Then Omar, Akbar's older brother, accompanied him to the bus station. Akbar's father and eldest brother were at work, unable to say goodbye in person. The two brothers sat at the bus station into the early morning, waiting until it was time for Akbar to board. Akbar was to meet his smuggler in Nimroz, a remote desert province on the Iran-Pakistan border, a lawless region notorious for smuggling and banditry.