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By Mehrullah Rahman
When families flee war, physical survival is only the first step. For millions of Afghan refugees, true recovery requires treating the psychological scars that cross borders with them.
What happens when people escape war but cannot escape its psychological scars? Can a person truly be safe if fear follows them wherever they go? For many Afghan refugees moving between Afghanistan and Pakistan, the deepest wounds are carried not on the body, but in the mind.
When families are forced to flee, urgent needs like food, water, and shelter dominate humanitarian attention. Yet, beyond these immediate necessities lies another crisis: the severe erosion of stability, belonging, and identity. These invisible wounds do not show up like damaged buildings, but they affect every part of life. Mental health must be treated as a core humanitarian concern, not an afterthought. A crisis response that protects only bodies but neglects minds leaves recovery half finished.
My understanding of this crisis comes not only from research, but from my own lived experience of displacement. SHATTERED DREAMS AND SILENT BURDENS
Before being forced to flee to Pakistan, I was a high school student in Kabul with dreams that reached far beyond the classroom. I wanted to become a doctor and build a future through hard work. Those ambitions gave my life direction and a sense of security. That security shattered in August 2021 when the Taliban seized power. My father lost his job, our family’s stability disappeared, and we were forced to leave. What stayed with me most was the invisible burden—the constant uncertainty and fear about the future. Through this experience, I began to understand a reality shared by millions of refugees worldwide: displacement does not end with crossing a border.
What I experienced is not unique. According to the World Health Organization (WHO), approximately one in five people living in conflict-affected areas experiences a mental health condition, including depression, anxiety, or post-traumatic stress disorder (PTSD). Psychological distress is a widespread consequence of conflict, not just an isolated individual experience.
The United Nations High Commissioner for Refugees (UNHCR) and the International Organization for Migration (IOM) both recognize that forced displacement entails the loss of safety, social networks, and a sense of belonging. Furthermore, reports by Human Rights Watch document how the fear of arrest, deportation, and prolonged legal uncertainty generate persistent anxiety among Afghan refugees in Pakistan. These findings demonstrate that the mental health impacts of displacement are not secondary concerns; they are urgent humanitarian challenges that must be addressed alongside physical protection.
For many Afghan refugees in Pakistan, psychological trauma is as painful as the loss of their homes. Years of changing migration policies, family separation, and limited access to healthcare and education have left many adults and children struggling with hopelessness.
Fortunately, there are champions in this space. Dr. Silsila Sherzad, who grew up as an Afghan refugee in Pakistan before becoming a consultant psychiatrist and trauma therapist in Quetta, now provides vital mental healthcare to refugees. Drawing on her own background, Dr. Sherzad underscores that healing requires sustained psychosocial support, not just emergency rations.
Humanitarian groups like the International Rescue Committee (IRC) and UNHCR have also stepped up, providing counseling, safe spaces, and legal assistance to help vulnerable families cope with trauma. However, this assistance too often remains short-term and uneven. Systemic gaps require predictable, long-term international action to ensure continuous support.
Responding to the hidden mental toll of displacement requires a shift in how we deliver aid. Governments and NGOs must recognize mental health as an essential component of every response, not an optional service delivered only after immediate needs are met.
To design more effective and holistic responses, humanitarian practitioners should prioritize the following:
Integrate mental health support early: Mental health care should not be an afterthought. Access to counseling and emotional support must be included from the very beginning of a displacement crisis.
Create safe spaces for connection: Displaced people need environments where they can share their experiences without fear or judgment. Community groups and social networks help reduce isolation and rebuild a sense of belonging.
Reduce the stigma: Many individuals suffer silently because mental health challenges are misunderstood. Leaders and organizations must promote awareness and encourage people to seek help without shame.
Restore purpose through opportunity: Healing is also about restoring hope. Providing opportunities for education, skills development, and employment helps refugees regain control over their futures.
Listen to displaced voices: The most effective solutions begin by understanding those directly affected. Organizations must involve displaced communities in designing programs, as they uniquely understand their own needs and paths to recovery.
Displacement does not end when people find physical safety. For millions of refugees, the deepest wounds are carried through fear, uncertainty, and the loss of hope. A true humanitarian response must go beyond survival; it must also support healing, dignity, and the mind. Without addressing the trauma experienced by displaced populations, efforts to support long-term recovery will always remain incomplete.
Mehrullah Rahman is an Afghan author, English literature instructor, and advocate for refugees.