class=”entry-title”>The Impact of Psychiatric Mental Health Nurse Practitioners on Mental Health Care

>The Need for Mental Health Care in Children and Adolescents

Mental health disorders among children and adolescents have seen a significant increase in recent years, with alarming consequences. Youth suicide has become the second leading cause of death for individuals aged 10-34, and emergency room visits for self-inflicted injuries among adolescents are on the rise. These statistics highlight the urgent need for mental health care in this vulnerable population.

Untreated mental health disorders have a devastating impact on individuals, families, and society as a whole. The cost of mental disorders in youth is estimated to be a staggering $247 billion annually. Despite the prevalence and consequences of these disorders, many children and adolescents do not receive the necessary treatment from mental health care providers.

Access to care and the current healthcare delivery system pose significant barriers to receiving appropriate diagnosis and treatment. It is crucial to address these challenges and prioritize the mental health concerns of children and adolescents to ensure their overall well-being and future success.

The Impact of Mental Health Concerns

Table: The Consequences of Untreated Mental Health Disorders in Children and Adolescents

Area of Impact Consequences

Educational performance Lower academic achievement, higher dropout rates

Physical health Increased risk of chronic conditions and poor overall health

Social relationships Difficulty establishing and maintaining healthy relationships

Substance abuse Elevated risk of developing drug or alcohol dependency

Legal involvement Higher likelihood of encounters with the criminal justice system

These consequences emphasize the critical need for early intervention and comprehensive mental health care for children and adolescents struggling with mental health disorders. By addressing these challenges, we can prioritize the well-being of young individuals and foster a healthier and more resilient society as a whole.

The Role of Psychiatric-Mental Health Nurse Practitioners

Psychiatric-Mental Health Nurse Practitioners (PMHNPs) play a vital role in providing comprehensive and effective mental health care to children and adolescents. With their specialized education and training, PMHNPs are equipped to conduct thorough mental health assessments, deliver holistic care, and manage psychiatric medications.

PMHNPs are skilled in evaluating the mental, emotional, and social needs of their patients, allowing for a more holistic understanding of their overall well-being. Through this comprehensive approach, PMHNPs can develop personalized treatment plans that address the unique challenges and concerns of each individual, resulting in improved mental health outcomes.

In addition to their assessment and treatment capabilities, PMHNPs are qualified to manage psychiatric medications. With their expertise in psychopharmacology, they can prescribe, monitor, and adjust medications as needed to ensure optimal outcomes for their patients.

Key Responsibilities of PMHNPs Benefits

Conducting comprehensive mental health assessments Allows for a thorough evaluation of patients’ mental health needs

Providing holistic care Addresses the physical, emotional, and social aspects of mental health

Managing psychiatric medications Ensures proper treatment and adjustment of medications

By fulfilling these crucial responsibilities, PMHNPs contribute to the delivery of high-quality mental health care, helping individuals achieve and maintain optimal mental well-being. Their expertise and dedication are instrumental in bridging the treatment gap and ensuring access to quality care for children and adolescents.

Integration of Psychiatric Care in Primary Care Settings

Integrating psychiatric care into primary care settings is a crucial strategy for improving access to mental health services. The collaborative care model, which involves the integration of behavioral health (BH) care managers and psychiatric consultants into the primary care team, has shown promising results in improving depression and anxiety outcomes. The primary care setting serves as a gateway for individuals seeking healthcare services, making it an ideal platform for addressing mental health concerns.

Collaborative care involves a team-based approach where primary care providers work together with BH care managers and psychiatric consultants to deliver comprehensive and coordinated care. This model allows for a more holistic and integrated approach to mental health, ensuring that patients receive the necessary support and treatment from a multidisciplinary team. Through collaborative care, primary care providers can confidently address mental health concerns and provide evidence-based interventions.

The role of psychiatric-mental health nurse practitioners (PMHNPs) in this integrated approach is instrumental. PMHNPs have the expertise in mental health assessment, diagnosis, and treatment to support primary care providers in delivering high-quality care. They can provide education and consultation to primary care teams, contribute to systematic screening and monitoring of mental health conditions, and ensure evidence-based treatment interventions are implemented. By leveraging the unique skill set of PMHNPs, the integration of psychiatric care in primary care settings can be optimized, leading to improved access to mental health services and better patient outcomes.

Benefits of Integrating Psychiatric Care in Primary Care Settings

Improved access to mental health services for patients

Enhanced coordination and continuity of care

Reduced stigma associated with seeking mental health treatment

Increased efficiency in managing mental health concerns

Cost-effective approach to delivering mental health care

By integrating psychiatric care within the primary care setting, individuals can receive comprehensive and timely mental health support. Primary care providers can address mental health concerns in a familiar and accessible environment, reducing barriers to care and improving overall mental wellbeing.

Primary Care Setting Integrated Psychiatric Care

Access to mental health services Limited availability Improved access with on-site BH care managers and psychiatric consultants

Coordination of care Fragmented and disconnected Enhanced coordination through collaboration between primary care and psychiatric providers

Stigma Barriers to seeking mental health treatment Reduced stigma by normalizing mental health care within the primary care setting

Efficacy of treatment Suboptimal management with limited mental health expertise Optimized treatment outcomes with the integrated expertise of primary care and psychiatric providers

Integrating psychiatric care in primary care settings is a win-win solution that benefits both patients and healthcare providers. It allows for early identification and intervention of mental health concerns, leading to improved outcomes and better overall healthcare experiences.

Challenges and Opportunities in Mental Health Integration

Primary care clinics face various challenges when it comes to integrating mental health care. These challenges arise due to limited behavioral health (BH) training among primary care providers and inconsistent BH referral processes. Additionally, the busy nature of primary care settings further complicates the integration process.

One of the main challenges is the lack of standardized communication between BH and primary care teams. Without efficient communication channels, it becomes difficult to ensure seamless collaboration and coordination between the two teams, leading to potential gaps in patient care.

To address these challenges, it is crucial to involve psychiatric-mental health nurse practitioners (PMHNPs) in the integration efforts. PMHNPs possess expert BH knowledge and can provide valuable insights and support to primary care teams. They can participate in team trainings, facilitate communication and collaboration between BH and primary care providers, and contribute to the development of workflows and processes that support the integration of mental health care in primary care settings.

By leveraging the expertise of PMHNPs, primary care clinics can enhance their capacity to address psychosocial concerns and provide comprehensive care to patients with mental health needs. Through their involvement, PMHNPs can help ensure that mental health care is integrated effectively into the primary care setting, ultimately improving access to quality care for patients.

The Impact of Psychiatric Mental Health Nurse Practitioners in Rural Areas

Rural areas often face significant challenges in accessing mental health care, including a shortage of mental health professionals and limited resources. However, Psychiatric-Mental Health Nurse Practitioners (PMHNPs) have emerged as essential providers of mental health care in these underserved communities. In states with no restrictions on their prescribing abilities, PMHNPs account for 50% of all mental health prescriber visits in rural areas. This highlights the critical role that PMHNPs play in ensuring access to mental health care for individuals living in rural communities.

Scope-of-practice regulations and the flexibility of PMHNPs’ training and education allow them to provide a wide range of mental health services in rural areas. They can assess and diagnose mental health conditions, develop treatment plans, provide therapy and counseling, and prescribe psychiatric medications. By offering comprehensive care, PMHNPs can address the mental health needs of individuals in rural areas, improving their overall well-being and quality of life.

The Impact of PMHNPs in Rural Areas:

Increased access to mental health care

Reduced travel and transportation barriers for patients

Improved mental health outcomes

Addressing the shortage of mental health professionals

Enhanced coordination and integration of care

Benefits of PMHNPs in Rural Areas Challenges in Rural Mental Health Care

Timely access to care

Continuity of care

Reduced stigma associated with mental health

Improved patient satisfaction

Limited mental health resources

Lack of specialized providers

Transportation barriers

Distance to care facilities

The presence of PMHNPs in rural areas not only addresses the immediate mental health needs of individuals but also contributes to the overall well-being and development of these communities. By providing accessible and high-quality mental health care, PMHNPs play a vital role in ensuring that individuals in rural areas have the same opportunities for mental health support as those in urban areas. Their contributions help to bridge the gap in mental health resources, reduce disparities, and promote equitable access to care.

Expanding the Role of Psychiatric-Mental Health Nurse Practitioners

The current mental health crisis in the United States necessitates a national effort to improve access to mental health care. As part of this effort, expanding the role of Psychiatric-Mental Health Nurse Practitioners (PMHNPs) can significantly contribute to addressing the growing demand for services. PMHNPs have a unique skill set and expertise that can be leveraged to deliver high-quality mental health care and improve outcomes.

By increasing the mental health workforce capacity, including PMHNPs, we can ensure that more individuals have access to timely and effective mental health care. PMHNPs can provide comprehensive assessments, individualized treatment plans, and ongoing care management for patients with mental health concerns. Their ability to integrate physical, emotional, and social aspects of care makes them valuable assets in delivering holistic and patient-centered mental health services.

Furthermore, PMHNPs can also play a crucial role in settings such as primary care clinics, where mental health needs often go unrecognized or unaddressed. By collaborating with primary care providers, PMHNPs can enhance the identification and management of mental health conditions, leading to earlier interventions and improved outcomes. Their expertise in psychiatric medication management can also help optimize treatment plans and reduce the burden on specialty mental health services.

The Importance of a National Effort

A national effort to expand the role of PMHNPs is crucial to address the mental health crisis in the United States. This effort should include policy changes that remove barriers to practice, increase funding for mental health education programs, and expand reimbursement opportunities for PMHNP services. Additionally, strategies to promote collaboration and integration between PMHNPs, primary care providers, and other mental health professionals should be developed.

With concerted efforts and investments, PMHNPs can be at the forefront of delivering accessible, high-quality mental health care. The expansion of their role will not only help meet the increasing demand for services but also contribute to improving the overall mental wellbeing of individuals and communities.

Table: Key Benefits of Expanding the Role of PMHNPs

Benefits Description

Improved Access Increased capacity to provide mental health care, particularly in underserved areas

Comprehensive Care Integration of physical, emotional, and social aspects of care in treatment plans

Collaboration in Primary Care Enhanced identification and management of mental health conditions in primary care settings

Optimized Treatment Expertise in psychiatric medication management for improved treatment outcomes

Expanding the role of PMHNPs is a crucial step towards addressing the mental health crisis in the United States. By leveraging the unique skills and expertise of PMHNPs, we can improve access to mental health care, deliver comprehensive and holistic care, and enhance collaboration across healthcare settings. It is imperative to recognize the vital contribution of PMHNPs in the mental health workforce and invest in their education, training, and support to create a future where mental health care is accessible to all.

The Future of Psychiatric-Mental Health Nursing

The field of psychiatric-mental health nursing is evolving to meet the changing needs of the mental health workforce and patient population. As the demand for mental health care continues to rise, it is crucial to invest in the education, training, and support of Psychiatric-Mental Health Nurse Practitioners (PMHNPs). These professionals have demonstrated their value and impact in improving mental health access and outcomes.

By recognizing and maximizing the potential of PMHNPs, we can create a future where mental health care is accessible, integrated, and patient-centered. PMHNPs have the necessary skills and expertise to address the diverse needs of the patient population, including children, adolescents, and underserved communities. With their advanced training in psychiatric care, PMHNPs can bridge the gap in mental health specialist visits and provide primary care settings with the necessary tools and resources to deliver high-quality mental health care.

Key Factors Shaping the Future of Psychiatric-Mental Health Nursing Impact

Expanding the PMHNP workforce Increased access to mental health care for underserved populations

Removing scope-of-practice barriers Enhanced capacity of PMHNPs to provide comprehensive mental health care

Collaboration with primary care providers Integrated and coordinated mental health care in primary care settings

Policy changes and investment Improved resources and support for PMHNPs

As mental health continues to be a pressing societal issue, it is crucial to prioritize the growth and development of the mental health workforce. By investing in PMHNPs, we can ensure that individuals in need have access to the care and support they require. The future of psychiatric-mental health nursing holds great promise in expanding mental health access, improving patient outcomes, and promoting overall mental wellbeing.

Conclusion

Psychiatric-Mental Health Nurse Practitioners (PMHNPs) are making a significant impact on mental health care, particularly in addressing the needs of children, adolescents, and underserved populations. With the current state of mental health requiring innovative solutions, active involvement of PMHNPs in shaping the future of psychiatric care is crucial. By removing scope of practice barriers and expanding opportunities for collaboration, PMHNPs can play a critical role in improving access to quality mental health care and promoting mental wellbeing.

PMHNPs have the necessary education, training, and scope of practice to provide effective mental health care. They can conduct comprehensive mental health assessments, provide holistic care, and manage psychiatric medications. By integrating psychiatric care into primary care settings and participating in collaborative care models, PMHNPs can support primary care providers in delivering evidence-based treatment interventions for conditions like depression and anxiety.

Despite challenges in integrating mental health care, PMHNPs can contribute to overcoming these obstacles by providing expert behavioral health knowledge, facilitating communication and collaboration between teams, and assisting in the development of workflows and processes that support mental health integration. By recognizing and maximizing the potential of PMHNPs, we can create a future where mental health care is accessible, integrated, and patient-centered.

FAQ

What role do Psychiatric-Mental Health Nurse Practitioners (PMHNPs) play in shaping the future of healthcare?

PMHNPs have the opportunity to increase access to advanced mental health care, particularly for children and adolescents.

What is the prevalence of mental health disorders among youth in the US?

Estimates suggest that 13-20% of children have been diagnosed with a mental, emotional, or behavioral disorder.

How can PMHNPs help address the treatment gap and improve mental health outcomes for children and adolescents?

PMHNPs can conduct comprehensive mental health assessments, provide holistic care, and manage psychiatric medications.

What is the impact of untreated mental health disorders on individuals, families, and society?

The cost of mental disorders in youth is estimated to be $247 billion annually.

What barriers prevent many children and adolescents from receiving formal mental health treatment?

Limited access to care and the current healthcare delivery system are significant barriers to receiving appropriate diagnosis and treatment.

How can PMHNPs contribute to integrating psychiatric care into primary care settings?

PMHNPs can provide education, consultation, and support to primary care providers and contribute to systematic screening and monitoring of mental health conditions.

What challenges do primary care clinics face in integrating mental health care?

Challenges include limited behavioral health training among primary care providers, inconsistent referral processes, and a lack of standardized communication between BH and primary care teams.

How can PMHNPs help address these challenges?

PMHNPs can provide expert behavioral health knowledge to primary care teams, participate in trainings, and facilitate communication and collaboration between BH and primary care providers.

What role do PMHNPs play in ensuring access to mental health care in rural areas?

PMHNPs account for 50% of all mental health prescriber visits in rural areas, where they have emerged as the primary mental health prescribers.

How can the role of PMHNPs be expanded to improve mental health access?

Policy changes targeting the PMHNP workforce can increase their capacity to provide mental health care and address the growing demand for services.

How can PMHNPs contribute to improving mental health care in the future?

By recognizing and maximizing the potential of PMHNPs, we can create a future where mental health care is accessible, integrated, and patient-centered.

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For those with a New Year’s resolution of adding a little spice to their life, a sex expert has revealed the kinkiest new bedroom trends for 2025.

Dr Jessica O’Reilly, a sexologist and relationship expert, serves up five ‘novel approaches’ to sex, which she promises will lead to a more fulfilling experience between the sheets.

To enhance arousal and pleasure, Dr O’Reilly advises trying ‘multisensory integration,’ which involves stimulating sight, sound, touch, taste, and smell, while having sex. 

This, she says, will ‘create richer and more fulfilling experiences.’ 

Among her other top tips, Dr O’Reilly advises people to incorporate adventurous positions, music and even erotic art to ramp up their sex lives. 

She wrote for Astro Glide: ‘As we approach 2025, new year’s resolutions begin to take center-stage. Goals often relate to fitness, diet, finances, travel and daily practices with health and self-improvement topping the list of planned commitments. 

‘Relationships and sex may not claim top spots among resolutions despite the fact that prioritizing intimacy, pleasure, and connection can be just as transformative. 

‘Of course, the best sex of your life isn’t just about the physical act itself, but is intertwined with emotional connection, exploring desires, cultivating confidence, and embracing curiosity and playfulness.’

Dr Jessica O’Reilly, who is based out of Toronto, advises trying out ‘multisensory integration’, which involves stimulating sight, sound, touch, taste, and smell, while having sex

Estimates suggest nearly 50 percent of marriages end in divorce, and sexual satisfaction – or rather dissatisfaction –  is a major driver for calling its quits, so keeping things interesting in the bedroom could be marriage-saving. 

Ignite the senses 

To keep things spicy, Dr O’Reilly first recommends visual stimulation. She suggests using ‘ambient lighting like dimmable lamps, colored lightbulbs or candles to create a visually appealing environment.’

For an even bolder approach, she says you can also consider ‘hanging erotic art or playing sexy videos in the background’ while being intimate with a partner.

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Next, Dr O’Reilly recommends ‘auditory enhancement,’ writing that sound can be a turn on.

She advises making a music playlist with tracks on it that ‘move you.’

To ignite a little more passion, she adds: ‘You may opt for rhythms that guide your hips or symphonies that create crescendos of emotion. 

‘Use whispered affirmations and erotic storytelling to set the mood.’

Next, Dr O’Reilly looks at how you can make touch more than just skin-to-skin contact with a range of different objects, from textured bed linens to silky lingerie. 

The relationship expert explains: ‘Introduce varied textures through bedding, clothing and accessories. 

‘Silk sheets, velvet cushions or textured blindfolds and restraints can provide novel sensations. 

‘Incorporate temperature play with warmed or cooled objects to stimulate nerve endings.’

Spicing things up for the New Year, sexologist Dr Jessica O’Reilly has revealed some of her top sex kinks for 2025

To ‘play with cooling sensations across the entire body,’ Dr O’Reilly’s top tip is storing lubricant in the fridge before a rendezvous.

In terms of igniting your sense of smell, scented candles, essential oils and incense sticks are among her suggestions.

And when it comes to which scent to pick, she says vanilla, jasmine, peppermint and sandalwood are associated with heightened arousal. 

Lastly, when it comes to incorporating taste into sex, she suggests incorporating flavored lubes, edible body paints and aphrodisiac foods such as oysters, chocolates and strawberries into your routine.

And one bedroom tool Dr O’Reilly says is essential: lube, which can be used for ‘sensory mapping.’ 

She explains: ‘Lube can be more than just a practical tool – it’s an invitation to explore your partner’s body in new and exciting ways through pleasure mapping. 

‘This practice involves discovering areas of the body that bring the most pleasure when touched, kissed, or stimulated. 

‘By adding a few drops of lube, you can heighten sensations and transform even familiar areas into sources of unexpected pleasure.’ 

She suggests starting out by applying a small amount of lube to various areas of your partner’s body such as their neck, inner arms, lower back, or thighs. 

Then, you can follow on by ‘gently exploring each area using your hands, lips, or even a makeup brush, while observing their reactions.’

To make the process more ‘playful and exploratory,’ Dr O’Reilly says you can invite your partner to close their eyes so that they can ‘tune into the experience.’

Touching on the benefits of ‘sensory mapping,’ she concludes: ‘It is more than physical – it’s a way to deepen intimacy, understanding and connection. 

‘By combining touch with attentive listening to your partner’s responses, you create a shared journey of discovery, celebrating new pathways to pleasure and strengthening your bond.’

Switch up oral sex 

Two more of Dr O’Reilly’s sex tips for 2025 look at different methods of oral sex. 

Her first technique, called ‘the joystick,’ involves the receiver using their hands on the back of the giver’s head to move them around ‘like a joystick, directing the pace, rhythm, and intensity to align with their desires’.

To increase intimacy further, Dr O’Reilly advises maintaining eye contact when possible and for both parties to use ‘tantalizing verbal affirmations.’ 

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Different sounds or words, she says, will allow the receiver to ‘communicate enthusiasm,’ while they can be used by the server to ‘reinforce their willingness to give pleasure.’

Dr O’Reilly predicts the other type of oral sex that will be on trend in 2025 is ‘irrumatio.’

She explains this is a variation where the receiver takes the lead, ‘guiding the motion as their penis enters their partner’s mouth at their preferred pace and depth.’

As this puts the receiver in control, she warns as with any intimate activity, ‘open communication about desires, limits, and boundaries is essential before engaging.’

In scenarios where verbal safe words may not be feasible she advises establishing non-verbal signals – such as snapping fingers or raising a hand – in advance. 

Go to the brink of pleasure 

Dr O’Reilly’s final top kink for the New Year is a sexual technique called ‘edging.’

Edging is the practice of stimulating yourself or your partner to the point of climax but stopping just before reaching orgasm, resulting in greater sexual pleasure. 

Along with feeling ‘localized intensity,’ Dr O’Reilly says this technique – which can be repeated multiple times – gives a ‘full-body wave of pleasure from prolonged stimulation.’

She adds: ‘In addition to intensified physical sensations, the emotional overwhelm of edging can take pleasure and connection to new heights. 

‘For couples, edging fosters communication, trust, and intimacy by encouraging mutual exploration and anticipation. It can also allow for extended states of arousal to amplify desire and deepening emotional vulnerability.’

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UNESCO-listed musical instrument stifled in Afghanistan
UNESCO-listed musical instrument stifled in Afghanistan

The UN agency UNESCO recognises the art of crafting and playing the rubab as intangible cultural heritage in Afghanistan, Iran, Tajikistan and Uzbekistan

Wood shavings littered the floor of Sakhi’s cramped workshop in the Afghan city of Herat as another rubab, the national musical instrument of his homeland, took shape under his deft hands.

Sakhi has crafted two rubabs a month for decades, and he refuses to set down his tools even as a Taliban crackdown strangles music in Afghanistan.

“I know only this work and I need to make money somehow,” said Sakhi, surrounded by rubabs in different stages of completion.

But far more important to him than money is the “cultural value”, said the craftsman in his fifties, whose name has been changed for his safety along with those of others interviewed by AFP.

“The value of this work for me is… the heritage it holds. The heritage must not be lost,” he said.

The UN agency UNESCO agrees, recognising in December the art of crafting and playing the rubab as intangible cultural heritage in Afghanistan, Iran, Tajikistan and Uzbekistan.

Made of dried mulberry wood and often inlaid with mother-of-pearl, the lute-like rubab is one of the oldest instruments in the region, its twanging sound stretching back thousands of years.

But that heritage is threatened in Afghanistan under the Taliban authorities’ near-total ban on music, considered corrupting in their strict interpretation of Islamic law.

Since coming to power in 2021, Taliban authorities have banned music in public, from performances to playing tracks in restaurants, in cars or on radio and TV broadcasts.

They have shuttered music schools and smashed or burned musical instruments and sound systems.

Many Afghan musicians fled out of fear or in need of work after losing their livelihoods in one of the world’s poorest countries where jobs are scarce.

The Taliban authorities have encouraged former musicians to turn their talents to Islamic poetry and unaccompanied vocal chants — also the only forms of music allowed under their previous rule from 1996-2001.

– ‘Peace to the soul’ –

Amateur rubab player Gull Agha has a picture of his teacher from that time, the pieces of his rubab broken by Taliban authorities cradled in his lap.

Since their return, Taliban morality police have also destroyed one of Gull Agha’s rubabs and made him swear to stop playing.

But he still sometimes strums a rubab he made himself for tourists visiting Herat, long a cradle of art and culture in Afghanistan, though he laments that it slips easily out of tune.

“The main thing that motivates me to continue playing the rubab is to make a contribution to Afghanistan — we should not let the skills of our country be forgotten,” he said.

Rubab is a string instrument made from dried mulberry wood from deserts

But as professional musicians went into exile and his former students saw no future in practising, he fears the craft will atrophy.

“It’s our duty to pass on our local music to the next generations as our ancestors passed it down to us,” said the 40-year-old.

“Rubab is an art… art brings peace to the soul.”

He started playing more than 20 years ago during a music revival in Afghanistan after the end of the previous Taliban rule.

At that time, organisations to support artists sprung up in the country.

Mohsen, a long-standing artists’ union member, choked back tears as he recalled how their musicians were always “a fixture of the happy moments in people’s lives”.

“Unfortunately, happiness has been taken from this nation as well as from the artists,” he said.

Mohsen is still optimistic about the future of the rubab in Afghanistan, saying musicians inside and outside the country have been spurred to keep its traditional music alive.

“People don’t play for money now, they play to bring joy to others and so the music survives,” he said.

“No force, no person, no system can silence its sound.”

– ‘Never lost’ –

Rubab player Majid was once a fixture of the many musical performances in the capital Kabul.

But he had not played the rubab for more than three years out of fear of being overheard, until one December afternoon when he picked up a rubab in a house near a street of now-shuttered music shops.

The lute-like rubab is one of the oldest instruments in the region but its heritage is threatened in Afghanistan under the Taliban authorities’ near-total ban on music

Smiling, he struck the strings but stopped abruptly as the courtyard door banged open, fearing it was Taliban forces.

The neck of his 35-year-old rubab was previously broken when morality police raided homes after the Taliban takeover.

He repaired it the best he could, and still regularly tends to his “dear rubab”, he said, gently running his hands over the instrument.

“As long as I live, I will keep it with me, and I hope my children will keep it… but no matter what, rubab culture will not be lost,” said the 46-year-old.

“Music is never lost. As they say, ‘There can never be a death without tears or a wedding without music’.”

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