Abstract
Objectives: Colombia’s civil conflict and persistent socio-economic disparities have contributed to mental health inequalities in conflict-affected territories. We explore the magnitude of mental health inequalities, contributing socio-economic factors, and sociodemographic characteristics that explain these differences. Methods: The study draws on data collected in 2018, using the household survey Conflicto, Paz y Salud (CONPAS) applied to 1,309 households in Meta, Colombia. Logistic regression and decomposition analysis were used to analyze the risk of mental health disorders, measured with the Self-Reporting Questionnaire -20 (SRQ-20). Results: Individuals with lower socio-economic status are at a higher risk for mental health disorders. Forced displacement accounts for 31% of the measured mental health inequalities. Disparities in employment, education level, disability and conflict incidence between municipalities are other contributing factors. Women and people with disabilities are respectively 2.3 and 1.2 times more prone to present a mental health disorder. Conclusion: It is necessary to tackle the identified risk factors and sociodemographic circumstances that contribute to mental health inequalities in conflict-affected territories, as these hinder adequate/equitable access to mental health services.
Highlights
Mental health is a global development issue in conflict-affected territories [1]
The violence experienced during civil armed conflicts tends to persist over time, an issue which produces sustained mental health
The CONPAS survey is representative at the level of conflict incidence of the municipality, measured using the scale developed by the Conflict Analysis Resource Center (CERAC)
Summary
Mental health is a global development issue in conflict-affected territories [1]. Conflict may increase the chances of experiencing mental disorders, such as depression, anxiety, and psychosomatic disorders [2]. Reports around the world show a high prevalence of negative mental health outcomes as a consequence of war [3]. A study on the Rwandan genocide reports a 24.8% prevalence of posttraumatic stress disorder (PTSD) symptoms in 2,091 subjects [4]. A study on the 20thcentury Guatemalan civil war reports anxiety symptoms in 54.4%, depression symptoms in 38.8%, and PTSD in 11.8% of refugees, 20 years after the civil conflict [5]. The violence experienced during civil armed conflicts tends to persist over time, an issue which produces sustained mental health
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