Abstract
BackgroundA decade of conflict in Chechnya destroyed infrastructure and resulted in widespread exposure to violence. Amidst substantial reconstruction, periodic violence has contributed to an ongoing atmosphere of insecurity. We conducted a qualitative study to understand the mental health and psychosocial problems affecting adult Chechens in this context to inform development of assessment tools for an evaluation study related to individual counseling.MethodsData were collected in July 2014. A convenience sample of 59 Chechen adults was asked to Free List all problems affecting people in the area. Four problems were explored further in 19 Key Interviewee (KI) interviews, with respondents identified using snowball sampling. Data analysis was conducted in Russian by the Chechen interviewers.ResultsMultiple mental health and psychosocial problems emerged, including ‘bad psychological health’, ‘depression’, ‘stress and nervous people’, and ‘problems in the family’. Aggression, ‘emotional blowing’, and ‘not adequate’ behavior were frequently reported indicators of these problems, with negative effects on the whole family. Chechens reported seeking help through informal social networks, psychiatric and psychological services, and Islamic Centers.ConclusionChechens reported mental health and psychosocial problems similar to those experienced in other post-conflict settings. The description of ‘emotional blowing’ mirrored prior findings in Chechen asylum seekers and fits within a cluster of cultural concepts of distress featuring anger that has been identified in other conflict-affected populations. Further exploration of the nature and prevalence of this construct, as well as evaluations of interventions aimed at reducing these symptoms, is warranted.
Highlights
A decade of conflict in Chechnya destroyed infrastructure and resulted in widespread exposure to violence
Key interviewee interviews Four problems were explored in the Key Interviewee (KI) interviews: 1) bad psychological health was selected in order to understand whether this constituted a distinct local syndrome or was a summary term of multiple problems; 2) depression and 3) stress and nervous people were selected as these are mental health problems the Médecins Sans Frontières (MSF) psychosocial counseling program aims to address and intended to evaluate in the subsequent outcome evaluation study; and 4) problems in the family was selected to further understand the nature and consequences of these problems
The frequently reported issue of drug and alcohol problems was not selected because substance use was not intended to be assessed as a primary outcome in the subsequent evaluation; this problem was often discussed by KIs in the course of their interviews
Summary
A decade of conflict in Chechnya destroyed infrastructure and resulted in widespread exposure to violence. We conducted a qualitative study to understand the mental health and psychosocial problems affecting adult Chechens in this context to inform development of assessment tools for an evaluation study related to individual counseling. The mental health impacts of conflict have been welldocumented, with reviews consistently citing elevated rates of mental disorders in populations exposed to conflict and other mass violence [1, 2]. Beyond the direct effects of mass violence, mental health is affected through prolonged. In the Republic of Chechnya in the North Caucasus, the mental health needs of the local population are not Nguyen et al Conflict and Health (2016) 10:16 well understood. The social code places high value on individual duty, family honor, respect for women, hospitality, friendship and brotherhood, and mutual help and charity [10, 12]
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