Abstract
BackgroundOlder adults in Colombia have seen a number of stressful life events – including the Colombian armed conflict, forced misplacement and recently COVID-19. These events likely have had and are having a substantial impact on people’s mental health and well-being, whilst mental health care provision in Colombia is not sufficient and often access is limited and unaffordable. Therefore, the aim of this study is to understand the impact of stressful life events on the mental health of older adults living in Colombia, and co-produce, pilot, and evaluate a community-based mental health intervention in Turbo.MethodsThis 3-year international mixed-methods study comprises of three phases: Phase I will explore the impact of stressful life events on the mental health of older adults living in Colombia, and their mental health needs, via quantitative needs assessments and qualitative interviews and focus groups; Phase II will involve synthesising the findings from Phase I as well as conducting a systematic review and qualitative interviews with experts into implementing mental health interventions in LMICs to co-produce a community-based mental health intervention with older adults and local community group leaders and care providers; Phase III will involve the piloting and evaluation of the mental health intervention via quantitative and qualitative assessments. Co-production and public involvement underpin each element of this project.DiscussionAppropriate mental health care is as important as physical health care, but this study also looks at how we might integrate these findings into community-level public health initiatives for application both within Colombia and more widely in both LMICs and more developed countries. This study protocol will act as a guide for the development and adaptation of psychosocial mental health interventions in different cultures and contexts.
Highlights
Older adults in Colombia have seen a number of stressful life events – including the Colombian armed conflict, forced misplacement and recently COVID-19
The proportion of Colombian older adults is expected to rapidly increase by 2050 from 10 to 20% of its current 45 million population. This rise is increasingly impacting upon Colombian communities, in regions like Urabá in the Department of Antioquia, one of 32 departments/regions, that have suffered throughout their history from inequality and lack of development due to inattention from the state and the constant presence of prolonged political conflict that deepens these structural conditions of vulnerability [3]
Considering the lack of accessible and available mental health care and support in Colombia and low- and middleincome countries (LMICs) more broadly [12], this study provides an important step in improving our understanding of the need for mental health support whilst offering a direct solution by developing a community-based mental health intervention, in line with the World Health Organisation’s mental health Gap Action Programme to scale up mental health services in LMICs [13]
Summary
Older adults in Colombia have seen a number of stressful life events – including the Colombian armed conflict, forced misplacement and recently COVID-19. Colombia has suffered political violence since the midtwentieth century notably the Colombian armed conflict, an armed conflict between guerrillas groups and the government [1], and more recently drug cartel related violence after the peace treaty with the FARC guerrilla [2].
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