Mental Health in Post-Conflict Colombia – Ways Ahead

Project summary

After the recent peace agreement in Colombia between FARC and the government, the authorities are facing the huge challenge of rebuilding communities, public services and peaceful coexistence, particularly in the areas most severely marked by the armed conflict. The mental health gap, including absence of health care to stigmatized and vulnerable groups (e.g. ex-combatants, internally displaced people, mentally ill and other minorities), makes up a considerable challenge, where new knowledge is needed. This research project will analyse existing health information and undertake a supplementary mixed methods study in five selected conflict-ridden departments of Colombia. The study will comprise a survey based on a proportional sample of 2500 persons as well as 10 focus group interviews.

The project is carried out in a collaboration between DIGNITY, the Colombian Ministry of Health and the private Universidad Externado. Based on quantitative and qualitative data about, inter alia, violence exposure, mental health needs, service preferences, social capital and stigmatization of the populations, health interventions addressing these needs will be designed and pilot tested in the five departments. A monitoring and evaluation system will be set up, providing data on the usage and effectiveness of the intervention. Local stakeholders will be engaged in the research project. Five scientific articles and five reports in Spanish will be produced. Preparations for a follow-up project, scaling up the intervention, will be made. Valuable new research capacity will be developed for all three partner organisations as well as with the field teams in the five departments.

Outputs

Midterm report
Beginning 2020, a preliminary analysis of the 15 project municipalities based on Colombian national data was performed to assess the territorial distribution and characteristics of vulnerable groups in the country.

A quantitative household survey focusing on conflict and mental health in five regions and in-depth qualitative interviews were planned to be kicked off in spring 2020. Furthermore a study on secondary traumatization among the interviewers had been prepared.

However, after seeing the first case of COVID-19 in Colombia on March 6 2020, it quickly became clear that the interview-related activities could not be implemented due to the restrictions and health risks associated. The number of COVID-19 cases quickly escalated, and in the beginning of August 2021, Colombia had more than 4.8 million recorded cases and 120,000 deaths. The country went into strict lockdown late March 2020,and restrictions have been lifted and tightened several times since then.

To be prepared for any given development of the COVID-19 situation, a contingency plan accounting for different possible scenarios was developed along with some additional project adjustments. A module on COVID-19 was added to the survey and new locally placed interviewers were hired, to account for potential regional lockdowns and travel restrictions within municipalities. Finally, the sampling strategy was adjusted, along with the necessary protocols accounting for health and safety-measures.