“With mental health and land, we have enough to live”. Social determinants of mental health in fifteen conflict-affected municipalities of Montes de María, Colombia: an exploratory mixed method study.

Author:

Rubio-León Diana Carolina1,Cano-Sierra Laura1,Reyes-Rivera María Juliana1,Abitbol Pablo2,García-Padilla Dennys1,Forero-García Sara Lucía1,López-López Wilson1

Affiliation:

1. Pontificia Universidad Javeriana

2. Universidad Tecnológica de Bolívar

Abstract

Abstract

Background Armed conflicts affect mental health. In Colombia, many communities have been victims of armed conflict and multiple social inequalities and injustices for more than six decades. Our research explored the social determinants of mental health in fifteen municipalities affected by the armed conflict in Montes de María, Colombia. Methods We used a convergent parallel mixed-method design involving leaders and community members of Montes de María in Colombia, a region deeply affected by the armed conflict. We assessed mental health (PHQ-4 and DASS-21), social support (Medical Outcomes Study Social Support Survey - MOS), and sense of community (Brief Sense of Community Scale - BSCS) in a sample of 134 leaders and community members. Concurrently, we held 35 focus groups and 2 regional meetings with 167 leaders to further explore the social determinants of mental health in the region. Both quantitative and qualitative analyses were conducted, triangulating the information to ensure comprehensive and robust findings. Results The quantitative data analysis showed significative relations among different social determinants of health (SDH) and the mental health variables of anxiety, depression and stress. Social support and sense of community appear to be protective factors for mental health. Qualitative data revealed that armed conflict, state abandonment, economic issues, lack of opportunities, social capital, social cohesion and barriers to access mental health services are SDH that have impacted the current mental health of the community. Conclusions The results suggest social determinants of health impact the mental health of conflict-affected communities. Both quantitative and qualitative findings highlight the region's challenges, their capacity for resilience, and the urgent need for more effective policies and robust support to address mental health and socioeconomic issues in Montes de María.

Publisher

Springer Science and Business Media LLC

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3. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021;GBD 2021 Risk Factors Collaborators;Lancet,2024

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