Enhancing Public Mental Health for Youths in Post-Civil War Settings: Exploring Depression, Anxiety, Sleeping Disturbances, and Related Risk and Protective Factors

Abstract

Abstract Background: Mental health research in post-conflict societies has predominantly concentrated on war-related traumas and post-traumatic stress disorder among those who lived through the conflict. However, there remains a significant gap in understanding the prevalence and severity of depression, anxiety disorders, sleeping disturbances among the younger generation in post-civil war societies, as well as their associations with age, gender, and risk and protective factors. This study aims to bridge this gap by focusing on young people in Mozambique, a resource-poor nation, two decades after the cessation of the civil war. Methods: The study used mixed methods comprising qualitative and quantitative instruments that included the Beck Depression Inventory-II (BDI-II), Self-Report Questionnaire (SRQ) and Nocturnal Intrusions after Traumatic Experiences Questionnaire (NITE). The sample involved n = 794 young people in homesteads and schools. To examine the results, univariate analysis, chi-square tests, binary logistic regression analyses and odds ratio were used. Results: Risk factors were pervasive in households, communities, and schools. Mental health problems were commonly linked to severe depression (14.2%), anxiety-related disorders (39.3%), sleep disturbances (37.3%), and anxiety dreams (27.5%). Gender, age, and protective factors were associated with the incidence and severity of mental health outcomes, while living with both parents protected against the severity of anxiety-related disorders. Conclusions: Understanding the contextual mental health needs of young people in post-civil war Mozambique is crucial for developing insights to craft and implement targeted public mental health policies and interventions in resource-limited settings. Addressing mental health issues among young people necessitates a concentrated effort on understanding and managing the interplay of risks and protective factors within families, communities, and schools.