A Qualitative Approach to Informing Mental Health Programming in Central African Republic

Abstract

The Central African Republic (CAR) is a country with a long history of violent conflict, extreme poverty, and little to no mental health infrastructure for a population with profound exposure to ongoing trauma. In 2015, 70% of the population was displaced internally or to surrounding countries, and 80% had witnessed violence. An empirical study of mental health in CAR found that 50% to 80% of the population reported clinically significant anxiety or depression. Such epidemiological data suggest extremely high levels of distress, yet more culturally relevant information is needed to better understand contextual responses to trauma, and associated mental health needs. To address this empirical gap, the present study engaged in a collaborative partnership with humanitarian organizations and local religious groups in CAR to conduct a series of focus groups with community members. Qualitative exploratory research methodology was used, as it can inform the development and delivery of intervention, and shape policy initiatives to increase mental health endeavors that promote healing from trauma. Focus group discussions were recorded, transcribed, and then coded, resulting in 3 primary themes: safety/disarmament and reestablishing education; traumatic experiences of physiological arousal and generalized distress; and subsequent idioms of distress and lack of mental health treatment or availability of services. These themes illustrate the importance of further developing and maintaining systems that provide safety, education, and mental and physical health care services to the general population in CAR. Ongoing conflict jeopardizes the formation of new systems, and investment in established systems that need improvements and resources. Without government and political support, these endeavors will continue to languish until peace and stability is widespread throughout the country.