Mental health disorders in population displaced by conflict in Colombia: Comparative analysis against the National Mental Health Survey 2015

Abstract

Background and objectives

Colombia is one of the countries with the highest levels of internal displacement resulting from armed conflict. This population has greater chances of experiencing a mental health disorder, especially in territories historically affected by armed conflict. Our objective was to compare the levels of possible mental health disorder in people experiencing internal displacement in Meta, Colombia, a department historically affected by armed conflict, compared to the internally displaced population in the National Mental Health Survey of 2015.

Methods

Analysis of data collected in the National Mental Health Survey (ENSM) of 2015, study with representative data at national level and the Conflict, Peace and Health survey (CONPAS) of 2014, representative study of the degree of impact of the conflict on the municipality, conducted in the department of Meta, Colombia. To measure possible mental health disorder, the Self-Report Questionnaire-25 (SRQ-25) was used. Internal displacement is self-reported by people surveyed in both studies. An exploratory analysis is used to measure possible mental health disorders in the displaced population in the ENSM 2015 and CONPAS 2014.

Results

1089 adults were surveyed in CONPAS 2014 and 10,870 adults were surveyed in the ENSM 2015. 42.9% (468) and 8.7% (943) of people reported being internally displaced in CONPAS 2014 and ENSM 2015, respectively. In both studies, internally displaced populations have greater chances of experiencing any mental health disorder compared to non-displaced populations. For CONPAS 2014, 21.8% (95%CI, 18.1−25.8) of this population had a possible mental health disorder (SRQ+) compared to 14.0% (95%CI, 11.8−16.3) in the ENSM 2015. Compared with the ENSM 2015, at the regional level (CONPAS 2014), displaced people had a greater chance of presenting depression by 12.4% (95%CI, 9.5−15.7) compared to 5.7% (95%CI, 4.3−7.4) in the ENSM 2015, anxiety in 21.4% (95%CI, 17.7−25.3) compared to 16.5% (95%CI, 14.2−19.1) in the ENSM 2015, and psychosomatic disorders in 52.4% (95%CI, 47.5−56.7) in CONPAS 2014 compared to 42.2% (95%CI, 39.0−45.4) in the ENSM 2015. At the national level (ENSM 2015), displaced people had greater possibilities of presenting, compared to the regional level, suicidal ideation in 11.9% (95%CI, 9.3–14.1) compared to 7.3% (95%CI, 5.0−10.0) in CONPAS 2014 and bipolar disorder in 56.5% (95%CI, 53.2−59.7) compared to 39.3% (95%CI, 34.8−43.9) in CONPAS 2014.

Conclusions

The greater possibilities of displaced populations at the regional level of experiencing a mental health disorder, compared to this same population at the national level, may represent and indicate greater needs in mental health care services in territories affected by conflict. Therefore, and given the need to facilitate access to health services in mental health for populations especially affected by armed conflict, there is a need to design health care policies that facilitate the recovery of populations affected by war and, simultaneously, that reduce inequities and promote the fulfilment of one of the most important and, at the same time, least prioritised health objectives in international development: mental health.