Youth Mental Health Care in Colombia
What is the issue?
Mental illness is cited as a key threat to health, wellbeing and productivity and the successful transition into adulthood, having now become the leading cause of disability and poor life outcomes for young people globally. For young people living in a conflict or post-conflict context, there is increased likelihood of having poor mental health.
Colombia has experienced decades-long internal armed conflict, which has caused death and displacement. Conflict and violence impacts on the mental health of children and young people, leading to behavioural, cognitive or emotional problems with long-term mental and psychological effects.
What did we do?
This research adopted a mixed methodology to map the provision of mental health services for young people (0-25 years) living in Colombia and to understand existing mental health policy and provision of services for this group. In depth research took place in three case studies in the Pacific Region where youth mental health is shaped not just by political and criminal violence but is compounded by high levels of poverty and lack of opportunities for employment and education. These issues particularly impact the marginalised afro-Colombian and indigenous populations.
What did we find?
Mental health policy and legislation has evolved in Colombia over the past 30 years (figure 2). Current mental health policy emphasises the differential approach meaning resources are focused on individual services for victims of conflict and those demobilising from conflict. Whole population mental health is affected directly and indirectly by conflict. This means that current policy omits a whole population focus and does not specifically address the needs of young people.
Although there has been progress, mental health service provision remains unequally distributed with provision largely located in major cities (figure 1). There are less services and lower numbers of professionals in remote and rural areas, and in the poorest departments of the country. None of the institutions identified offers mental health services specifically for children. This means that many young people cannot access help when they need it and areas of greatest need have the least provision.
Local stakeholders (community organisations and schools) play an important role in supporting young people with their mental health through creating safe spaces for listening and implementing activities that provide emotional support to young people. International organisations and State Institutions facilitate access to formal psychological therapy and try to formalise pathways to access services. There are significant gaps in the connections between local stakeholders resulting in poor communication or referral of young people if services are unable to meet their needs. Community based services are crucial to complement state-led mental healthcare services as they provide spaces for psychological safety and emotional expression. Our research showed the importance of safe spaces and of cultural and artistic practices connected to nature and the outdoors, where young people can find support for emotional expression.
These fragile connections between those working to support youth mental health are impacted by conflict, which frequently destroys social tissue at a very granular level. Reconstructing these connections is critical to effectively support better mental health. This disconnection is compounded by the stress of growing up amidst violence, poverty and insecurity, creating a sense of hopelessness. Fragmented systems and communication challenges leave young people isolated and unsupported.
Policy Recommendations
- Existing policy frameworks for youth mental health need adapting for conflict and post-conflict contexts
- Policy needs to support the regrowth of social tissue between communities, local stakeholders and state services to improve and increase access to services.
- Local, national and international policymakers can help ensure effective and sustainable care pathways through supporting community organisations and making formal links between state services and different stakeholders in local networks.
Contact
Professor Paul Jackson, Professor of African Politics and Director of Research for the College of Social Sciences, University of Birmingham p.b.jackson@bham.ac.uk
For more information please visit:
https://www.birmingham.ac.uk/research/projects/mapping-mental-health-resources-for-young-people
Read the full brief: Youth Mental Health Care in Colombia (PDF, 371KB)