SEATTLE, Washington — Although Colombia’s ongoing 50-year conflict has decreased in intensity, raised levels of mental health problems continue to afflict the lives of survivors. Those displaced by the conflict are exposed to economic and physical stressors in unfamiliar places, and mental health services are underinvested and unequally distributed in rural areas. Many organizations such as the United Nations Development Programme, War Child and Mercy Corps are providing psychological support to victims of Colombia’s conflict so they can rebuild their lives and reach their full potential.
A Devastating Conflict
For over half a century, Columbia has endured a relentless and violent civil conflict prompted by the Revolutionary Armed Forces of Colombia (FARC), a Marxist guerilla group seeking to overthrow the state. Though supposedly fighting against elitism and corruption, the FARC became involved in the drug trade and gained a criminal reputation for terrorizing citizens through forced displacements, violent attacks, targeted killings, sexual exploitation and kidnappings.
Colombia’s armed conflict has killed more than 200,000 people and displaced more than seven million, producing the largest number of internally displaced peoples (IDPs) in the world. The FARC officially disbanded in 2016 after a successful peace deal was secured with Colombia’s government, reducing the conflict’s intensity. However, ex-guerrilla militant activity and drug trafficking continue to perpetuate systemic violence within communities.
Mental Health in Columbia
Colombia’s armed conflict has had devastating mental health consequences on its survivors. Although the conflict has been marked as “low-intensity,” its violent repercussions continue to plague the peace and well-being of Columbia’s civilian population. Nearly 50% of individuals experience permanent conflict from the presence of armed groups, while almost 45% encounter intermittent conflict in their communities. Post-traumatic stress disorder is exceptionally prevalent for those enduring intermittent conflict, revealing the long-term mental health effects of trauma after intense violence ceases.
Epidemiological studies have found increased levels of mental health problems in victims, especially among those displaced by the conflict. Columbia’s IDPs often flee armed violence in rural areas, encounter exploitation and violence during the migration process and resettle in slums of large cities controlled by armed groups. Most of Colombia’s IDPs are displaced for life, facing physical and economic stressors in unfamiliar landscapes with little access to essential services such as electricity, sanitation, transportation, education and healthcare. Moreover, 15.9% of displaced adults struggle with psychiatric disorders, and studies have found higher rates of mental health problems among children from displaced families. Additionally, the 4.9% lifetime prevalence of suicide attempts, one of the highest in the world, is increasing among post-conflict populations.
Mental Health Investment and Distribution: The Urban-Rural Divide
Mental health services for victims of the conflict have been underinvested and unequally distributed. In 2011, Columbia’s government established the Victims and Land Restitution Law to prioritize mental health treatment to survivors of the conflict. Although well-designed, the initiative has been slow to develop and may not have the financial and human capacity to provide widespread support. Mental health services, as well as the mental health workforce, have been underinvested in Columbia, and although the country provides universal healthcare coverage, its two-tier system leaves the poor and most vulnerable with lower-quality care.
Mental health services are also unevenly distributed between urban and rural areas. Large cities in Colombia provide more widespread and greater mental health services, while survivors in rural towns are often neglected and left with little to no assistance. Moreover, 90% of the country’s psychiatrists work in large cities, even though rural populations are most affected by the trauma of ongoing violence. Resulting poverty from the conflict has also had a devastating impact on the mental health and well-being of rural communities. Continued guerilla violence in Colombia’s countryside has prevented economic development and the provision of government assistance.
In 2018, poverty affected more than 35% of rural people, many of whom are still grappling with the trauma of permanent and intermittent violence. Studies have identified a cyclical relationship between mental health and poverty; poverty increases the risk of mental disorders, while mental disorders increase the likelihood of falling into poverty. This damaging cycle has prevented survivors from accessing crucial psychological healing and economic opportunity to restore what has been lost.
Many humanitarian organizations are working to provide psychological support so that victims of Colombia’s conflict can rebuild their lives. The United Nations Development Programme (UNDP) helped more than 13,500 victims gain access to legal and psychological support workshops throughout the country, helping Columbians understand and advocate for their mental health rights. Ensuring the mental health and well-being of children post-conflict is crucial to creating a brighter future for Colombia. War Child, an organization working to improve the lives of children affected by armed conflict, is strengthening the capacity of Colombia’s youth to cope with violence and prevent recruitment into armed groups. Utilizing schools and involving teachers in the process has been instrumental in ensuring children have a safe learning environment, psychosocial support and leading roles in local decision-making processes. Additionally, Mercy Corps has provided skill-building workshops and education to more than 62,000 youths living in conflict zones and is working to combat Colombia’s cycle of violence by providing leadership and income-generating training to former child soldiers.
Efforts like these have been transformative in addressing the mental health needs of the victims of Colombia’s conflict, giving them the tools they need to fulfill their full potential and rebuild communities in preparation for a brighter future.