Efficacy of a Primary Care Mental Health Program for Victims of the Armed Conflict in Colombia

Abstract

In Colombia, there are more than 8,000,000 victims of the armed conflict, some of whom suffer physical and mental health problems or family, work, or social life issues—or both. Although some programs have been devised to treat these psychosocial problems, it still is necessary to evaluate their efficacy so that they may replicated. Accordingly, the purpose of this study was to (1) assess the efficacy of a rurally based primary care mental health program that deals with the psychological problems of children, adolescents, and adults who have been victims of the armed conflict and (2) identify the relationships between stress, resilience, and coping skills in these adolescents and adults. The method used was a quasi-experimental design with separated samples and pre- and postintervention measures. By means of a multistage purposive-random sampling, 127 children, 162 adolescents, and 677 adults were selected for the preintervention sample and 126 children, 162 adolescents, and 676 adults for the postintervention sample. The application of a set of questionnaires allowed identifying some psychological problems at the pre- and poststage of the intervention program. A comparative analysis of the pre and post scores conducted through a Mann-Whitney test revealed a significant decrease in most of the psychological problem scores of children and adults, who changed from the clinical to the normal range. Adolescents who were in a normal preintervention range remained in that range. Both adolescents and adults reduced the use of negative coping skills. Resilience scores remained high after the intervention program. A structural equation modeling confirmed the relationships among stress, resilience, and coping skills, which were the same in adolescents at both the pre and post samples, as well as in adults at the pre and post samples.