Improving mental health and human capital: developing a mental health intervention for 'Youth in Action' programme in post-conflict areas in Colombia

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Colombia endured more than five decades of armed internal conflict leaving behind high rates of mental health problems among the Colombian youth. Conflict and associated mental health issues also cause great cost to human capital. These disorders are usually long-lasting and commonly co-exist with other physical/mental conditions. Despite these harmful consequences, there is little evidence of effective mental health interventions for helping young people affected by the conflict. Most services are fragmented, inadequate, and difficult to access for the majority of those victims of the conflict with mental health problems. This is a 36-month project to address the need for better designed mental health interventions for younger people affected by the conflict that can help not only to provide relief with their mental health problems but also allow these young people to make better use of the assistance available to improve their future economic prospects. The project aims to develop a feasible and acceptable mental health intervention that addresses comorbid mental health problems through a co-design process with extensive involvement of the community. The intervention will be embedded within one the largest social programmes (Youth in Action' or Jóvenes en Acción JeA) in Colombia to assist young vulnerable populations living in poverty. The intervention developed will be subsequently implemented and evaluated in three municipalities with high proportion of young people affected by the conflict and where JeA is available. The evaluation will consider the impact on the mental health as well as on the training and educational outcomes of the young participants with mental health problems receiving the intervention.To project will use a three-phase approach:1. We will update a review of the literature in the subject and explore in depth the mental health needs, resources available, and local contexts through interviews with participants, especially those affected by the conflict, and JeA staff.2. We will undertake the development of the intervention identifying potentially useful components and strategies based on the existing evidence. A potentially feasible intervention will be put through a co-designed, participatory process (involving JeA beneficiaries, JeA staff, and other relevant stakeholders) to gather ideas as to whether this intervention can be potentially feasible and acceptable to the target population. Once a preliminary agreement is reached this will go through another more intensive process of adaptation using similar co-designed processes. Once an agreement is reached in terms of the content and strategies to deliver the intervention, this will be assembled and tested with a small sample of potential users to ensure there are no major technical problems to deliver the intervention.3. Finally the co-developed, approved and usable intervention will be tested in a pilot study using appropriate scientific methods to evaluate the feasibility, acceptability and usefulness in 'real-settings'. Results will inform if the intervention improves clinical and educational and employment prospects among those who use it. We will share findings with stakeholders and policymakers to argue for more and better mental health services to serve our populations. All participants will provide informed consent and projects will receive ethical approval.Our multidisciplinary team of experienced professionals from some of the best research centres in Colombia and the UK has been working together for almost a decade, showing an excellent track record of equitable and successful collaboration. We also have well-established partnerships with representatives from government and civil society. We have a deep knowledge of the settings and have developed excellent connections with policymakers to ensure implementation in a larger and sustainable way.