A Participatory Psychosocial Care Approach to of Mental Health in Colombia (PPC-Colombia)

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Context: For over 50 years Colombia has suffered from one of the most impactful and long enduring violent armed conflicts worldwide. So far, around 8 million people have been displaced (the highest number of internally displaced people (IDP) worldwide. Direct exposure to violence and displacement coupled with inadequate and uneven provision of mental health services have had enormous consequences for mental health nationwide. One of the regions that is most affected by the armed conflict is Montes de Maria that forms part of Sucre and Bolivar administrative divisions. Between 1958-2018, and especially from 1996 till 2006, the regions suffered some of the highest number of mass killings, assassinations, disappearances, and sexual violence cases. During the same time 215,000 people have been displaced.Governmental attempts to improve mental health provisions for the affected populations are generally pharmaceutically based with little attention to the local realities and have recently been critically hampered by renewed armed violence, arrival of Venezuelan refugees, natural disasters, and most recently by COVID-19. As a result, millions of individuals in communities with vulnerable populations (i.e. females, indigenous peoples, rural communities, the displaced) face serious mental health challenges. Given the current conditions imposed by the pandemic there is an urgent need for evidence based approaches that employ the existing knowledge and tap into communal and individual resources to provide context relevant and sustainable mental health support.Project Aims: Thus, our multidisciplinary proposal aims to co-create a conceptual framework to provide sustainable therapeutic interventions grounded in communal and individual resources on the basis of the current political and social context in Colombia by comprehensively analysing existing databases of mental health (NMHS) and conflict (Colombian Reconciliation Barometer, Observatory of Memory and Conflict Database Database of Armed Conflict in Colombia); and integrating community based (socio-therapy) and social psychological (social networks and social interactions) approaches.Main Objectives: a) establish interdisciplinary (researchers, community partners and state agencies) collaboration to identify the specific mental health needs of the local communities in the Montes de Maria Region in the wake of the current conditions, i.e. forced displacements, immigration, and the pandemic; b) co-create a conceptual framework based in the local processes and one that considers the social, political, and cultural context to support community based interventions; c) pilot a sustainable and context relevant psycho-social intervention to improve and promote mental-health, and social cohesion.Applications and Benefits: The most vulnerable (i.e. females, indigenous peoples, rural communities, the displaced) in the Montes de Maria regions will benefit most directly from this research as they will be involved in the conceptualization, design, and implementation of the proposed project. They will have access to social support sources, will gain valuable information on the specific aspects seeking and obtaining mental health support in the region. The facilitators will benefit from basic training that will enable them to continue to provide support. The local communities will broaden their capacity to support the IDPs in the region. Finally, the research assistants and early career researchers will also benefit as they will gain valuable experience in conceptualization and implementation of interdisciplinary research and extend their research network. The conceptual framework we will develop is likely to be adapted to address similar challenges that the vulnerable communities face elsewhere.