Mapping Mental Health Resources for Young People Living in a Conflict Con-text at The Colombian Pacific Region

这个项目是关于长期暴露在冲突和暴力中的人们，特别是年轻人的心理健康会发生什么。我们对创伤后应激障碍及其对前战斗人员的影响了解很多，但还有很多其他心理健康问题会影响年轻人，这是暴力本身或冲突局势中存在的压力的结果。目前，实地经验与集中卫生服务提供者所做的大型研究之间的理解存在差距，这些研究侧重于精神卫生的正式临床记录。我们想要做的是将社会科学与临床方法结合起来，远离有正式记录的城市地区。大多数冲突发生在农村，然而这些农村地区在提供服务方面经常被忽视。这当然是哥伦比亚的情况，在城市和农村地区以及不同地区之间存在着巨大的不平等。在经历暴力和冲突后的心理健康问题后，年轻人发现很难融入社会。这些问题，包括抑郁症、其他精神障碍和专门与年轻人有关的社会心理问题，在很大程度上被忽视了。在当地社会和社区环境退化或破坏、人权遭到侵犯或由于冲突而经济机会有限的情况下，这种情况可能特别严重。太平洋区域是受冲突影响最严重的地区之一，是哥伦比亚贫困率最高的地区之一，主要是农村地区，由于持续接触暴力，心理健康比率仍然很高。这项研究在三个方面采取了一种创新的方法：它明确地将地方、中观和宏观层面联系起来，认识到许多精神卫生保健，例如，存在于地方一级，这可能是有效干预的机会；它代表了哥伦比亚和英国团队的合作，也代表了当地民间社会组织的合作；它采用了一种创新的混合方法，将社会科学和临床方法与心理健康联系起来。这意味着我们可以将关于健康和福祉的可持续发展目标3与关于和平、正义和强大机构的可持续发展目标16联系起来，特别是通过解决心理健康在受冲突影响的社会中作为一种排斥形式的问题。可持续发展目标的一个组成部分是纳入边缘化群体，而患有精神健康问题的群体是最边缘化的群体之一，往往是由于行为问题、药物滥用或抑郁症造成的。这些办法的结果将提供初步证据，以确定政策和服务的重点，以便努力减少获得保健服务方面的不平等现象。并提供证据，改善心理健康服务的提供，使年轻人有更好的机会，并降低继续处于贫困中的风险。与社区服务机构合作制定正式心理保健服务工作的综合模式，将支持受冲突影响的年轻人的心理健康需求。这将是哥伦比亚第一个以青年心理健康和综合服务发展为重点的同类研究项目，在冲突后经历类似转变的其他领域具有极好的应用潜力。

This project is about what happens to the mental health of people, particularly young people, when they have been exposed to conflict and violence for a long time. We know a lot about PTSD and what that can do to former combatants, but there are a lot of other mental health issues that can affect young people as a result of violence itself, or the stress of existing in a conflict situation. At the minute there is gap in understanding here between the experience on the ground and the large studies done by centralised health providers that concentrate on formal, clinical records of mental health. What we want to do is to involve social science together with clinical approaches and to move away from the urban areas where there are available formal records. Most conflicts happen in the countryside and yet these rural areas are frequently neglected in terms of service provision. This is certainly the case in Colombia where there are big inequalities between urban and rural areas and across regions. Young people find it very hard to integrate in to society after experiencing mental health issues after violence and conflict. These issues including depression, other mental disorders and psychosocial problems related specifically to young people, have been largely ignored. This may be particularly serious in contexts where local social and community environments have been degraded or undermined, there have been breaches of human rights, or where there are limited economic opportunities as a result of conflict. The Pacific Region was one of the most conflict-affected areas, has some of the highest rates of poverty in Colombia, is primarily rural, and continues to have high rates of mental health as a result of ongoing exposure to violence.This research takes an innovative approach in three ways: it explicitly links the local, the meso and the macro levels, recognising that much mental health care, such as it is, exists at the local level and that is where there may be an opportunity for effective intervention; it represents co-production both between Colombian and UK teams, but also with civil society organisations at the local level; and it uses an innovative mixed methods approach linking social science and clinical approaches to mental health. This means that we can links SDG3 on Health and Well Being with SDG16 on Peace, Justice and Strong Institutions, specifically through addressing mental health as a form of exclusion in societies affected by conflict. An integral element of the Sustainable Development Goals is inclusion of marginalised groups, and those suffering from mental health issues are among the most marginalised, often resulting from behavioural problems, substance abuse or depressionThe result of these approaches will provide initial evidence to focus policy and services in order to try and reduce inequalities in access to health care, and to provide evidence to improve the provision of mental health services in order for young people to have better opportunities and face a lower risk of remaining in poverty. The development of an integrated model of working for formal mental health care services in partnership with community services will support conflict-affected young people's mental health needs. This will be the first research project of its kind in Colombia focusing on youth mental health and integrated service development and has excellent potential for application in other areas going through similar transitions after conflict.