“The professionals weren’t from here”: provision of mental health services in the context of the Colombian armed conflict
Abstract Background The provision of mental health care services in different municipalities of Colombia has been significantly affected by the armed conflict, especially in rural areas. From the Social Determinants of Health (SDH) perspective, this study aimed to understand the characteristics of t...
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | Archives of Public Health |
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| Online Access: | https://doi.org/10.1186/s13690-025-01561-z |
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| author | Diana Carolina Rubio-León Laura Cano-Sierra María-Juliana Reyes-Rivera Sara Lucia Forero-García Dennys García-Padilla Pablo Abitbol Wilson López-López |
| author_facet | Diana Carolina Rubio-León Laura Cano-Sierra María-Juliana Reyes-Rivera Sara Lucia Forero-García Dennys García-Padilla Pablo Abitbol Wilson López-López |
| author_sort | Diana Carolina Rubio-León |
| collection | DOAJ |
| description | Abstract Background The provision of mental health care services in different municipalities of Colombia has been significantly affected by the armed conflict, especially in rural areas. From the Social Determinants of Health (SDH) perspective, this study aimed to understand the characteristics of the provision of mental health services in the context of armed conflict from the perspectives of healthcare personnel and administrative staff involved in mental health care in the Montes de María region. Methods A descriptive qualitative study was carried out with 49 participants from the healthcare and administrative sectors. Data were collected through 15 semi-structured interviews and 7 focus groups held in 2023 and 2024. A content analysis was conducted using NVivo 14. Results Two main categories were identified: (1) Deficiencies in Service Provision and Access, where professionals reported issues in the provision of mental health services in Montes de María, including shortcomings in public policy, barriers to access and continuity of the services, infrastructure limitations, bureaucratic obstacles, high staff turnover, lack of contextualization, limitations in the conceptualization of mental health, ethical and professional misconduct, and security threats due to the ongoing armed conflict; and (2) Successful Approaches to Mental Health Care, in which participants highlighted effective strategies characterized by implementing context-sensitive interventions, incorporating community involvement in service provision planning, and transcending an individual and psychopathological perspective of mental health. Conclusions This study highlights how both the provision of health services and armed conflict act as key social determinants of mental health. In Montes de Maria, the complex mental health and psychosocial needs of the population remain unmet due to the absence of adequate, context-sensitive health services. Moreover, existing regulations designed to ensure access to mental health services fail to translate into effective implementation in the region. A potential solution lies in the sustained community engagement, from the initial planning of healthcare services to the direct involvement of community members as health promoters. The proposed SDMH framework, along with this study’s findings, should serve as the foundation for updating Colombia’s National Mental Health Policy, ensuring a dedicated section that addresses the specific needs of regions affected by armed conflict. |
| format | Article |
| id | doaj-art-3ea06fc32ad14e828fe5f7f6ac528623 |
| institution | Kabale University |
| issn | 2049-3258 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Archives of Public Health |
| spelling | doaj-art-3ea06fc32ad14e828fe5f7f6ac5286232025-08-20T03:53:08ZengBMCArchives of Public Health2049-32582025-05-0183111310.1186/s13690-025-01561-z“The professionals weren’t from here”: provision of mental health services in the context of the Colombian armed conflictDiana Carolina Rubio-León0Laura Cano-Sierra1María-Juliana Reyes-Rivera2Sara Lucia Forero-García3Dennys García-Padilla4Pablo Abitbol5Wilson López-López6Psychology and Health Research Group, School of Psychology, Pontificia Universidad JaverianaSocial Ties and Cultures of Peace Research Group, School of Psychology, Pontificia Universidad JaverianaSocial Ties and Cultures of Peace Research Group, School of Psychology, Pontificia Universidad JaverianaSocial Ties and Cultures of Peace Research Group, School of Psychology, Pontificia Universidad JaverianaPsychology and Health Research Group, School of Psychology, Pontificia Universidad JaverianaRegional Group of Historic Memory, Universidad Tecnológica de BolívarSocial Ties and Cultures of Peace Research Group, School of Psychology, Pontificia Universidad JaverianaAbstract Background The provision of mental health care services in different municipalities of Colombia has been significantly affected by the armed conflict, especially in rural areas. From the Social Determinants of Health (SDH) perspective, this study aimed to understand the characteristics of the provision of mental health services in the context of armed conflict from the perspectives of healthcare personnel and administrative staff involved in mental health care in the Montes de María region. Methods A descriptive qualitative study was carried out with 49 participants from the healthcare and administrative sectors. Data were collected through 15 semi-structured interviews and 7 focus groups held in 2023 and 2024. A content analysis was conducted using NVivo 14. Results Two main categories were identified: (1) Deficiencies in Service Provision and Access, where professionals reported issues in the provision of mental health services in Montes de María, including shortcomings in public policy, barriers to access and continuity of the services, infrastructure limitations, bureaucratic obstacles, high staff turnover, lack of contextualization, limitations in the conceptualization of mental health, ethical and professional misconduct, and security threats due to the ongoing armed conflict; and (2) Successful Approaches to Mental Health Care, in which participants highlighted effective strategies characterized by implementing context-sensitive interventions, incorporating community involvement in service provision planning, and transcending an individual and psychopathological perspective of mental health. Conclusions This study highlights how both the provision of health services and armed conflict act as key social determinants of mental health. In Montes de Maria, the complex mental health and psychosocial needs of the population remain unmet due to the absence of adequate, context-sensitive health services. Moreover, existing regulations designed to ensure access to mental health services fail to translate into effective implementation in the region. A potential solution lies in the sustained community engagement, from the initial planning of healthcare services to the direct involvement of community members as health promoters. The proposed SDMH framework, along with this study’s findings, should serve as the foundation for updating Colombia’s National Mental Health Policy, ensuring a dedicated section that addresses the specific needs of regions affected by armed conflict.https://doi.org/10.1186/s13690-025-01561-zMental health servicesHealthcare personnelSocial determinants of mental healthHealth careArmed conflict |
| spellingShingle | Diana Carolina Rubio-León Laura Cano-Sierra María-Juliana Reyes-Rivera Sara Lucia Forero-García Dennys García-Padilla Pablo Abitbol Wilson López-López “The professionals weren’t from here”: provision of mental health services in the context of the Colombian armed conflict Archives of Public Health Mental health services Healthcare personnel Social determinants of mental health Health care Armed conflict |
| title | “The professionals weren’t from here”: provision of mental health services in the context of the Colombian armed conflict |
| title_full | “The professionals weren’t from here”: provision of mental health services in the context of the Colombian armed conflict |
| title_fullStr | “The professionals weren’t from here”: provision of mental health services in the context of the Colombian armed conflict |
| title_full_unstemmed | “The professionals weren’t from here”: provision of mental health services in the context of the Colombian armed conflict |
| title_short | “The professionals weren’t from here”: provision of mental health services in the context of the Colombian armed conflict |
| title_sort | the professionals weren t from here provision of mental health services in the context of the colombian armed conflict |
| topic | Mental health services Healthcare personnel Social determinants of mental health Health care Armed conflict |
| url | https://doi.org/10.1186/s13690-025-01561-z |
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