One-year outcomes of two community-based mental health interventions for Afro-Colombian survivors of the armed conflict and displacement

ABSTRACT

The objective of the study is to assess the middle-term effects (1 year after intervention) of two community-based mental health interventions, Common Elements Treatment Approach intervention, CETA, and Narrative Community Group Therapy intervention, NCGT, in two cities of the Colombian Pacific region (Buenaventura and Quibdó). A follow-up study was conducted on a cohort of trial participants. In this trial, the positive effects of two mental health interventions were evaluated; assessment was carried out in separate groups (CETA arm, NCGT arm and a control group) of the reduction of symptoms of anxiety, depression, post-traumatic stress and function impaired mentality. The participants were Afro-Colombian survivors of the armed conflict and displacement living in Buenaventura and Quibdó. They were surveyed using the same instrument used in the original trial. Intent-to-treat analyses were performed, and longitudinal mixed-effects regression models with random effects were used to analyse the middle-term effects of the interventions. At 1-year post-intervention, participants in Buenaventura who received the CETA intervention experienced a decrease in depression (−0.23; p = 0.02), post-traumatic stress symptoms (−0.23; p = 0.02) and total mental health symptoms (−0.14; p = 0.048). In Quibdó, the NCGT intervention significantly improved function impairment (−0.30; p = 0.005). CETA and NCGT interventions have the potential to maintain a reduction of mental health symptoms in participants from the Colombian Pacific region.

KEYWORDS:

• Mental health
• community-based
• group therapy
• cognitive-behavioural therapy
• violence
• displacement

Acknowledgments

The authors want to thank the National Association of Displaced Afro-Colombians (AFRODES) for their collaboration during the fieldwork, Samantha Levin, MBA, for her editing assistance when preparing the manuscript and Sohaib Hassed for his critical revision of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study is made possible by the generous support of the American people through the United States Agency for International Development (USAID) Victims of Torture Fund, contract number AID-OAA-A-10-00046. The contents are the responsibility of the Cisalva Institute of Universidad del Valle and do not necessarily reflect the views of USAID or the United States Government. USAID did not take part in the design and conduct of the study, collection, management, analysis and interpretation of the data, or preparation, review or approval of the manuscript.

Notes on contributors

Francisco Javier Bonilla-Escobar

Francisco Javier Bonilla-Escobar is a MD, MSc, currently he is a PhD candidate at the University of Pittsburgh, USA.

Daniel Tobon-Garcia

Daniel Tobon-Garcia is a MD, MPH, and MPP, entrepreneur in the area of school health and well-being.

Luz A. Cordoba-Castro

Luz A. Cordoba-Castro is a statistician.

Sara G. Pacichana-Quinayaz

Sara G. Pacichana-Quinayaz is a FT, MSc, auxiliary professor at the Universidad del Valle, Colombia.

Andrés Fandiño-Losada

Andrés Fandiño- Losada is a MD, MSc, PhD and Associate Professor at the Universidad del Valle, Colombia.

María I. Gutierrez-Martinez

María Isabel Gutierrez-Martinez is a MD, MSc, PhD, professor at Universidad del Valle and Director at Cisalva Institute.