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反思冲突后环境中的恢复:支持哥伦比亚社区的心理健康。

Re-thinking recovery in post-conflict settings: Supporting the mental well-being of communities in Colombia.

机构信息

Faculty of Population Health Sciences, UCL Institute for Global Health, London, UK.

Centre for Primary Health and Social Care, School of Social Professions, London Metropolitan University, London, UK.

出版信息

Glob Public Health. 2020 Feb;15(2):200-219. doi: 10.1080/17441692.2019.1663547. Epub 2019 Sep 17.

Abstract

Addressing mental health needs is a central focus of the Colombian Government's framework for socio-political reconstruction following over 60 years of conflict. Informed by WHO standards, country efforts utilise biopsychosocial models that prioritise individual psychological and psychiatric conditions. However, increasing scrutiny of the deployment of Western approaches to mental health and recovery in the global south suggests a need to explore the best route to improving mental health outcomes. Our research contributes to these debates through a qualitative study of local understandings of mental health recovery related concepts among internally displaced persons in Colombia. Analysis of focus groups with 40 internally displaced men and women established definitions for emotional distress and recovery as parallel processes linked to the fracture and rebuilding of social worlds and family life. Definitions were shaped heavily by cultural, political, economic and legal contexts of everyday survival, often linked to experiences of structural and symbolic forms of violence. We conclude that a locally informed mental health recovery model that stretches beyond individual experiences of mental ill-health to promote ideas of collective social change would be best suited to addressing mental health needs of internally displaced groups in Colombia. Implications for practice are discussed.

摘要

解决心理健康需求是哥伦比亚政府在历经 60 多年冲突后进行社会政治重建框架的核心重点。根据世界卫生组织的标准,国家的努力利用生物心理社会模式,优先考虑个人的心理和精神状况。然而,对西方在全球南方的心理健康和康复方法的运用的日益严格审查表明,有必要探索改善心理健康结果的最佳途径。我们的研究通过对哥伦比亚境内流离失所者与心理健康康复相关概念的当地理解进行定性研究,为这些辩论做出了贡献。对 40 名境内流离失所的男性和女性进行焦点小组分析后,确定了情感困扰和康复的定义,将这两个定义作为与社会世界和家庭生活的断裂和重建相关的平行过程。这些定义受到文化、政治、经济和日常生活中生存的法律背景的强烈影响,通常与结构性和象征性形式的暴力经历有关。我们的结论是,一种本土化的心理健康康复模式,超越了个人心理健康不良的体验,促进了集体社会变革的理念,最适合解决哥伦比亚境内流离失所群体的心理健康需求。我们讨论了对实践的影响。

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