The invisible wounds of five decades of armed conflict: inequalities in mental health and their determinants in Colombia

Objectives: We analyzed the relation between exposure to the armed conflict and violence with mental health disorders in Colombia and assessed the extent and determinants of socioeconomic inequalities in mental health related to differential exposure to the conflict and violence. Methods: Regression and decomposition analyses were used in combination with the 2015 nationally representative Mental Health Survey (N = 10,853). Mental health disorders were assessed using the Self-Reporting Questionnaire (SRQ 20), and socioeconomic status by a Multidimensional Poverty Index. Results: 3% of adults have been victim of a violent crime and 13% victim of the armed conflict. Victims of the armed conflict have 1.74 times higher odds (p <.05) of suffering mental health disorders compared to non-victims. Differential exposure to the armed conflict among lower socioeconomic groups explains 86% of total inequality in mental health disorders. Conclusions: Interventions that increase quality and access of mental health treatments among victims of the conflict will not only lead to improvements in mental health among victims but also significantly reduce inequalities in mental health in Colombia.