A Qualitative Approach to Informing Mental Health Programming in Central African Republic

Abstract

The Central African Republic (CAR) is a country with a long history of violent conflict, extreme poverty, and little to no mental health infrastructure for a population with profound exposure to ongoing trauma. In 2015, 70% of the population was displaced internally or to surrounding countries, and 80% had witnessed violence. An empirical study of mental health in CAR found that 50% to 80% of the population reported clinically significant anxiety or depression. Such epidemiological data suggest extremely high levels of distress, yet more culturally relevant information is needed to better understand contextual responses to trauma, and associated mental health needs. To address this empirical gap, the present study engaged in a collaborative partnership with humanitarian organizations and local religious groups in CAR to conduct a series of focus groups with community members. Qualitative exploratory research methodology was used, as it can inform the development and delivery of intervention, and shape policy initiatives to increase mental health endeavors that promote healing from trauma. Focus group discussions were recorded, transcribed, and then coded, resulting in 3 primary themes: safety/disarmament and reestablishing education; traumatic experiences of physiological arousal and generalized distress; and subsequent idioms of distress and lack of mental health treatment or availability of services. These themes illustrate the importance of further developing and maintaining systems that provide safety, education, and mental and physical health care services to the general population in CAR. Ongoing conflict jeopardizes the formation of new systems, and investment in established systems that need improvements and resources. Without government and political support, these endeavors will continue to languish until peace and stability is widespread throughout the country.

The effect of the county legal framework on the implementation of mental health programmes in Nakuru County, Kenya

“…In the Central African Republic, Patel et al (2020) explain that volatility and civil strife characterized by internal displacement of people and violence have led to over 80% of the population experiencing mental issues, which include anxiety and depression. The government and international organizations have taken the initiative to implement mental health programmes.…”

“…The Mental Health Action Program (mhGAP) implemented by WHO has helped increase awareness of mental health's importance and its treatment. Nonetheless, mental health programmes have been inadequately delivered due to the insecure state of the country (Patel et al, 2020).…”

Building Back Better With International Perspectives in Psychology

“…The study highlights needs, ways, and means for educational systems to develop more culturally informed understandings of distress and well-being and culturally sensitive mental health services for international students. The second article in this issue focuses on the mental health needs of people in the Central African Republic who are often traumatized and displaced (Patel et al, 2020). This article highlights the importance of continuing to develop and maintain systems that provide safety, education, and mental health care services to the general population and the pivotal role for government and political support for these systems to sustain.…”