TY - JOUR
T1 - Vulnerability and mental health in Afghanistan
T2 - LookinG beyond war exposure
AU - Trani, Jean François
AU - Bakhshi, Parul
N1 - Funding Information:
The authors who were technical advisors to the Minister of Martyrs and Disabled were tasked by various disability stakeholders (government bodies, organisations of persons with disabilities, NGOs active in the field of disability, and U.N. agencies) to conduct a national case-control disability survey. The study was supported by the European Commission, UNOPS/UNDP, U.N. Mine Action Center for Afghanistan, Handicap International, French Embassy, and Swiss Agency for Development and Cooperation.
Funding Information:
This study was funded by the European Commission, UNOPS/UNDP, U.N. Mine Action Center for Afghanistan (Voluntary Trust Fund), Handicap International, French Embassy, and Swiss Agency for Development and Cooperation. Acknowledgements
PY - 2013/2
Y1 - 2013/2
N2 - This study examined the prevalence of mental distress among groups in Afghanistan considered to be at risk. Data were drawn from a representative cross-sectional disability survey carried out in Afghanistan including 5,130 households in 171 clusters throughout the 34 provinces of the country. The sample included 838 nondisabled control participants aged above 14, and 675 disabled participants. Results showed that various vulnerable groups (disabled people, the unemployed, the elderly, minority ethnic groups, as well as widowed, divorced or separated women) were at higher risk of experiencing mild to severe mental health problems. The adjusted odds ratio for war-related disability compared to nondisabled was 4.09 (95% confidence interval 2.09 to 7.99) for mild mental distress disorders, and 7.10 (3.45–14.5) and 14.14 (3.38–59.00) for moderate or severe mental distress disorders, respectively. Women with disabilities (whatever the cause of impairment) when compared with nondisabled men, as well as poorer segments of society compared to the richest, had a higher prevalence of mental health problems. Women with non-war-related disabilities compared with nondisabled men were respectively 3.35 (1.27–8.81) and 8.57 (3.03–24.1) times more likely to experience mild or moderate mental distress disorders. People who experience multiple vulnerabilities are more at risk of deteriorating mental health in conflict zones. The study shows that mental health, in times of war, is influenced by a combination of demographic and socioeconomic characteristics linked to social exclusion mechanisms that were in place before the conflict began and that are redefined in relation to the changing social, cultural, and economic contexts. Mental health policies and programmes must prioritise the most vulnerable segments of Afghan society.
AB - This study examined the prevalence of mental distress among groups in Afghanistan considered to be at risk. Data were drawn from a representative cross-sectional disability survey carried out in Afghanistan including 5,130 households in 171 clusters throughout the 34 provinces of the country. The sample included 838 nondisabled control participants aged above 14, and 675 disabled participants. Results showed that various vulnerable groups (disabled people, the unemployed, the elderly, minority ethnic groups, as well as widowed, divorced or separated women) were at higher risk of experiencing mild to severe mental health problems. The adjusted odds ratio for war-related disability compared to nondisabled was 4.09 (95% confidence interval 2.09 to 7.99) for mild mental distress disorders, and 7.10 (3.45–14.5) and 14.14 (3.38–59.00) for moderate or severe mental distress disorders, respectively. Women with disabilities (whatever the cause of impairment) when compared with nondisabled men, as well as poorer segments of society compared to the richest, had a higher prevalence of mental health problems. Women with non-war-related disabilities compared with nondisabled men were respectively 3.35 (1.27–8.81) and 8.57 (3.03–24.1) times more likely to experience mild or moderate mental distress disorders. People who experience multiple vulnerabilities are more at risk of deteriorating mental health in conflict zones. The study shows that mental health, in times of war, is influenced by a combination of demographic and socioeconomic characteristics linked to social exclusion mechanisms that were in place before the conflict began and that are redefined in relation to the changing social, cultural, and economic contexts. Mental health policies and programmes must prioritise the most vulnerable segments of Afghan society.
KW - Afghanistan
KW - conflict
KW - mental distress disorder
KW - socioeconomic factors
UR - http://www.scopus.com/inward/record.url?scp=84879230002&partnerID=8YFLogxK
U2 - 10.1177/1363461512475025
DO - 10.1177/1363461512475025
M3 - Article
C2 - 23427259
AN - SCOPUS:84879230002
VL - 50
SP - 108
EP - 139
JO - Transcultural Psychiatry
JF - Transcultural Psychiatry
SN - 1363-4615
IS - 1
ER -