(c) THRiVE: Dr Kennedy Amone-P'Olak
Dr Kennedy Amone-P’Olak, a THRiVE post-doctoral fellow from the University of Gulu in Uganda is spearheading an innovative study into the effects of war on the mental health of young people in Uganda. Dr Amone-P’Olak, who is being mentored by researchers at the Department of Psychiatry in Cambridge,explained the details of his study to an audience at the Centre of African Studies on Wednesday 2nd November 2011.
Uganda recently emerged from 20 years of war in which thousands of youths were displaced or abducted, and many were tortured, forced to commit atrocities or indoctrinated by the warring forces. Dr Amone-P’Olak chose to focus his study on a broad category of “War-Affected Youths” (WAYs) as he feels that whilst there are existing efforts to investigate the mental health of child soldiers and abductees, there is a lack of research for youths who were affected by the war in other ways, such as displacement or the loss of family members.
The Social Ecology Model - taken from http://tinyurl.com/65g2o37
The study is innovative because it uses a Social Ecology model to examine the effects of war not only on the individual, but on their families and the wider community. It also uses qualitative methods, which are more suitable for investigating certain psychosocial issues, on top of the quantitative methods which past studies have been restricted to. As well as examining the effects on society, the study will look at how the youth’s personal context interacts with their experiences of war to understand their long-term mental health outcomes. For example, the effect of social skills or coping strategies upon the risk and severity of depression or psychotic symptoms.
Dr Amone-P’Olak successfully co-ordinated the first round of data-collection, collecting data from 539 participants aged 18-35 years old who were abducted for at least 6 months. About 30% of these are female. More data will be collected in June, with reassessment of previous participants to track any changes, plus 40 in depth interviews and 20 focus group discussions. Data will also be collected from WAYs who were not abducted to provide a comparative control sample; something that has not been attempted before in this area of research.
Dr Amone-P’Olak is hoping to gain long term funding so that the study can be extended into a sustained, longitudinal investigation. This is particularly important because much of the data in the field at the moment can only be analysed cross-sectionally, and is produced by western researchers from international NGOs, such as MSF, that only spend a short amount of time in country. Such data often does not reflect the long-term mental health effects of the war.
The issue of poorly co-ordinated action by international NGOs was also highlighted by Dr Amone-P’Olak. He discussed the different accreditation techniques used by the many NGOs who trained counsellors in the post-war period. The length of training given for counselling certification varied wildly, from as little as 3 days up to several months. This has generated an unregulated ecosystem whereby practitioners with very different amounts of experience are viewed as equal, and patients often suffer as a result.
Whilst Dr Amone-P’Olak has just started analysing the data, some preliminary results have demonstrated the social turmoil which the war has caused in parts of Uganda. For example, 51% of married female abductees, who were often denied a childhood, are married to a fellow abductee. This highlights the need for capacity building in counselling services if Uganda is to cope with an imminent rise in families with war-affected parents who both have a greater risk of mental health issues, and have not experienced a stable family life.
by Cam Stocks