Social Determinants of Mental Health in Armed Conflict-affected Municipalities.

Network analysis revealed strong conditional associations linking mental health outcomes with sense of community and perceived social support.

• The network analysis included 23 nodes with a sparsity of 0.708.
• Mental health variables assessed included depression, stress, and anxiety.
• Sociodemographic variables showed minimal integration within the network.
• Psychosocial care showed moderate centrality, indicating relevant but secondary associations with mental health compared to more central nodes.

Qualitative findings identified armed conflict, state abandonment, economic issues, lack of opportunities, and barriers to accessing mental health services as social determinants of health (SDH) that have impacted community mental health.

• 35 focus groups were conducted with community leaders and members.
• Two regional meetings were held with 167 leaders to further explore social determinants of mental health.
• These determinants were identified across fifteen municipalities affected by armed conflict in Montes de María, Colombia.
• Communities have been affected by armed conflict and multiple social inequalities for more than six decades.

Social capital and communitarian resistance strategies were identified as factors that promote mental health in Montes de María.

• Qualitative data from focus groups and regional meetings highlighted these community strengths.
• These findings emerged from communities in fifteen armed conflict-affected municipalities.
• The study involved 167 leaders in regional meetings and additional participants in focus groups.
• These strategies were framed as existing strengths upon which psychosocial interventions could build.

A convergent parallel mixed methods design was used, combining quantitative mental health assessments with qualitative focus groups and regional meetings.

• The quantitative component assessed 134 leaders and community members using PHQ-4, DASS-21, MOS Social Support Survey, and Brief Sense of Community Scale (BSCS).
• The qualitative component included 35 focus groups and two regional meetings with 167 leaders.
• Methodological triangulation was applied to integrate both data types.
• Quantitative and qualitative analyses were conducted concurrently.

The study findings highlight the urgent need for more effective psychosocial interventions for conflict-affected populations that build on existing social and community support strengths.

• Both quantitative and qualitative findings highlighted the region's challenges alongside its capacity for resilience.
• Recommended interventions should focus on psychosocial care that leverages existing social and community support strengths identified in Montes de María.
• The study was conducted across fifteen municipalities affected by the armed conflict in Montes de María, Colombia.
• The population has experienced armed conflict and multiple social inequalities and injustices for more than six decades.