Demobilized population in Colombia: the risk of “going backward”
The research "Mental health in the context of Demobilization, Disarmament, and Reintegration: trajectories, suffering spectra, and quality of life of the Colombian armed conflict demobilized population," was carried out by the Externado de Colombia and the Agency for Reintegration and Normalization.
· Results of the survey of 27 thousand people demobilized from armed groups in the reintegration process.
· Return to armed conflict or criminal activities is the result of a series of issues, the subjects, as well as their contexts and Colombian society structural factors. Up to 77% have a medium risk of returning to the armed conflict.
· Of the population studied, about 17%, almost 4500 people, accumulate risks from their past experience situations that merit particular and careful attention.
· 61% of the population has specific signs of emotional distress that may be causing mental health disorders.
· The persistence of social, economic, and cultural conditions generated by war, prevent peace consolidation.
· The research defines intervention priority areas and proposes a comprehensive care model with a community perspective.
Peace is signed, but multiple expressions of violence persist; new and varied forms of crime emerge; corruption abounds; verbal violence and intolerance are a daily occurrence. What is happening?
The research conducted by the State Agency for Reintegration and Normalization – ARN – and the Health, Medical Knowledge, and Society area of the Center for Research on Social dynamics – CIDS – of the Externado de Colombia Social and Human Sciences Faculty, provides answers to this question as well as other pressing ones. Up to what point is the path traveled by those in the process of demobilization and integration into civilian life in danger of being upturned?
In 2010, CIDS researchers, led by Diego Mauricio Aponte Canencio, designed for the ARN a Psychosocial Multiaxial Survey (EMP) to detect mental health problems and improve the psychosocial care provided by the institution. The instrument is still being applied today by the ARN. The results of its application by ARN professionals in a collaborative effort between the Academia and the State, generated the book “Salud mental en el contexto Desmovilización Desarme y Reincorporación: trayectorias, espectros de sufrimiento y calidad de vida en población desmovilizada del conflicto armado colombiano” written by Diego Mauricio Aponte and José Zapata (Externado Publishing) introduced April 24, 2019, at the Bogotá International Book Fair.
The survey, characterizing the nearly 27,000 people in the process of reintegration during the period 2010-2014, can provide guidelines for those making their transition to civilian life today, after the peace agreement, emphasize the researchers.
A general characterization of the population was obtained regarding the probability of mental disorders (significant presence of different clinical events symptoms, understood as expressions of emotional distress); pronounced personality traits; life paths and perceived quality of life, with the idea of associating mental health with the armed conflict. All these, to provide important inputs to understand and act on the immediate future, as part of an effort to improve outcomes in a field recording 70 percent successful experiences, according to the ARN official figures. This number is not at all daunting when compared, for example, with 70 percent of recidivism in population associated with the justice system.
It is, explain the authors, “an approach that touches emotional suffering elements and gets close to the past and present history of each subject and the different contexts to provide a comprehensive framework of the life process. (Because) it would be impossible to study the psychic conditions separately from the socio-historic contexts on which they are structured and configured… (It is) understanding the various symptoms or disorders caused by the armed conflict experience, resulting from grief, mental health injury, exposure to cruel and barbarism experiences, frustration, exclusion, chronic stress, emotional damage, and participants’ social association. Also, it implies understanding the uneasiness resulting from the transition from the armed conflict military life dynamics to civil life and reintegration process dynamics.”
What people’s life trajectories reveal
The life paths of those who today are part of demobilization and reintegration programs provide fairly accurate information on the probabilities of returning to armed groups. It is an exercise that compares the risk level before entering the armed organization, the time spent in it, and the reintegration process into civilian life. The trajectories are observed based on eight central points, considered determining factors of the conflict and emotional discomfort:
Disposition for breach of regulations (non-compliance with the law); Disposition for conflict cultural context (normalization of war cultural patterns); Disposition for risk networks (weakness of protective social networks and the presence of risk criminal networks; Disposition for associations (effects of victimization experiences, not elaborated); Disposition for non-democratic political practices (corrupt, exclusive, violent, non-participatory, and authoritarian); Disposition for deficit of adaptive social recursion (imbalance between social and labor skills and opportunities); Disposition for labor-productive inclusion, and Disposition for health and self-care conditions.
Following are the most significant results:
– 77% of the population studied shows, in the total of all the key points, a medium risk, as opposed to 22% low risk, and 1% high risk. That is, in the population surveyed, there is a medium risk of returning to war.
-The more warning signals in the key points, the more risk of returning to armed activity. 17% register more than three signs – approximately 4500 people in the study require particular attention.
-The point indicating the highest risks is “Adaptive social recursion deficit.” 93% of the population reported a medium to high-level risk; individuals recognize imbalances between the skills they have and the opportunities to use them in the reintegration context. The topics addressed relate to resolving
conflicts, communication, and skills, allowing them to “fend for themselves” in productive terms in a legal environment.
– Following in importance is “Association effects.” Of the 81.6% of the population reporting risk in this area, close to 42.9% recognize that association effects present a high risk, and only 18.3% of the population is in a state of alleviation. This reflects the accumulation of grief, loss, cruelty, savagery, and proximity to death; situations they have not had the opportunity to develop and which imply significant vulnerability regarding mental health and emotional involvement.
-The “risk networks ” axis presents troublesome figures: while there is a decrease in the support networks (family and social) fragility risk in 40.2% of the population, 50% feels there is a fragility increase or, on the contrary, a growth of dangerous networks, acting as a type of crime magnet.
In conclusion, according to the document, “In a large part of the population, risk conditions prevail and persist or risk situations increase in the final moment, compared to the time people joined armed groups… (These) particular risk constellations must be taken into account to assess and guide the processes of reintegration or reinstatement and the construction of a lasting peace in the post-conflict.”
Another relevant point is the correlation between indicators of undemocratic political culture, risk networks, and normalization of cultural patterns of war and violence that, according to the authors, should be a priority for Governments.
The mental health of those who leave the war
The study draws a certain specific vulnerability of the population analyzed regarding their mental health. Factors existing before joining armed groups are identified, and others due to tensions inherent to the process experienced after leaving the war: employability, reconstruction of ways of life, re-encounters with families, insecurity and life risk, training needs, the presence of groups stimulating crime, fears of rejection, legal procedures, and, in the case of the FARC, the challenges of functioning in a frankly, rarefied and polarized political context.
Also observed in the population studied is the significant presence of symptoms: post-traumatic stress 31%; anxiety 27.3%; intermittent explosive disorder, impulse control 26.2%; manic conditions 23%; depression 17.1%; pathological gambling 13.8%; psychosis, 10%; problematic consumption of alcohol 7.8%; consumption of psychoactive substances, 4.1%.
On the “personality traits” scale, the research emphasizes that “while there are some tendencies that may indicate recidivism risks or unlawful, disruptive behavior, they are not major… So, the decision of joining armed groups is better explained by political violence, social and cultural context conditions.”
– 59.2% of those polled acknowledged the death of relatives by violence; 52.9% are recognized as victims (themselves or members of their families); 25% experienced family abandonment; 51% feel that in the place they lived before joining the armed group there were no employment opportunities; 48% witnessed cruel or violent situations before joining the armed group, and 38% was familiar with illegal economies.
Poor quality of life perceived
The study measured self-perceptions and the emotional and physical environment, as well as the opportunities this environment contributes to the reintegration process. 36% shows some self-dissatisfaction; 41% signal limitations in some environment adaptation skills; 42% does not perceive well their emotional supports and their ability to remain stable in this sense; 47.2% has an unsatisfactory perception of their living conditions objective; and 61.2% feel the social environment, and their life conditions objective does not provide sufficient elements to go beyond their current limitations.
Away from the Madhouse
As an alternative to dealing with the described reality, the research formulates a disruptive proposal regarding the traditional approach to the necessary mental health in the absence of an institutional architecture for the post-conflict. The proposal takes it out of the hospital setting, discards the mental health asylum solution, and downplays the focus on the individual, to design an integration project, with community involvement, local vision, and long-term goals. It is conceived as follows:
“A participatory social device helping territories’ governance in aspects of coexistence, celebration of diversity, overcoming stigma and distrust, community and individual well-being, attention to vulnerability (…) Actions should be articulately directed to multiple levels of incidence (all at once): strengthening of the subjects; reunions and family support; dynamics activation, and collective and pairs projects; labor insertion; training and development of knowledge and skills; socio-cultural and symbolic activation of peace, coexistence, solidarity, and diversity; preventing and coping with various forms of violence; decrease and discouraging crime and illegality; inclusion, social and political participation, and strengthening of institutions.”
Only by the above, reiterate the authors of the study, can peace consolidation be achieved and a new war outbreak averted. Also, ultimately, a reflection directed to those struggling to erase the war from their lives:
“Wars leave only pain, and often, no winners or losers. To each and every one of the ex-combatants, a word of encouragement to stay on the path for peace.”