Pubdate: Sun, 20 Feb 2005 Source: Sun-Sentinel (Fort Lauderdale, FL) Copyright: 2005 Sun-Sentinel Company Contact: http://www.sun-sentinel.com/ Details: http://www.mapinc.org/media/159 Author: Toby Muse, Special Correspondent Bookmark: http://www.mapinc.org/areas/Colombia WAR, POVERTY UNHINGE NATION Depression, Anxiety Rising Amid Violence Four decades of internal conflict have turned Colombia into an anxiety-ridden nation struggling to overcome an epidemic of emotional problems, mental health professionals say. More than 40 percent of Colombians between ages 18 and 65 acknowledged suffering mental illness at least once during their lifetimes, including depression and substance or alcohol abuse, according to a study by Dr. Juan Posada. One-fifth of Colombians have experienced profound feelings of anxiety. The reasons: Battles by drug gangs, an ongoing civil war, high murder and kidnapping rates, along with double-digit unemployment and grinding poverty. "It's obvious that this mix of high levels of criminal violence, the civil war and rates of poverty and unemployment is having an effect on the mental health of Colombians," said Posada, a psychiatrist who completed Colombia's largest survey of the population's mental health. Posada's team, in conjunction with the World Health Organization's global survey of mental health, interviewed more than 4,600 Colombians. The consequences are alarming, say social services agencies, which have reported a crisis of abuse of women and children. One in 10 Colombian adults may be alcoholics, Posada said, citing studies. And while the suicide rate is low for South America, it is on the rise. "It's generally seen that as societies become more peaceful, homicides go down and suicides go up," said Posada, who estimates that more than 1 million Colombians have attempted suicide. "Here in Colombia, we've got a high murder rate and over the past decade we've seen a one percentage point rise in suicide attempts, and I fear that will continue growing." Posada's study found that mental health conditions varied by region. The worst affected of Colombia's 45 million inhabitants were in the country's capital, Bogota, and on the Pacific coast, where the country's worst violence and poverty are found. The best mental health was in the country's Caribbean coast, which includes the tourist destinations of Cartagena and Santa Marta. "Undoubtedly, the Caribbean's more relaxed attitude to life helps mental health," said Posada, who pointed out that much of the coast had escaped the violence plaguing the rest of the country. Mental health workers said they are worried that because violence is so common, Colombian society is becoming desensitized to the suffering of others. "Unfortunately, when killings occur every day, people become accustomed to them and this can generate a situation where people see little value in other people's lives ... making it easier to take life," said Alejandro Lombardo, head of the mental health department in the Central Hospital in Bogota. Colombia's security officials said they realize that being targets of violence has made police officers and soldiers vulnerable to mental illness. After a man killed five fellow soldiers in January, the nation's defense minister, Jorge Alberto Uribe, ordered a revision of all the military's psychological programs. "Now the army understands that mental health is as important as physical health," said Col. Jose Toledo, who leads the army's psychological program. But with a lack of mental-health awareness outside Colombia's major cities, aid that is available for security troops is not there for civilians in rural areas where the civil war is being fought. Studies show that one-quarter of the civilian population that is victimized or sees violence suffers from post-traumatic stress. Meanwhile, the perpetrators of violence that sometimes includes killing entire families with chain saws or blunt instruments also can suffer deep psychological scars, doctors say. Some killers have been forcibly recruited into both rebel and paramilitary forces, and the law requires military service. "These people must be carrying around some profound feelings of guilt and anger at society for the horrors they've been forced to participate in," Lombardo said. "This guilt contributes to the large numbers of people fleeing the ranks of the guerrillas and the paramilitaries." - --- MAP posted-by: Derek