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."
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MAP posted-by: Derek