Why is this research valuable?

Youth mental health is the leading cause of disability and poor life outcomes for young people¹. Adversity and trauma during childhood caused by conflict and violence can cause long-term mental and psychological problems. Colombia has known a decades-long internal armed conflict, which caused death and displacement. Conflict is ongoing in many parts of the country, in spite of the 2016 peace agreement. In the Pacific region, political and criminal violence is compounded by high levels of poverty and lack of opportunities for employment and education. The majority Afro-Colombian population in this region face historical racism and marginalisation.

We undertook research in the city of Quibdó in the Chocó province, one of the poorest of Colombia, with poverty levels as high as 72%. Here, we analysed what types of support young Afro-Colombian persons need to promote their mental health, which forms and systems of support are available to them and if and how these are integrated. 

How did it all start? This research started as a promise between two PhD students - one from the UK working in mental health (Dr Fenton) and one from Colombia working in disability and poverty (Dr Pinilla-Roncancio) that if the opportunity to work together on a project relating to mental health in Colombia came up – they would go for it!

In 2020 an international team assembled funded by ESRC ODA Newton-Caldas Fund (UK): ES/V013297/1 and Ministerio de Ciencia, Tecnología e Innovación (Minciencias). The team included expertise ranging from gender and international peace and conflict scholars; to health with psychologists and a psychiatrist; and social and health policy scholars. This interdisciplinary group were all committed to working together to understand and map what mental health support young people in Colombia, particularly in the Pacific Region, had access to.

What was the research process like?

One of the greatest assets in this project was the interdisciplinary team. Interdisciplinarity is challenging, but it forces you to generate new knowledge because the vantage points (methodologically, epistemologically, practically, socially and emotionally) you are coming from are so varied. The greatest challenges, however, came from the context in which the work took place – one of global uncertainty because of the Covid-19 pandemic; and economic uncertainty presenting funding challenges and strain on the project. Teamwork, reflexivity and adaptability (and a lot of discussion) meant we were able to deliver the project as anticipated despite significant obstacles.

The fieldwork for this part of the study led by Dr Carranza and Dr Weber was exceptional, not just in its quality, but because of the highly difficult context in and time at which that work took place. Because of the sensitive nature of the topic and the challenges of working with young people who are less used to voicing their opinion and participating in research, we undertook participatory arts based research using a variety of methods. Through the course of our co-produced community setting based research we built two communal gardens, we painted two murals (one at a university, one in ‘el barrio’), we co-created and hosted a play with young people, and through workshops young people developed 17 ecological maps, 16 of which were shared with the research team. 

So what did we find?

We found that young people were living amongst an environment of insecurity and high levels of violence, and many of those we worked with had moved to Quibdó after displacement due to conflict and violence. Some of them had lost friends and family members as a result of conflict and criminal violence. They also mentioned that displacement, insecurity and the lack of employment opportunities pushed young people into crime, creating a cycle of violence and insecurity. Culture, for instance through the use of rituals, medicinal and edible plants, served as a source of resilience and strength in this difficult situation.

Our research showed that young people in Quibdó find support mostly from friends and family. At the same time, some of the young people we worked with had no or little of family support, due to absence because of displacement, or limited emotional caregiving due to parents being preoccupied by sustaining their family in a context of poverty. Many young people find alternative individual coping mechanisms if there was no emotional support available, for instance through the use of social media, dance, rap, music, reading, sleeping or crying. Nature and being outdoors, for instance walking along the river, was also highlighted as important.

There seemed little connection between young people’s micro (close family and friends), meso (school, faith organisation, community setting, neighbourhood) and exosystems (formal mental health or healthcare services). As a result, young people feel largely isolated and unsupported. This disconnection, compounded by the stress of growing up amidst violence, poverty and insecurity, created a sense of hopelessness for young people. Our research showed the importance of safe spaces, connected to nature and outdoors activities, and to cultural and artistic practices, where young people can let off steam, find support and emotional expression

What are the implications of these findings, and what happens next?

Our research^2–4   has implications for how we build and manage health systems for young people⁵, particularly those growing up in conflict or post-conflict contexts. Public policy should aim to better connect young people to existing mental health services. Persons trusted by young people, such as teachers or sports instructors, could play a key role in this. To facilitate such connections, the provision of community based safe spaces, like sports clubs or cultural centres are essential

Since we finished this part of the research we have applied for additional funding, and have used this to advance eco-mapping methods and create an ecological mapping tool (publication forthcoming) for use by those in communities working with young people.

We are also always looking for new ways to collaborate on improving mental health outcomes for young people in partnership with other global scholars – so if you are reading this and you are curious – please do reach out!

UK PI/Co-PI: Professor Paul Jackson p.b.jackson@bham.ac.uk, Dr Sarah-Jane Fenton s.h.fenton@bham.ac.uk 

Colombia PI/Co-PI: Professor Juan Pablo Aranguren jp.aranguren@uniandes.edu.co, Dr Mónica Pinilla-Roncancio mv.pinilla@uniandes.edu.co 

References:

1. WEF. A Global Framework for Youth Mental Health: Investing in Future Mental Capital for Individuals, Communities and Economies. (2020).
2. Fenton, S.-J. et al. Macro level system mapping of the provision of mental health services to young people living in a conflict context in Colombia. BMC Health Serv. Res. 24, 138 (2024).
3. Weber, S. et al. Mapping mental health care services for children and youth population in Colombia’s Pacific: potential for boundary spanning between community and formal services. Int. J. Ment. Health Syst. 18, 9 (2024).
4. Weber, S. et al. Growing up amidst violence: mapping mental health ecologies with young people on Colombia’s Pacific Coast. Confl. Health 19, 23 (2025).
5. Fenton, S.-J. & Carr, S. Mental Health. in Healthcare Management, 4e (eds. Moralee, S., Sidhu, M., Smith, J. & Walshe, K.) pp 427-455 (McGraw-Hill Education, Maidenhead, UNITED KINGDOM, 2025).