Mental health and welfare in post conflict setting: A study from highly conflict affected area in Nepal

（内乱後のメンタルヘルスと福祉課題 –ネパールの激しい内乱地域における研究 )

GYAWALI BIJAY11S3020

International university of health and welfare

Why this research necessary?

Civil war causalities ( 1996-2006)

Civil war (1996-2006)

Maoist group

Government Group

Total

Killed 4930 8339 13227

Killed ( children )

172 175 347

Lost 1147 1147

Post conflict socio-

psychological Impact

Psychological aspect

Quality of life

Happiness and

wellbeing

Research basic objectives

Methodology

1.Research review 2.Interview with questionnaire in highly conflict areaa)BDI-II( Beck depression Inventory-II)-28 question about depression based on DSM-IVb)WHO Quality of life BREF(WHOQOL-Bref)c)The subjective wellbeing inventory(SUBI)

Methodology

• 75 participant from Bardiya• 47 Male/28 Female• 41% farmer• Age mean 28.45• 16.5% hadn't attend any formal school• Interview time minimum 15min to maximum 1

hrs. /12 day

BECK DEPREESION INVENTAORY -II

• BDI-II based on DSM VI( APA) • 21 QUESTIONS• Scoring system consists minimal, mild,

moderate and severe

Beck depression results

minimal mild moderate severe0

5

10

15

20

25

30

9

16

28

22

BDI-II RESULT

• Twenty-nine percent (n=22) of the total participant was having significant severe depression level. Similarly, 38%(n=28) have moderate level, 21%(n=16) have mild and 12%(n=9) have minimal level of depression.

Evidence of post conflict Depression

• Political violence and mental health in Nepal prospective study( George Washington university)-30.9-40.6%( 2007)

• Studies from post-conflict South Sudan found rates of depression as high as 50%. Bayard, R., Eliaba, Y. Damundu, Olivia, L. & Egbert, S. Post-conflict mental health needs: Across-sectional survey of trauma, depression and associated factors in juba, South Sudan, BMC psychiatry 2009 vol. 9.

QUALITY OF LIFE ( QOL)

• WHO defines Quality of Life as individuals perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.

• It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships, personal beliefs and their relationship to salient features of their environment.

QOL all component mean

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 260.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

WHOQOLBRIF-Result

Physica

l

psychologic

also

cial

Enviroment

0

5

10

15

20

25

30

conflicted afeected personcontrol group

QOL RESULT

satisfaction of life satisfaction with health

0

0.5

1

1.5

2

2.5

3

3.5

4

control groupconflict affected group

Result discussion

1. Over half of participate met symptom criteria for depression, and among them 29 percent are 　suffering from severe kind of depression. The three high mean recorded items, were loss of pleasure, sadness, and crying. 2.This study provides important 　 evidence on the prevalence of post conflicts depression in Nepal. Further research is required to explore the findings and appropriate responses.

Results discussion

• Victims affected with conflicts had significant low QOL BREF scores and lower physical, psychological, social and environmental subdomain scores than the general population. This indicates that conflicted affect the all the human aspect of life.

Conference Gandhi’s sarvodaya and its socio-psychological aspect-The 6th European conference on Positive Psychology (ECPP2012), Moscow, Russia, June

Change in time perspective Resulting from psychotherapy-The 1st international conference of time perspective Coimbra ,Portugal September

Training/activities 1.Cognitive behavioral therapy (CBT) training from BECK INSTITUTE ,USA

2.Acceptance and commitment therapy from NOVENA MEDICAL CENTER,SINGAPORE

3.TSUJI ASIA FOUNDATION

ANNUAL RESEARCH BOOK

4.WORLD BOOK OF LOVE 100 researcher from 50 country editor Leo Bormans

5. Third World Congress on Positive Psychology being held June 27-30, 2013 in Los Angeles, California.6. 27th World Congress of the International Association for Suicide Prevention ,Norway

Thank you