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Abstract
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OBJECTIVE: To investigate the associations of war and post-conflict factors with mental health among Sierra Leone's former child soldiers as adults.
METHOD: In 2002, we recruited former child soldiers from lists of soldiers (aged 10-17) served by Disarmament, Demobilization, Reintegration centers and from a random door-to-door sample in five districts of Sierra Leone. In 2004, self-reintegrated child soldiers were recruited in an additional district. At 2016/17, 323 of the sample of 491 former child soldiers were reassessed. Subjects reported on war exposures and post-conflict stigma, family support, community support, anxiety/depression, and post-traumatic stress symptoms.
RESULTS: 72% of subjects were male; mean age, 28. 26% reported killing or injuring others; 67% reported being victims of life-threatening violence; 45% of female, 5% of male subjects, reported being raped; 32% reported death of a parent. In 2016/17 (Wave 4), 47% exceeded the threshold for anxiety/depression; 28% exceeded the likely post-traumatic stress disorder threshold. Latent class growth analysis yielded three trajectory groups based on changes in stigma and family/community acceptance; "Improving Social Integration" (n = 77) fared nearly as well as the "Socially Protected" (n = 213). The "Socially Vulnerable" group (n = 33) had increased risk of anxiety/depression above the clinical threshold and possible PTSD and were around three times more likely to attempt suicide.
CONCLUSION: Former child soldiers had elevated rates of mental health problems. Post-conflict risk and protective factors related to outcomes long after the end of conflict. Targeted social inclusion interventions could benefit long-term mental health of former child soldiers.
Copyright © 2019. Published by Elsevier Inc.
Language: en |