Inequalities in mental health between post-conflict recovery and pandemic-induced challenges in conflict-affected territories in Colombia

After the landmark 2016 peace agreement in Colombia, significant strides were made to reduce inequalities in mental health. However, a development paradox arises when considering the contrasting dynamics introduced by the COVID-19 pandemic. This study explores the balance of progress and setbacks in conflict-affected territories, with a specific focus on examining the exacerbation of mental health disparities amid the COVID-19 pandemic. Data from the Conflicto, Paz y Salud (CONPAS) survey, encompassing 865 households over 2019-2020, are utilized to explore and analyze the presence of inequalities in mental health. Through the integration of the SelfReport Questionnaire (SRQ-20), the Household Wealth Index (HWI), and the Oaxaca-Blinder change decomposition method, the research highlights the socioeconomic shifts impacting these trajectories. The analysis reveals a stark development paradox. While Colombia was advancing in its recovery and general mental health was improving, the disruptions of the pandemic intensified mental health disparities. This contrast is evidenced by a notable shift in the mental health concentration index from -0.067 in 2019 to -0.130 in 2020 is observed, indicating that vulnerable groups, especially women, residents of territories highly affected by the armed conflict, and those with educational disadvantages, bore the brunt of these challenges. In the context of the broader development discourse, this study contributes to the existing frame of research by providing a nuanced analysis between "post-conflict" recovery and the unforeseen impacts of global crises on mental health. This work complements previous studies on mental health and the Sustainable Development Goals (SDGs) by offering a detailed examination of the socioeconomic factors that exacerbate mental health disparities in the wake of the COVID-19 pandemic. It particularly focuses on areas affected by armed-conflicts in lower- and middle-income countries and provides an explanation of how this situation affects the scope of the SDGs.