Adolescent Mental Health in Post-Conflict Communities: Results from a Cross-Sectional Survey in Northern Uganda

Abstract Background In response to the call for greater attention to mental health challenges among youth in low-income post-conflict communities, a mixed-methods cross sectional survey was carried out in Lira District, Uganda in Spring 2022. The political history of Lira District, the epicenter of the decades long conflict between the Lord’s Resistance Army (LRA) and the Ugandan government, makes for an especially interesting case study of the political and social determinants of mental health on those directly impacted by conflict, and on children growing up in post-conflict communities. Methods The study evaluated the mental health of adolescents (14–17 years of age), along with their knowledge, attitudes, and beliefs about mental health conditions and their access to critical mental health services. Cross-sectional surveys were administered on households, and adolescents living in the homes, schools, and health care facilities within six parishes located in the Lira District of northern Uganda. Results The study found 66% of adolescents indicated poor well-being and possible symptoms of depression and 41% of adolescents reported at least 4 childhood trauma events. Over 35% reported feeling extremely sad and 60% reported feeling socially isolated during the COVID lockdowns that lasted from 2020 to 2021. Nearly half of the adolescents aged 13–17 surveyed (N = 306) believed that witchcraft caused mental health problems, while less than 20% believed that traumatic experiences could be a cause. 40% of respondents had no idea of where to seek mental health care, and few facilities had mental health services available. Conclusions The study results indicate that adolescents throughout the Lira District in northern Uganda suffer from poor mental health, low access to mental health services, and persistent myths that lead to stigma related to mental health conditions. Moreover, the study results point to multiple social and political determinates of mental health outcomes, including those directly linked to past armed conflict in the area, and the need for community-informed analyses and interventions to adequately address the causes of poor mental health in northern Uganda and beyond.