Associations of Conflict-Related Trauma and Ongoing Stressors with the Mental Health and Functioning of West Papuan Refugees in Port Moresby, Papua New Guinea (PNG).

Journal: PloS one

Volume: 10

Issue: 4

Year of Publication: 2016

Affiliated Institutions:  Psychiatry Research and Teaching Unit, Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, Australia; South Western Sydney Clinical School, Liverpool Hospital, Faculty of Medicine, University of New South Wales, Sydney, Australia. Psychiatry Research and Teaching Unit, Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, Australia. South Western Sydney Clinical School, Liverpool Hospital, Faculty of Medicine, University of New South Wales, Sydney, Australia; Simpson Centre for Health Services Research, Faculty of Medicine, University of New South Wales, Sydney, Australia. Division of Public Health, School of Medicine and Health Sciences, University of Papua New Guinea (UPNG), Port Moresby, Papua New Guinea. Port Moresby General Hospital and School of Medicine and Health Sciences, University of Papua New Guinea (UPNG), Port Moresby, Papua New Guinea.

Abstract summary 

Documentation is limited in relation to the mental health of the people of West Papua, a territory that has been exposed to decades-long political persecution. We examined associations of traumatic events (TEs) and current stressors with mental disorder and functioning, amongst 230 West Papuan refugees residing in six settlements in Port Morseby, Papua New Guinea (PNG). We used culturally adapted modules to assess exposure to TEs and mental disorders. Current stressors and functioning were assessed using modifications of measures developed by the World Health Organization (WHO). 129 of 230 respondents (56%) reported exposure to at least one traumatic event (TE), including: political upheaval (36.5%), witnessing or hearing about family members tortured and murdered (33.9%), and not being able to access medical care for family members (33%). One fifth of respondents (47, 20.4%) experienced exposure to high levels of TEs (16 to 23). 211 (91.7%) endorsed at least one or more ongoing stressors, including: exposure to illicit substance use in the community (91.7%), problems with safety and the protection of women (89.6%), no access to legal rights and citizenship (88.3%), and lack of adequate shelter and facilities (85.2%). A quarter (26.9%) met criteria for one or more current mental disorder, and 69.1% reported functional impairment ranging from mild to extreme. Mental disorder was associated with being male (adjusted odds ratio=2.00; 95% CI=1.01-3.97), and exposure to the highest category of ongoing stressors (AOR=2.89; 95% CI=1.08-7.72). The TE count showed a dose-response pattern in its relationship with functional impairment, the greatest risk (AOR=11.47; 95% CI=2.11-62.37) being for those experiencing the highest level of TE exposure (16-23 events). West Papuans living in settlements in Port Moresby reported a range of TEs, ongoing stressors and associated mental disorders characteristic of populations exposed to mass conflict and persecution, prolonged displacement, and ongoing conditions of extreme hardship.

Authors & Co-authors:  Tay Alvin Kuowei AK Rees Susan S Chen Jack J Kareth Moses M Lahe Sylvester S Kitau Russell R David Kura K Sonoling Joyce J Silove Derrick D

Study Outcome 

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Statistics
Citations :  Rees, van de Pas R, Silove D, Kareth M. Health and human security in West Papua. Med J Aust. 2008;189(11–12):641–3.
Authors :  9
Identifiers
Doi : e0125178
SSN : 1932-6203
Study Population
Male,Women
Mesh Terms
Adolescent
Other Terms
Study Design
Study Approach
Country of Study
Guinea
Publication Country
United States