PLoS ONE
Volume 10, Issue 4, 2015

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) (Article) (Open Access)

Tay A.K. , Rees S. , Chen J. , Kareth M. , Lahe S. , Kitau R. , David K. , Sonoling J. , Silove D.
  • a Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia, South Western Sydney Clinical School, Liverpool Hospital, University of New South Wales, Sydney, NSW, Australia
  • b Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
  • c South Western Sydney Clinical School, Liverpool Hospital, University of New South Wales, Sydney, NSW, Australia, Simpson Centre for Health Services Research, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
  • d Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
  • e Division of Public Health, School of Medicine and Health Sciences, University of Papua New Guinea (UPNG), Port Moresby, Papua New Guinea
  • f Division of Public Health, School of Medicine and Health Sciences, University of Papua New Guinea (UPNG), Port Moresby, Papua New Guinea
  • g Port Moresby General Hospital, School of Medicine and Health Sciences, University of Papua New Guinea (UPNG), Port Moresby, Papua New Guinea
  • h Port Moresby General Hospital, School of Medicine and Health Sciences, University of Papua New Guinea (UPNG), Port Moresby, Papua New Guinea
  • i Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia

Abstract

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 doseresponse 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. © 2015 Tay et al.

Author Keywords

[No Keywords available]

Index Keywords

vocational education emergency medicine social psychology refugee mental health service bereavement Australia conflict mental health human risk assessment Refugees comorbidity middle aged psychosis Stress, Psychological mental stress mental function assessment controlled study Anxiety Disorders panic Young Adult cross-sectional study Humans Adolescent male female intermittent explosive disorder risk factor substance use prevalence Papuan people Article Papua New Guinea functional disease major clinical study emergency care adult separation anxiety health care access posttraumatic stress disorder generalized anxiety disorder Stress Disorders, Post-Traumatic world health organization illicit drug Conflict (Psychology) psychotrauma major depression medical care citizenship somatization
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84928811557&doi=10.1371%2fjournal.pone.0125178&partnerID=40&md5=4c9c42d1e906e6374e23fb532e3c7bc0
DOI: 10.1371/journal.pone.0125178
ISSN: 19326203
Cited by: 14
Original Language: English