The state of mind of internally displaced persons in South Sudan: a study of mental health in Malakal

Purpose South Sudan experienced a major humanitarian crisis following the outbreak of civil war in 2013, resulting in the internal displacement of millions of people. A research study was designed with the aim to explore the psychiatric morbidity patterns in a post-emergency setting. Design/methodology/approach In stage one of a two-stage descriptive study, 2,100 individuals were approached, of whom 1,985 were screened for psychological distress using the WHO-SRQ 20, using a cut-off score of 5 and above. Participants who screened positive proceeded to Stage 2 and completed the Composite International Diagnostic Interview (CIDI), to measure psychiatric disorders. All selected participants were also administered the IES-R self-report scale to assess post-traumatic stress symptoms caused by traumatic events, a Brief Disability Questionnaire (BDQ) and the Alcohol Use Disorders Identification Test (AUDIT). Findings Overall, 49.8% of participants screened positive for psychological distress on the SRQ-20. Among the 988 participants who screened positive, 54.8% met CIDI criteria for depression, 40.6% for anxiety, and 33.4% for somatisation, while 29.8% met the specified IES-R threshold for PTSD symptoms. Probable alcohol dependence was identified in 17.2% of Stage 2 participants. In adjusted analyses, women had lower odds of probable alcohol dependence than men (OR = 0.15, 95% CI 0.10–0.23), while Nuer (OR = 2.87, 95% CI 1.34–6.12) and Shilluk participants (OR = 4.48, 95% CI 2.50–8.02) had higher odds than Dinka participants. The mean BDQ disability score was 6.20 (SD = 4.94), with higher adjusted disability scores observed among older participants, particularly those in the oldest age category (B = 5.30, 95% CI 4.07–6.54; ß = 0.28). Originality/value The internally displaced persons’ unmet mental health conditions highlight the importance of early identification and access to appropriate mental health support.