Household roles, poverty and psychological distress in internally displaced persons affected by violent conflicts in Indonesia

Background Some of the possible reasons for deteriorating mental health among forced migrants have been identified as poverty, traumatic experiences before migration and postmigration negative life events. Previous studies suggest that the prevalence of psychological distress of forced migrants is higher among women than men. However, there is a lack of studies of internally displaced persons (IDP) that assess the relationship between psychological distress and selected variables in low income countries. Objectives This study aims to assess the association between poverty, household roles and psychological distress among IDP in Ambon, Indonesia, and to identify different risk factors of psychological distress across household roles. Methods In a cross-sectional study carried out in Ambon from July to September 2005, 460 adults were recruited from 200 households in 10 camp locations on Ambon Island. The Hopkins Symptom Check List-25 was used as a dichotomous variable (‘‘case’’ score ‡ 1.75) to measure psychological distress, and questionnaires were used to measure socioeconomic level, trauma experiences related to conflict and current health conditions. Data were collected through faceto- face structured interviews. Results The overall prevalence of psychological distress was 47%. Prevalence was highest among women, regardless of their household roles (55%), and lowest among men (37%). Different risk factors for psychological distress were identified for each household role. Poverty-related risk factors were only significant among ‘‘mothers’’. An important risk factor for ‘‘fathers’’ was long-term illness (lasting more than three months), and for ‘‘mothers’’ was witnessed murder. Conclusion Different risk factors were identified for each household role of IDP, indicating that their mental health care requirements may be different