title: War experiences, general functioning and barriers to care among former child soldiers in Northern Uganda: the WAYS study.
abstract: BACKGROUND
  Exposure to war is associated with considerable risks for long-term mental health problems (MHP) and poor functioning. Yet little is known about functioning and mental health service (MHS) use among former child soldiers (FCS). We assessed whether different categories of war experiences predict functioning and perceived need for, sources of and barriers to MHS among FCS.
  
  
  METHODS
  Data were drawn from an on-going War-affected Youths (WAYS) cohort study of FCS in Uganda. Participants completed questionnaires about war experiences, functioning and perceived need for, sources of and barriers to MHS. Regression analyses and parametric tests were used to assess between-group differences.
  
  
  RESULTS
  Deaths, material losses, threat to loved ones and sexual abuse significantly predicted poor functioning. FCS who received MHS function better than those who did not. Females reported more emotional and behavioural problems and needed MHS more than males. FCS who function poorly indicated more barriers to MHS than those who function well. Stigma, fear of family break-up and lack of health workers were identified as barriers to MHS.
  
  
  CONCLUSIONS
  Various war experiences affect functioning differently. A significant need for MHS exists amidst barriers to MHS. Nevertheless, FCS are interested in receiving MHS and believe it would benefit them.
authors.affiliation: Department of Psychology, Gulu University, PO Box 166, Gulu, Uganda Department of Psychiatry, University of Cambridge, Cambridge, UK Department of Psychiatry and Mental Health, Gulu University, PO Box 166, Gulu, Uganda.
authors.forename: Kennedy
authors.initials: K
authors.lastname: Amone-P'Olak
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Jones
authors.affiliation: MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Meiser-Stedman
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, UK.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Abbott
authors.affiliation: Save the Children International, PO Box 10414, Dar Es Salaam, Tanzania.
authors.forename: Paul Stephen
authors.initials: PS
authors.lastname: Ayella-Ataro
authors.affiliation: Department of Clinical and Curative Services, Ministry of Health, PO Box 7272, Kampala, Uganda.
authors.forename: Jackson
authors.initials: J
authors.lastname: Amone
authors.affiliation: Department of Psychiatry and Mental Health, Gulu University, PO Box 166, Gulu, Uganda.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ovuga
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D003130:Combat Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D003415:Crime / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D008605:Mental Health Services; D008889:Military Personnel / Q000523:psychology*; D011581:Psychological Tests; D012044:Regression Analysis; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology; D014857:Warfare; D055815:Young Adult
keywords: Northern Uganda; care; mental health problems; war-affected population