Adoecimento mental das pessoas vítimas da instabilidade do solo nos bairros afetados pela extração de sal-gema, em Maceió, Alagoas

Abstract

In Maceió, Alagoas, Brazil, in 2018, fractures appeared in the soil and buildings in the neighborhoods of Pinheiro, Mutange, and Bebedouro. Geological studies indicated destabilization of cavities from salt-gem extraction, and due to the imminent risk of ground subsidence, authorities began the process of relocating residents from the risk areas. The impacts of socio-environmental disasters can manifest through an increase or worsening of mental disorders, displacement, property loss, and limited or impaired access to health services. The study aimed to identify the presence of common mental disorders in individuals affected by ground instability in the neighborhoods of Pinheiro, Mutange, and Bebedouro. This mixed quantitative-qualitative study involved 158 former residents of these areas, recruited through snowball sampling, social media links on Instagram©, invitations, and an online questionnaire available on Questionpro©, after approval by the Ethics Committee of the Federal University of Alagoas. The tools used included: 1) a sociodemographic and health data questionnaire, 2) the Center for Epidemiologic Studies Depression Scale, 3) the Beck Anxiety Scale, and 4) the Self Report Questionnaire for common mental disorders at the primary care level. The analysis was conducted in two parts: 1) mental illness and its relation to the relocation of individuals affected by ground instability in the neighborhoods impacted by salt-gem extraction, and 2) the feelings of former residents regarding the losses they experienced due to the ground subsidence in their former neighborhoods. The first part analyzed absolute and percentage frequencies, mean, standard deviation, minimum, median, and maximum using McNemar’s test, gross prevalence ratios by Poisson regression model with robust variance, and 5% significance. The second part was guided by an open-ended question from the questionnaire, with data analyzed using Iramuteq software.Most participants were adults, female, black/brown, with a high level of education, and reported worsened monthly income, physical health, mental health, and perception of life after relocation. There was an increase in demand for psychological/psychiatric support and presence of suicidal ideation. The majority (87.34%) were at risk for depression, moderate and severe anxiety (55.70%), and screening positive for common mental disorders (77.22%). After relocation, those with higher psychiatric demands and suicidal ideation showed a higher prevalence of depression, severe anxiety symptoms, and positive screening for common mental disorders. The hierarchical descending classification analysis generated four semantic classes. Class 1 is associated with Class 2. Class 4 is associated with Classes 1 and 2. Class 3 is associated with Classes 1, 2, and 3. A higher frequency of common mental disorders was identified in Class 3 (34.4%), followed by Class 1 (27.43%), Class 4 (21.9%), and Class 2 (16.4%).Class 1 contained words describing the relocation of residences such as: live, still, pay, feel, neighborhood. Class 2 included words related to the company and the damage caused by it such as: life, company, cursed, Braskem, destroy. Class 4 featured words related to positive experiences in their residences such as: everything, home, good, friend, nostalgia, memory. Class 3 was associated with feelings and emotions experienced by former residents.In Brazil, environmental disasters resulting from natural resource exploitation highlight the need for stricter regulation and monitoring of companies, as well as increased societal engagement to prevent and mitigate negative impacts on the population, including the physical and mental health needs of these former residents, alongside the commitment associated with their forced eviction.