Research Paper
Mourning our dead: The impact of Mexico’s war on drugs on citizens’ depressive symptoms

https://doi.org/10.1016/j.drugpo.2018.07.004Get rights and content

Abstract

Background

Research has shown the substantial impact on mental health for victims of drug-related crime in Mexico, especially individuals who have been heavily exposed to violence. However, the effect of drug-related violence in non-victims has been less studied because causal pathways via indirect violence are more ambiguous. We argue that drug-related violence does have an influence on the mental health of non-victims: For example, because of how violence is publicized by criminal groups, including their use of gruesome killing methods in executions, or via news about government confrontations with these criminal groups.

Methods

We estimate linear models of the effect of drug-related violence (CIDE-PPD database) on depression symptoms (MxFLS 2009–2012). We use lagged violence variables to match the time when individuals’ depression symptoms were reported, using different proxies of violence.

Findings

Our findings suggest a negative effect of drug-related violence on the mental health of individuals, specifically in relation to communication used by criminal groups (narcomessages), the brutality of executions, and the confrontations between government forces (specifically local police) and criminal groups.

Conclusions

Our findings suggest that the general population is a direct victim of the psychological violence imposed by the use of narcomessages. This additional effect of the war on drugs should be considered when deciding how to address the psychological effects of drug-related violence. The government should provide safer public spaces to improve perceptions about security, and more mental health services in communities that are most affected by organized crime violence. Mental health is also affected when police forces fight criminal groups. These findings corroborate the crisis of local institutions, the low confidence citizens have in police, and/or the infiltration of organized crime in local police corps. Mexico requires police reform, not only to avoid the involvement of the military in public security operations, but also to avoid social and psychological damage produced by weak police forces fighting organized crime.

Introduction

Research has found that the impact on mental health of victims of drug-related crime in Mexico is substantial and long-lasting, especially in those who have been heavily exposed to violence (Feinstein, 2012; Flores, Reyes, & Reidl, 2014; Leiner et al., 2012; Lusk & McCallister, 2013). However, the effect of drug-related violence on the mental health of non-victims has been less studied and more contested because causal pathways via indirect violence are more uncertain. The literature on crime shows that the mental health of non-victims is influenced by vicarious exposure to violence (witnessing and hearing about it), fear, and the victimization of individuals’ close acquaintances (Brück & Müller, 2010; Clark et al., 2008; Dustmann & Fasani, 2014; Lopes et al., 2015; Paula et al., 2008; Scarpa, Hurley, Shumate, & Haden, 2006).

We build on these findings to analyze the effect that drug-related violence has on the mental health of non-victims, using data for Mexico. Our empirical strategy tests several hypotheses. First, we posit that, once we control for sociodemographic variables and municipal characteristics, drug-related violence at the municipal level influences the mental health of the population (not necessarily direct victims). Moreover, when the executions include gruesome methods of killing or narcomessages, the effect is greater. We also claim that media coverage of violent events, active advertising of the murders by criminal organizations, and the direct victimization of individuals’ relatives and acquaintances, work as stress transmission channels for non-victims. Finally, we propose that the effect of violent events on the population’s mental health differs depending on the party involved and the type of government intervention: whether it is a consequence of clashes between or within criminal groups, or of confrontations between different government organizations and criminal groups.

To measure mental health, we use a depression index constructed with information from the Emotional Wellbeing section of the Mexican Family Life Survey (MxFLS). The MxFLS is a longitudinal survey that is representative of the Mexican population with information on 35,600 individuals (Rubalcava & Teruel, 2013). Drug-related variables are gathered from the CIDE-PPD Dataset for the years in which drug-related violence peaked in the country, including the confrontations of different governmental forces with criminal groups and executions committed by criminals. The Dataset comprises detailed information such as the techniques used for executing victims, communication techniques used by criminals to promote their violent actions, and the number of detainees and those injured in confrontations. A detailed description of the CIDE-PPD Dataset is described below.

Our quantitative analysis suggests that at population level, depressive symptoms are not affected when executions increase in the municipality, however, the effect is positive and significant when narcomessages are used by criminal groups to publicize their violent actions, and when criminals use gruesome killing methods. If the aim of ‘leaving a message’ is to generate fear, the general population, although not a direct victim of murder, becomes a direct victim of psychological violence. Governmental interventions to fight organized crime also have negative effects on mental health, specifically when local or state police forces participate in confrontation. Different proxies are used to measure the interaction between governmental forces and criminal groups, including number of detainees, the injured and killed, and the number of confrontations. Finally, our findings suggest that individuals who were previously victimized (or someone in their household) are more likely to develop depressive symptoms when confrontations occur in their municipality.

These findings have some important implications for policy. First, the effects of violence on mental health are heterogeneous depending on who the perpetrators of this violence are. For instance, when the government participates in violent events, the effect on mental health is negative, specifically when it is local or state police forces who are involved in the confrontation. As they are the closest forces to the community, these results are worrisome and could be a consequence of corruption at local level and illustrative of a lack of confidence the citizens have in their police (UVM, 2017). Second, the public discourse claiming that it is only direct victims of organized crime who are affected by the current violence in Mexico is no longer valid. If the general population is affected by the practice of leaving narcomessages, by knowing about the gruesome techniques used to kill people, by knowing someone who was victimized by organized crime, or by the fact that the government confronts criminal groups, the war on drugs is a strategy that is causing damage to citizens who are not directly involved in the conflict. These non-direct victims should be identified, and mental health services should be provided in the most affected communities.

This paper makes various contributions to the literature. First, the empirical strategy combines, for the first time, high-quality longitudinal survey data with administrative information about the “war on drugs” in Mexico, which was not available before the publication of the CIDE-PPD Dataset. Second, drug-related violence is not only measured by homicide rates, but by variables that could have different effects on mental health outcomes. Finally, this article explores a different cost of the war on drugs by considering the mental health of the population, and it highlights the policy implications regarding the consequences of the increasing violence in Mexico.

Section snippets

A review of the literature

The direct impacts of personal victimization on victims’ mental health have been the focus of several studies in which direct victimization always leads to mental health sequelae. These studies are summarized in Table 1.1

In contrast, the effect that violence has

Description of the data

To test our hypotheses, we use two different data sets. First, mental health variables and individuals’ sociodemographic characteristics are gathered from the Mexican and Family Life Survey (MxFLS). Second, proxies of drug-related violence are obtained from the CIDE-PPD Dataset. Both sources of data are described below.

Analysis

Table 3 shows the results of the linear regressions using different measures of drug-related violence. Column A uses as proxies, the rate of executions per 100,000 inhabitants and the number of confrontations in the municipality; Column B incorporates the rate of executions and the number of confrontations covered by the press; Column C adds the rate of executions with rope marks and bindings; and column D includes the number of executions with narcomessages left next to the bodies. In all

Discussion

In this article, we argue that drug-related violence influences the mental health of the general population and we test several hypotheses that might explain this outcome. First, we hypothesize that individuals are affected by executions conducted with brutality. Moreover, population is affected specifically when executions are publicized either by the perpetrators (leaving messages next to the executed bodies) or by the press. Second, we posit that the way violence affects the population is

Declarations of interest

None.

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