Mental disorders among Somali refugees: developing culturally appropriate measures and assessing socio-cultural risk factors

Soc Psychiatry Psychiatr Epidemiol. 2006 May;41(5):400-8. doi: 10.1007/s00127-006-0043-5. Epub 2006 Mar 6.

Abstract

Background: There are few mental health data for Somali people. This is due to the absence of culturally validated appropriate assessment instruments and methodological challenges. We aimed to develop a culturally appropriate instrument, and address the methodological challenges and assess some risk factors for mental disorder among Somalis in London.

Methods: Following a comprehensive process of cultural adaptation of the MINI Neuropsychiatric Interview, we assessed ICD-10 mental disorders among 143 Somalis recruited from GP registers and community sites. Associations with demographic and economic characteristics, sampling venues, cultural and migration related risk factors are reported.

Results: A higher risk of mental disorders was found among Somalis who used Khat (OR = 10.5, 1.1-98.3) claimed asylum at entry to the UK (OR = 12.8, 2-81.4) and recruits from primary care rather than from community sites (OR = 5.9, 1.4-25.8). A lower risk of mental disorders was found amongst Somalis in employment (OR = 0.03, 0.01-0.61), and those receiving education in the UK and in Somalia (OR = 0.13, 0.02-0.92). Over a third of subjects had any mental disorder (36.4%, 28.4-44.4), mainly common mental disorders (CMD) (33.8%, 26-41.5) and post-traumatic stress disorder (PTSD) (14%, 8.8-20.8). CMD were found among 80% of those with PTSD.

Conclusion: Public health interventions for Somalis should focus on CMD as well as PTSD, khat use and mental health screening for suicide risk and mental disorders on arrival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Catchment Area, Health
  • Community Mental Health Services / statistics & numerical data
  • Culture*
  • Demography
  • Female
  • Humans
  • International Classification of Diseases
  • London / epidemiology
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / ethnology*
  • Mental Disorders / therapy
  • Prevalence
  • Psychology
  • Refugees / psychology*
  • Refugees / statistics & numerical data
  • Registries
  • Risk Factors
  • Severity of Illness Index
  • Somalia / ethnology