Culturally Appropriate Mental Health Care for Somali Immigrants and Refugees

In Somali culture, mental illness is the result of disordered social or spiritual relationships rather than individual mental problems (2). The cure is often specific readings from the Qur’an, or other rituals performed by a religious leader (2;3;6). Mental illness is often dealt with within strong social networks of family and friends, but it is highly stigmatized and rarely discussed openly (1;6;7). As a result, Somali immigrants and refugees usually only turn to formal mental health services as a last resort. While these are general trends, it is important to consider an individual’s relationship to the cultural conceptions of mental health, as well as the role of their cultural identity more broadly (8). In addition, it is important to address post-migration stressors rather than only pre-migration because post-migratory experiences are stronger predictors of mental distress (1;9). To provide adequate services to Somali immigrants and refugees, providers must find common ground with clients on the meaning of mental illness, and validate traditional methods of treatment (1). School-based services may be more acceptable for youth because of lower stigma in this setting, and their changing perspectives on mental health in the acculturation process (5;9).

A Community-Based Participatory Research model was used in multiple studies, and it facilitated not only data collection, but further engagement with the local Somali communities (10;3;5). There were some quantitative or mixed methods studies. However, most were qualitative studies based on a mixture of interviews and focus groups. Some studies focused on Somalis in Europe, or refugees more generally but their information lined up with results from U.S.-based studies (1;2;6;10). One study was a review of studies on mental health for refugees, but the rest were original research.

Acculturation may affect the perceptions of mental health among Somali youth, but more research is necessary. Somali youth still displayed strong ties to their culture, but there is also evidence that their perceptions of mental health are different than that of their parents (5). Multiple sources addressed the importance of family as a source of support, but Somali adolescence also expressed unwillingness to talk to their parents about issues because their parents wouldn’t understand (5;6;7). Therefore, while there is significant literature on Somali conceptions of mental health, the literature is less settled on how this culture influences Somali youth in the U.S. However, the literature does seem to agree that school based mental health services are the best option for serving Somali youth (5;6;7).