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

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 41; no. 5; pp. 400 - 408
• Main Authors: Bhui, Kamaldeep, Craig, Tom, Mohamud, Salaad, Warfa, Nasir, Stansfeld, Stephen A., Thornicroft, Graham, Curtis, Sarah, McCrone, Paul
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.05.2006; Springer Nature B.V
• Subjects: Adolescent; Adult; Biological and medical sciences; Catchment Area (Health); Community Mental Health Services - utilization; Culture; Demography; Female; Humans; International Classification of Diseases; London - epidemiology; Male; Medical sciences; Medical screening; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - ethnology; Mental Disorders - therapy; Mental health; Migration; Minority & ethnic groups; Oppression; Post traumatic stress disorder; Prevalence; Primary care; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Recruitment; Refugees; Refugees - psychology; Refugees - statistics & numerical data; Registries; Risk Factors; Severity of Illness Index; Somalia - ethnology; Techniques and methods; United Kingdom; Somali Republic; Europe; Africa; London; Somalia; United Kingdom > UK; Social environment; Human; Evaluation; Foreign language version; refugees; Mental health; Psychometrics; Refugee; adaptation; Revised drafting; Test reliability; Intertrial interval; Test validation; cultural; psychiatric; Interrater agreement; instruments; Cultural environment; Directive interview; Risk factor; Mental disorder; Somali; Public health
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-006-0043-5

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. 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. 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. 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.