Mental disorders among Somali refugees
- 1.8k Downloads
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.
KeywordsSomali refugees cultural adaptation psychiatric instruments
This study was funded by London Region NHS R&D Project reference no: RCC01924
- 1.UNHCR (2005) http://www.unhcr
- 13.Health of Londoners Project (1999) Refugee health in London: key issues in public health. Director of Public Health. ELCHA. Aneurin Bevan House. 81–91 Commercial Rd. London E1Google Scholar
- 15.HEA (1998) Health and lifestyles: black and minority ethnic groups in England. Health Education Authority, LondonGoogle Scholar
- 18.Scobie S, Basnett I, McCartney P (1995) Can general practice data be used for needs assessment and health care planning in an inner-London district? Public Health Med 17(4):475–83Google Scholar
- 19.Warfa N, Bhui K, Craig T, et al. (2005) Somalis mental health and mobility in two areas of London: a qualitative study. (Under review: requested revision submitted to Health & Place)Google Scholar
- 20.Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC (1998) The mini-international neuro-mental interview (MINI): the development and validation of a structured diagnostic mental interview For DSM-IV and ICD-10. J Clin Psychiatry 59(Suppl 20):22–33PubMedGoogle Scholar
- 23.Knudsen HC, Vazquez-Barquero JL, Welcher B, Gaite L, Becker T, Chisholm D, Ruggeri M, Schene AH, Thornicroft G (2000) Translation and cross-cultural adaptation of outcome measurements for schizophrenia. EPSILON Study 2. European Mental Services: inputs linked to outcome domains and needs. Br J Psychiatry Suppl(39):s8–s14CrossRefGoogle Scholar
- 26.Slade M, Thornicroft G (1999) Camberwell assessment of need. Gaskell Royal College of Psychiatrists, LondonGoogle Scholar
- 27.Bhui K (2001) Mental health needs assessment for ethnic and cultural minorities. In: Thornicroft G (ed) Measuring mental health needs. London: Gaskell, pp 420–434Google Scholar
- 28.Gandek B, Ware Je, Aaronson Nk, Apolone G, Bjorner Jb, Brazier Je, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M (1998) Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project International Quality of Life Assessment. J Clin Epidemiol 51(11):1171–1178CrossRefPubMedGoogle Scholar
- 29.de Jirolamo G, McFarlane AC (2003) The epidemiology of PTSD: a comprehensive review of the international literature. In: Marsella A, Friedman MJ, Gerrity ET, Scurfield RM (eds) Ethnocultural aspects of post-traumatic stress disorder. Washington: American Psychological Association, pp 33–86Google Scholar
- 30.Griffiths P (1998) Qat use in London: a study of qat use among a sample of Somalis living in London. Paper 26. Central Drug Preventions Unit, Home Office, LondonGoogle Scholar
- 34.Royal College of Psychiatrists (2002) Employment opportunities and mental disabilities. Council Report CR111. Royal College of Psychiatrists, LondonGoogle Scholar
- 35.Wilkinson G, Marmot M (2003) Social determinants of health. The solid facts. World Health Organisation, DenmarkGoogle Scholar