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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
UNHCR (2005) http://www.unhcr
Bhugra D (2004) Migration and mental health. Acta Psychiatrica Scandinavica. 109:243–258
Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Levelle J (1992) The Harvard trauma questionnaire: validating A cross-cultural instrument for measuring torture, trauma, and post-traumatic stress disorder in Indochinese refugees. J Nervous Mental Dis 180:111–116
Miller, et al (2002) The relative contribution of war experiences and exile-related stressors to levels of psychological distress among Bosnian refugees J Traumatic Stress 15(5):377–387
de Jong JT, Komproe IH, Van Ommeren M, El Masri M, Araya M, Khaled N, van De Put W, Somasundaram D (2001) Lifetime events and post-traumatic stress disorder in 4 postconflict settings. JAMA 286(5):555–562
de Jong JT, Komproe IH, Van Ommeren M (2003) Common mental disorders in postconflict settings. Lancet 361(9375): 2128–2130
Turner SW, Bowie C, Dunn G, Shapo L, Yule W (2003) Mental health of Kosovan Albanian refugees in the UK. Br J Psychiatry 182:444–448
Harrison H (2004) The Somali Community in the UK: what we know and how we know it. Information Centre about Asylum Seekers and Refugees in the UK.http://www.icar.org.uk/content/proj/prs.html
Spring M, Westermeyer J, Halcon L, et al. (2003) Sampling difficult to access refugee and immigrant communities J Nervous Mental Dis 191(12):813–819
Bhui K, Mohamud S, Warfa N, Craig T, Stansfeld S (2003) Cultural Adaptation of Mental Health Measures: improving the quality of clinical practice & research. Edit Br J Psychiatry 183:184–186
Jaranson M, Butcher J, Lacion L, et al. (2004) Somali and Oromo refugees: correlates of torture and trauma history. Am J Public Health 94(4):591–598
Bhui K, Abdi A, Abdi M, Pereira S, Dualeh M, Robertson D, Sathyamoorthy G, Ismail H (2003) Traumatic events, migration characteristics and mental symptoms among Somali refugees. Social Psychiatry Mental Epidemiol 38:35–43
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 E1
Hollifield M, Warner TD, Lian N, Krakow B, Jenkins JH, Kessler J, Stevenson Westermeyer J (2002) Measuring trauma and health status in refugees: a critical review JAMA 288(5):611–621
HEA (1998) Health and lifestyles: black and minority ethnic groups in England. Health Education Authority, London
Stewart R, Richards M (2002) Surveying older people from minority ethnic groups: an evaluation of a primary care sampling method for UK African-Caribbean elders. Int J Methods Psychiatr Res 11(4):178–83
Shaw CM, Creed F, Tomenson B, Riste L, Cruickshank JK (1999) Prevalence of anxiety and depressive illness and help seeking behaviour in African Caribbeans and white Europeans: two phase general population survey. BMJ 318(7179):302–305
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):475–83
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)
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):22–33
Lecrubier Y, Sheehan D, Weiller E, Amorin P, Bonora I, Sheehan K, Janavs J, Dunbar G (1997) The mini international neuromental interview (MINI) a short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry 12:224–231
Flaherty JA Gaviria FM, Pathak D, et al. (1988) Developing Instruments For Cross-Cultural Mental Research. J Nervous Mental Dis 176(5):257–263
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–s14
Edwards NC (1994) Translating written material for community health research and service delivery: guidelines to enhance the process. Can J Public Health 85(1):67–70
Ware J Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233
Slade M, Thornicroft G (1999) Camberwell assessment of need. Gaskell Royal College of Psychiatrists, London
Bhui K (2001) Mental health needs assessment for ethnic and cultural minorities. In: Thornicroft G (ed) Measuring mental health needs. London: Gaskell, pp 420–434
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):1171–1178
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 33–86
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, London
Odenwald M, Neuner F, Schauer M, Elbert T, et al. (2005) Khat use as a risk factor for psychotic disorders: a cross sectional and case-control study in Somalia. BMC Med 3:5 doi:10.1186/1741-7015-3-5
Carvalho F (2003) The toxicological potential of Khat. J Ethnopharmacol 87:1–2
Cox G, Rampes H (2003) Adverse effects of khat: a review. Adv Psychiatric Treatment 9:456–463
Royal College of Psychiatrists (2002) Employment opportunities and mental disabilities. Council Report CR111. Royal College of Psychiatrists, London
Wilkinson G, Marmot M (2003) Social determinants of health. The solid facts. World Health Organisation, Denmark
Summerfield D (2001) Asylum Seekers, refugees and mental health services in the UK. Psychiatric Bull 25:161–163
This study was funded by London Region NHS R&D Project reference no: RCC01924
About this article
Cite this article
Bhui, K., Craig, T., Mohamud, S. et al. Mental disorders among Somali refugees. Soc Psychiat Epidemiol 41, 400 (2006). https://doi.org/10.1007/s00127-006-0043-5