Somali Conceptions and Expectations Concerning Mental Health: Some guidelines for mental health professionals

The Somali population in New Zealand is a rapidly growing one that should be of interest to mental health professionals due to their experience of resettlement stressors and the refugee histories of many Somali. Many factors contribute to barriers and difficulties between mental health professionals and Somali clientele. We present here some of the cultural and religious issues influencing Somali conceptions and expectations about mental health services in an attempt to reduce barriers and difficulties. While Somali views are diverse, many view "mental illness" as only encompassing the most severe and possibly untreatable cases. Few Somali see warrelated trauma as a direct cause of their problems but instead cite preoccupation with reunifying their families or other resettlement stressors as direct causes. We outline some traditional treatments, especially the common use of Koran readings for dealing with both physical and mental health problems. Somatization of problems leads to a heavy reliance on General Practitioners. Complications with specialist referrals and inadequate cultural skills and knowledge of professionals aggravate adequate treatment with this population. Problems with translation and miscommunication are very common. We recommend that health professionals spend more time finding out about clients' family and community relationships, carefully explaining diagnoses and treatments, and listening to, incorporating, and facilitating Somali views on mental health issues and traditional treatments.