Study: Somalis ‘very traumatized’ after years of conflict

Study: Somalis 'very Traumatized' After Years Of Conflict
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WASHINGTON – People in Somalia are deeply traumatized by political instability, prolonged violence and a humanitarian crisis, according to a new health study.

The joint study by the United Nations, Somalia’s Ministry of Health and the country’s national university found that mental disorder is widespread across the country. It said the cases are about 77 percent higher than a previous study by the World Health Organization (WHO), which suggested that nearly 40% of the population in Somalia had a mental or psychological disorder.

The study further said that the prevalence of mental disorders among young people is significantly higher than previously reported.

“There is a high prevalence and wide range of different mental disorders (76.9%), substance use disorders (lifetime, 53.3%; current, 50.6%) and poor quality of life in both non-clinical and clinical populations,” the study said.

The study obtained by VOA Somali Service was conducted between October 25 and November 15, 2021. The data was collected from 713 participants in the cities of Baidoa, Kismayo and Dolow. The majority of participants (68.1%) were younger than 35 years and 58.5% were male.

All three cities host internally displaced people who have been affected by conflict and drought that forced pastoral communities to migrate to urban locations in search of food, water and security.

“Conflicts and clashes have led to mental illness because we are facing many of these challenges in our country,” a young person in Kismayo who was interviewed for the study told the researchers. “For example, explosions happen, and the witness can live with the shock and trauma which can affect their state of mind and even cause mental illness. Stress caused by unemployment also leads to mental health problems.”

The study is a collaboration between the WHO, the United Nations Peacebuilding Fund, the United Nations Children’s Fund (UNICEF), the International Organization for Migration (IOM), the Federal Ministry of Health and the Somali National University (SNU).

According to the WHO, which led the research, this is the first ever epidemiological study on mental health in Somalia.

“The study clearly shows that the prevalence of mental disorders is higher in the younger population than we initially thought or assumed through various estimates,” said Dr. Mamunur Rahman Malik, WHO Country Representative.

“Our previous WHO study suggested that only 40% of the population in Somalia may have a mental or psychological disorder. But what we have seen now is 76%, which is a high prevalence,” Malik told VOA.

Somalia’s Minister of Health Dr. Ali Haji Adam agrees that the mental health situation among the population is “very bad”.

“There have been armed conflicts, poverty, fear, instability and unemployment for a long time; this causes mental wounds,” Adam said. “They cannot handle what is happening in front of them; mothers and children are killed in front of them and it damages their mental health.”

Malik said a troubling finding is that the most common mental illness among this population is panic disorder and post-traumatic stress disorder.

“Panic disorder, 39%, and post-traumatic disorder at 37%. And this is among the young age group,” Malik said.

He said that if left untreated, this can lead to suicidal tendencies. He said in previous estimates that the WHO saw the suicide rate among the young population of Somalia as one of the highest in the world, 14 to 15 per 100,000 inhabitants. This new study shows that the risk of committing suicide among young people in Somalia is 22 per 100,000.

The authors of the study said this is surprising for a society where Islam is the dominant religion and where teaching forbids suicide. They urged physicians to counsel their patients about suicidal thoughts during evaluation, regardless of religious beliefs or practices.

Drug abuse

The second finding of the study is the high prevalence of addiction among the young population.

Adam said the younger generation most affected by mental illness are turning to substance abuse.

“A young person with an ambition and a future when they can’t realize their ambition and ambition, can’t find a job they face mental pressure,” Adam told VOA. “They are likely to turn to drug abuse.”

Malik agrees that the hopeless situation and the lack of adequate access to mental health facilities drives the mentally ill to abuse illicit substances.

“These are coping mechanisms, but this is self-destruction, that’s the most worrying factor for me,” he said.

The most common substance used was tobacco, 38%, followed by sedatives which are 37%, and these are not regulated in the country, Malik said.

He said Somalia is the only country that has not ratified the WHO Global Convention on Tobacco Control. He called on the Somali government to ratify and commit to controlling drug abuse of tobacco and sedatives.

“We are actually at risk of losing an entire generation because these young people have no hope for the future and they make up 70% of the people in this country,” Malik said. “Instead of using them as human assets, we risk losing them because there is a high burden of mental health and addiction, and this makes them non-productive and they become a huge economic burden.”

The increased mental illnesses can be seen at mental health services.

Dr. Liban Mohamed Omar opened a mental health clinic eight months ago after returning from Europe. He says his outpatient clinic and psychiatric center sees dozens of patients each week.

“Of the patients I see, two to three out of four people have mental health problems,” Omar told VOA.

In addition to the political and social upheavals in the country, women face specific challenges that worsen their mental health situation.

“Women meet many [cases of] abuse, like rape, Omar said.

Omar cited a lack of awareness and a lack of qualified mental health workers and services that forces many to resort to substance abuse and even consider ending their lives.

Peace building

The researchers see improving mental health as an integral part of peacebuilding in Somalia, a country wracked by civil strife since the collapse of the state in 1991.

Malik said that in conflict-affected countries, the burden of mental health is high.

“These young people who were carrying a huge mental health burden can be an easy target for radical forces because these are disillusioned youth,” Malik said.

“Our assumption is that if these people can be socially integrated after addressing their mental health condition, social cohesion and reconciliation in the community can increase and it can lead to peace building in a way that these mentally ill youth may not be targets for radical forces so that they can contribute to society.”

Malik said only 5 to 10 percent of primary health centers in Somalia are currently able to offer mental health services, far less than what is needed.

“The total number of mental health professionals in Somalia is 82 in a population of over 15 million,” Malik said. “And if you compare that in terms of mental health staff, per 100,000 population it’s less than one. So the future is in investing in mental health services at the primary care level.

The study recommended training of frontline healthcare workers, increased awareness and routine screening of mental disorders at the primary care level.