Background: Somalia has been without an effective government since the collapse of the military regime in 1991. Years of conflict, disasters, and insecurity have all contributed to very low scores for most health indicators due to poor governance, protracted conflict, underdevelopment, economic decline, poverty, social and gender inequality, and environmental degradation. The three-decade long protracted conflict has led to widespread psychosocial trauma, social deprivation and substance abuse with devastating consequences on mental health. A WHO study showed Somalia has one of the highest rates of mental illness in the world. The main aim of this study is to assist policy makers in setting priorities for the design and delivery of interventions to promote mental health and psychosocial wellbeing in Somalia. Methods: The study uses a systematic mapping technique (from January 1991 to May 2020) and data collected from public domain, to collect, collate, and present mental health data mainly from WHO’s Global Health Observatory. Since there is no primary database for Somalia’s public health research, the bibliographic databases used for mental health in this study included Medline, PubMed, CINAHL, PsycINFO, and Google Scholar. Data were extracted using techniques for web data mining for public health. Results: Systematic mapping of mental health-related issues in Somalia showed that policy-related determinants and mental health services dominated (74.4%), followed by the disaster-related determinants and women’s health consequences (39.3%). The ratio of the number of beds for mental health in general hospitals (per 100,000 population) in Somalia in 2017 is 0.5 compared to the Eastern Mediterranean region (EMR) at 6.4 and globally at 24. One of the biggest casualties of the civil war was loss of essential human resources in healthcare as most either fled the country or were part of the victims of the war. Conclusions: The vast scale of the mental health problems in Somalia and the priority setting guidelines for interventions to address the issues outlined in this paper, prompt a dire need that the Somali government and its national/international partners should prioritize and emphasize the need to invest in the prevention and the treatment of mental illness across the country.

Background: Despite the longstanding psychosocial impact of the interactable conflict in Somalia for the last 30 years, there is lack of epidemiological studies of mental health conditions, especially at the population level.Objectives: The aim of this study is to fill the epidemiological gap and provide population based data on mental health conditions in the South-Central region of Somalia. The specific objectives were: (1) To determine the epidemiological patterns of mental disorders in three sites; Baidoa, Dolow and Kismayo, (2) Understand the socio-demographic characteristics associated with mental health conditions in the study sites, and (3) To assess the correlates between psychological trauma and the mental wellbeing of the population.Methods: This was a cross-sectional study of 713 respondents recruited from the three sites namely Dolow, Baidoa and Kismayo. Data on sociodemographic characteristics and mental disorders were collected using the MINI and sociodemographic questionnaire. Basic descriptive statistics were used to summarize sociodemographic characteristics. Univariable and multivariable logistic regressions were used to examine factors associated with common mental disorders. Statistical significance was considered at a value of p <0.05.Results: Participants’ mean age was 32.6 (±10.7) years. More than half (58.5%) of the respondents were male. The overall prevalence of common mental disorders was 557 (78.1%) with panic disorder (39.3%), generalized anxiety disorders (34.9%), major depressive episode current (32.1) and PTSD (29.9%). According to the multivariable logistic regression analysis, being male AOR = 1.74 (95%CI = 1.25, 2.42), having a family size of more than 10 members AOR =1.37 (95% CI = 1.00, 1.89), being unemployed AOR = 1.90 (95%CI = 1.18, 3.06), experienced starvation AOR =3.46 (95%CI = 2.23, 5.37), khat use AOR = 5.87 (955 CI, 1.75–19.65), were identified as predicting factors for the common mental disorders among the study participants.Conclusion: There is a high prevalence of mental disorders with anxiety disorders being the commonest. Findings reflect earlier studies that showed higher rates in conflict and post-conflict settings. It also aligns with past studies in Somalia. As such, there is an urgent need to integrate mental health and psychosocial support within the primary healthcare and other service sectors such as education considering the vast majority of the population are young.

Background: The increase of mental health issues globally has been well documented and now reflected in the United Nations' Sustainable Development Goals as a matter of global health significance. At the same time, studies show the mental health situations in conflict and post-conflict settings much higher than the rest of the world, lack the financial, health services and human resource capacity to address the challenges.Methods: The study used a descriptive literature review and collected data from public domain, mostly mental health data from WHO's Global Health Observatory. Since there is no primary database for Somalia's public health research, the bibliographic databases used for mental health in this study included Medline, PubMed, CINAHL, PsycINFO, and Google Scholar.Results: The review of the mental health literature shows one of the biggest casualties of the civil war was loss of essential human resources in healthcare as most either fled the country or were part of the victims of the war.Conclusion: In an attempt to address the human resource gap, there are calls to task-shift so that available human resource can be utilized efficiently and effectively. This policy paper discusses the case of Somalia, the impact of decade-long civil conflict on mental health and health services, the significant gap in mental health service delivery and how to strategically and evidently task-shift in closing the mental health gap in service delivery.

Studies have documented on the role of religious leaders in providing psychosocial support to their members. However, there is a dearth of research in understanding the role imams play among Muslim communities in the Canadian context. The few studies that were undertaken in Europe and the United States revealed that imams played a significant role in addressing the psychosocial needs of their congregants, and this role increased in the post-9/11 era.This study explored experiences of imams in the provision of psychosocial support to Muslim Canadians, including new immigrants and refugees. We conducted in-depth, one-on-one interviews with faith leaders in a major metropolitan Canadian city. The data was transcribed and thematically analyzed using NVIVO. The study revealed that spiritual healing is considered the first line of care for psychosocial illness, and imams are considered the primary support network. The findings revealed that war-related traumas and post-resettlement challenges have significant impact on family functions and well-being.This study highlighted the need for culturally appropriate psychosocial support services for Muslim Canadians, including new immigrants and refugees. It also calls for better collaboration between service agencies and faith-based organizations in the communities to address these specific needs.

In British Columbia (BC), Canada, mental health reforms over the last decade have moved back and forth between calls for practices that restrict human rights and those that are rooted in equity and social justice. In this article, we explore some of these tensions and their implications for human rights and equity in mental health care by critically analyzing three policies guiding mental health reform in BC using an intersectionality-based policy framework. Specifically, we interrogate the effects of a biomedical and individualized framing of mental health and substance use. We argue that such a framing is buttressed by neoliberal ideology and lays the groundwork for public and professional acceptance of coercive practices with particular consequences for Indigenous and racialized populations. This framing is juxtaposed with a holistic wellness and trauma-informed policy framework anchored by an understanding of the impact of colonization. However, what is missing in both policy framings is a full account of the documented ongoing human rights violations experienced by many people accessing BC’s mental health system. Our analysis shows how applying an intersectionality-based policy framework allows for a deeper exploration of the complex, interlocking systems of power and oppression that give rise to these human rights violations. We conclude with a discussion of the important role that decolonizing and intersectional approaches play for capturing the complexities of systemic inequities and advancing mental healthcare that protects and promotes mental wellbeing and human rights.

The mental health situation in Kenya has been termed a silent epidemic threatening the mental wellbeing of the population. Deeply entrenched stigma and discrimination is systematic and directly influences access to mental health care, human rights violations, and social exclusion. Despite commitments to improve mental health care infrastructure, the ongoing impact of colonization perpetuates biomedical responses to mental health. Kenya ratified the UN Convention on the Rights of Persons with Disabilities (CRPD) in 2008 though mental health, criminal, and civil laws continue to be in violation of the Convention. We take a human rights and equity lens to critically analyze the biomedical dominance in mental health policy and practice. We employ an intersectional analytic framework to contextualize experiences of mental health injustices and apply aspects of an Intersectionality Based Policy Analysis Framework to the Ministry of Health’s Kenya Mental Health Policy 2015-2030 (2015) and the Ministry of East African Community (EAC) Labour and Social Protection’s National Plan of Action on Implementation of Recommendations made by the Committee on the Rights of Persons with Disabilities (2016) to explore how policy discourses influence understandings of mental health and responses. We analyze a disjuncture between human rights and social determinants framings of mental health in policy, and how a default to western biomedical solutions for addressing mental distress dominate institutionally and in practice. We urge the Kenyan government to abolish coercive mental health practices, remove systemic barriers that hinder participation, and establish supports to empower people with psychosocial disabilities and their organizational representatives (USP-Kenya) to ensure mental health responses are consistent with international human rights treaties.