Somali male refugees: Perceptions of depression and help-seeking

Background: In recent years, research has started to draw attention to the notion that Western biomedical concepts of mental illness such as depression may not be recognised, understood or treated in the same way across non-Western cultures. Research has begun to reveal the differences in how mental illness is conceptualised across non-Western cultures, highlighting the prominence of social and contextual factors in contrast to the Western biomedical view. This has implications not only on a global scale, but also for diverse populations living under the Western mental health system. The UK Somali community has been identified as a cultural group who rarely access psychological services, despite high rates of mental health diagnoses such as depression. In particular, Somali men are said to be at increased risk of suicide and frequently present in tertiary care, yet there is little research to explore how they understand concepts such as depression.
Aims: The purpose of the current study was to explore how Somali male refugees in the UK understand and perceive the Western concept of depression, alongside their views on coping and professional help in the UK.
Method: A constructivist grounded theory approach involved the use of twelve Somali male refugees in the community. They were interviewed with the aid of a vignette across three focus groups, with eight who participated in subsequent semi-structured interviews.
Results: Findings suggest that 'depression' appeared to be a result of the difficulties associated with migration, portrayed as an overall 'sense of disconnection'. The ‘health’ of the community appeared to link to the 'health' of the individual; highlighting the collectivist appraisals of self-worth. Help-seeking from Western professionals was portrayed as rare, and were conceptualised as lacking awareness of the needs of the Somali community in relation to their difficulties.
Conclusion: These findings highlight the importance of taking into account social and contextual factors, supporting the argument for a bio-psychosocial approach when making decisions about depression as a diagnosis. These differences in the way depression is conceptualised has implications for Western models of therapy, while indicating a need for counselling psychology to consider a move towards community-based work when working with these populations.