Making a case for youth mental health awareness and interventions in Somaliland
There has been an increasing concern to address the rising incidences of mental health problems facing young people globally. Several factors have been implicated to account for the rise in rates of depression, suicide, anxiety, sleep deprivation, and drug abuse in youthful population. However, compared to youth in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries, youth from Low Middle-Income Countries (LMIC) may have an elevated risk for mental health problems due to additional unique socioeconomic stressors.
A study by Hersi et al., (2017) examined the prevalence of mental distress and associated factors among undergraduate students in Somaliland. Located in the horn of Africa, Somaliland is an unrecognized self-declared de facto LMIC with a population estimate of 3.5 million. Somaliland has witness political instability amidst slow paced socioeconomic trajectory. Access to healthcare, education, employment opportunities, and other public amenities remain constrained. Particularly, for the youth the stress of living in a resource limited environment and the lack of shared socioeconomic opportunities may predispose them to adverse mental health outcomes and maladaptive coping mechanisms.
In their study Hersi et al., (2017) recruited 570 undergraduate students (Mage [SD] =23.5 [4.4]; 60.7% males, 87/9% not married). More than half of the participants (51.2%) were dependent on their parents for financial support for their education and receive a monthly income £ $100.
Using the Self Reporting Questionnaire (SRQ -20) and other sociodemographic variables a bivariate logistic regression was performed to identify the specific risk factors to mental distress among the sample of undergraduate students in Somaliland. Results from the study revealed a high prevalence rate of mental distress (19.8%). Specific sociodemographic factors found to be associated with risk of mental distress were female (AOR = 3.52), low-income bracket (AOR = 2.19), unsatisfactory relationship with friends (AOR = 7.33) and family (AOR = 11.52) and substance abuse (Khat [AOR = 2.87). Also, results from an open-ended question suggests that the lack of socioeconomic opportunities posed as a significant risk factor to mental distress.
Despite the paucity of literature exploring the mental health problems of youth in Somaliland, the current study together with similar research conducted among youth in LMIC reveal an elevated risk of mental health distress compared to the general population. The association between poverty and mental health has been established in literature.
The downstream effect of poverty, exposure to traumatic events, hopelessness, and political instability can be debilitating for young people whose sense of purpose and meaning to life is often futuristic in nature. Although, rates of mental distress have peaked among young people globally and in the general population, living in a post-conflict region with limited resources may impose additional stress to the youthful population particularly those in educational institutions. This is because, undergraduate education has its own unique stressors that it contributes to mental health and hence, undergraduate students in Somaliland may experience different layers of stressors.
Almost all the factors associated with mental distress in the current study (i.e., actors such as gender [female], low socio-economic status, unsatisfactory relationship, and substance abuse) have been reported in previous studies. However, this study contributes to understanding the correlates of mental distress of a specific group of youthful population in Somaliland and propose culturally appropriate interventions to mitigate the effects.
Although alcohol consumption was reported to be low in the study among undergraduate students, Khat use (a shrub which contains amphetamine like substance called cathinone) was found to be prevalent. The low use of alcohol might be due to religious and political restriction compared to Khat that appears to receive a favorable response as a recreational drug. Khat use may be a maladaptive coping mechanism in response to mental distress faced by the undergraduate students.
Hence, there is the need to highlight the health risk of Khat use among the students. It is imperative that clinicians, educational administrators, researchers, and policy makers deploy interventions that would help reduce the burden of mental health distress among the youthful population in Somaliland.
Reference
Hersi, L., Tesfay, K., Gesesew, H., Krahl, Wolfgang., Ereg, D., & Tesfaye, M. (2017). Mental distress and associated factors among undergraduate students at the University of Hargeisa, Somaliland: A cross-sectional Study. International Journal of Mental Health System, 11, 39 https://doi.org/10.1186/s13033-017-0146-2
