Factors associated with self-reported mental health difficulties in Somalia: a national health and demographic survey analysis of populations aged 10 years and older.
Omer H, Abdi K, Hassan Muse A • Global health action • 2026
The overall prevalence of self-reported mental health difficulties in Somalia is low (0.83%), but the burden is disproportionately concentrated among older adults and individuals with chronic physical comorbidities.
Key Findings
Results
The overall prevalence of self-reported mental health difficulties among Somali individuals aged 10 years and older was 0.83%.
Data were drawn from the 2020 Somali Health and Demographic Survey (SHDS) with a sample of 49,389 individuals aged 10 years and older.
Secondary data analysis used descriptive statistics and multilevel logistic regression models.
Authors note the low prevalence likely reflects severe impairment thresholds and cultural under-reporting rather than true low burden.
The study used a nationally representative sample.
Results
Advanced age was the primary correlate of self-reported mental health difficulties, with individuals aged 55 years and older having 14.30 times higher odds compared to those aged 10–19 years.
AOR = 14.30 for individuals aged 55 years and older versus the 10–19 year reference group.
This was identified as the strongest single predictor in the multilevel analysis.
The finding suggests a disproportionate burden among elderly Somali populations.
Results were derived from multilevel logistic regression controlling for socioeconomic and clinical factors.
Results
A history of stroke was significantly associated with higher odds of self-reported mental health difficulties.
AOR = 4.07 for individuals with a history of stroke.
Stroke was identified as one of the significant clinical correlates in the multilevel analysis.
This finding supports integration of mental health screening into stroke care pathways.
Results
Chronic back pain was significantly associated with higher odds of self-reported mental health difficulties.
AOR = 2.76 for individuals with chronic back pain.
Chronic back pain was identified as a significant clinical correlate alongside stroke and high blood pressure.
The association highlights the link between physical comorbidities and mental health burden in Somalia.
Results
High blood pressure was significantly associated with higher odds of self-reported mental health difficulties.
AOR = 2.57 for individuals with high blood pressure.
High blood pressure was among the top three clinical correlates identified in the multilevel analysis.
Authors recommend integrating mental health screening into primary care management of chronic physical conditions including hypertension.
Results
Formal secondary education was associated with lower odds of experiencing self-reported mental health difficulties in the Somali context.
Formal secondary education was identified as a protective socioeconomic factor in the multilevel analysis.
This was described as 'added knowledge' not previously documented in the Somali context.
The finding was identified through multilevel logistic regression controlling for other socioeconomic and clinical variables.
Results
Traditional nomadic living was associated with lower odds of self-reported mental health difficulties compared to other living arrangements.
Nomadic lifestyle was identified as a protective factor in the multilevel analysis.
This was described as 'added knowledge' specific to the Somali context.
The finding may reflect cultural, social cohesion, or lifestyle factors associated with nomadic communities in Somalia.
What This Means
This research suggests that roughly 1 in 120 Somalis aged 10 and older (0.83%) reported experiencing mental health difficulties, based on a nationally representative survey of nearly 50,000 people conducted in 2020. However, the authors caution that this figure likely underestimates the true burden because cultural norms around mental health in Somalia may discourage people from reporting problems, and the survey may only capture the most severe cases. The study found that mental health difficulties were far more common among older adults — people aged 55 and older were about 14 times more likely to report difficulties than teenagers — and among people living with physical health conditions such as stroke (about 4 times higher odds), chronic back pain (about 2.8 times higher odds), and high blood pressure (about 2.6 times higher odds).
This research also suggests that having a secondary education and living a traditional nomadic lifestyle were both associated with lower likelihood of reporting mental health difficulties. These findings are notable because they offer context-specific insights into protective factors in Somalia that have not been previously documented at a national level.
For public health purposes, this research suggests that Somalia's health system could benefit from incorporating mental health screening into existing care for chronic physical diseases like hypertension and back pain, since these populations appear to carry a disproportionate mental health burden. The findings also point to a need for specialized mental health support services tailored to elderly Somalis and to urban populations, helping to close what the authors describe as a significant treatment gap in a country still recovering from decades of conflict.
Omer H, Abdi K, Hassan Muse A. (2026). Factors associated with self-reported mental health difficulties in Somalia: a national health and demographic survey analysis of populations aged 10 years and older.. Global health action. https://doi.org/10.1080/16549716.2026.2727758