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What can Somali community talk about mental health tell us about our own? Contextualizing the symptoms of mental health

Juanita Ryan (Department of Corrections, New Zealand Government, Wellington, New Zealand)
Pauline B. Thompson Guerin (Department of Psychology, Pennsylvania State University, University Park, Pennsylvania, USA)
Fatuma Hussein Elmi (Logan Central Family Clinic, Brisbane, Australia)
Bernard Guerin (University of South Australia, Adelaide, Australia)

International Journal of Migration, Health and Social Care

ISSN: 1747-9894

Article publication date: 12 April 2019

Issue publication date: 15 July 2019




The purpose of this paper is to review all the research on Somali refugee communities’ “explanatory models” of “mental health” or psychological suffering, and also report original research in order to allow for more contexts on their “mental health” terms to emerge.


The authors talked in a conversational manner with a small number (11) of Somali people (10 females and 1 male), but this was done intensively over time and on multiple occasions. They discussed their community terms for “mental health” issues but in their own contexts and with their own examples.


The results showed that Somali as a community had three main groupings of symptoms: Jinn or spirit possession; waali or “craziness”; and a group of terms for serious anxieties, rumination, worrying and thinking too much. What was new from their broader descriptions of context was that the community discourses were based on particular contexts of the person and their behavior within their life history, rather than aiming to universal categories like the DSM.

Practical implications

Both research and practice on mental health should focus less on universal diagnoses and more on describing the contexts in which the symptoms emerge and how to change those contexts, especially with refugee and other less well-understood groups.


The review and original results support symptom-based or contextual approaches to mental health; we should treat the “mental health” symptoms in their life contexts rather than as a disease or disorder. We can learn from how Somali describe their “mental health” symptoms rather than treat their descriptions as crude forms of the “correct” western diagnostics.



This research was kindly supported by the New Zealand Foundation for Research Science and Technology through UOWX0203, “Strangers in Town: Enhancing Family and Community in a More Diverse New Zealand Society.”


Ryan, J., Thompson Guerin, P.B., Elmi, F.H. and Guerin, B. (2019), "What can Somali community talk about mental health tell us about our own? Contextualizing the symptoms of mental health", International Journal of Migration, Health and Social Care, Vol. 15 No. 2, pp. 133-149.



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