Somalia, a country beset by protracted conflict, environmental crises, and economic instability, faces a hidden yet formidable challenge: a rising mental health epidemic. The impact of these crises, coupled with the scarcity of mental health services, has left many Somalis grappling with psychological distress in silence, as explained by Alberto Macin, the mental health activity manager for Médecins Sans Frontières (MSF) in the region. His work sheds light on the reality that Somalia’s health crisis extends far beyond the visible and requires urgent, coordinated action.
Macin, who has worked on mental health initiatives in some of the world’s most challenging regions, underscores that mental health needs in Somalia are inextricably linked to wider socio-political and economic conditions. His team’s interactions with residents in Galkayo and Baidoa districts illustrate the spectrum of mental health challenges Somalis face: individuals recount displacement due to climate crises, trauma from sexual violence, and the burden of caring for family members afflicted with severe mental illness without sufficient resources.
According to the World Health Organization (WHO), the prevalence of mental disorders in conflict zones stands at approximately 13%, with both mild and moderate cases of depression, anxiety, PTSD, and bipolar disorder frequently documented. Yet, the stigma around mental health, compounded by limited access to clinical support, prevents many from seeking help. Vulnerable groups, especially women, children, and the elderly, remain disproportionately affected. The breakdown of traditional community support networks further exacerbates feelings of isolation, stress, and despair among displaced populations who now reside in overcrowded camps with little privacy or security.
The mental health needs MSF encounters in Somalia range from psychosomatic complaints to severe conditions like psychosis and substance abuse. However, the overwhelming distress stemming from trauma and ongoing insecurity often leads to the development of new conditions, including PTSD and acute stress reactions. While the humanitarian response to Somalia’s crisis focuses on critical needs like food, shelter, and basic health care, mental health remains under-prioritized. Consequently, the psychological toll of these hardships risks growing unchecked, with limited pathways to recovery for those affected.
MSF’s efforts to address this gap include integrating mental health services within its broader health programs, collaborating with the Ministry of Health (MoH) to provide psychological support, and running group activities aimed at promoting healthy coping mechanisms. Since the beginning of 2024, MSF has conducted nearly 5,000 mental health consultations and has reached over 38,000 people through group activities, community training sessions, and psychological first aid. Despite these initiatives, the scope of the problem is immense, and current resources are insufficient to meet the demand for mental health services across the country.
Beyond the immediate support that MSF and other agencies provide, Macin emphasizes the need for a sustainable and community-driven approach. Building mental health capacity within Somali communities could alleviate the demand for clinical specialists, who are scarce. Empowering communities to offer peer support and reestablishing traditional support systems could help fill the gaps. Encouragingly, community self-help groups can provide a sense of normalcy, fostering resilience among individuals and reducing the overall impact of psychological trauma.
For those in the early stages of trauma, access to psychological first aid—offered by trained volunteers, teachers, and health staff—can provide essential relief. By equipping community members with basic skills to support individuals in crisis, the response can be scaled to reach larger groups. This grassroots approach not only strengthens community ties but also helps alleviate the psychological burden of Somali families.
Despite the resilience demonstrated by many Somalis, the absence of widespread mental health support risks perpetuating a cycle of suffering. Macin’s appeal calls for mental health to be fully integrated into humanitarian efforts, encompassing both immediate relief and long-term care. He advocates for comprehensive strategies that address basic needs like food and shelter alongside psychological first aid and a clear referral system to mental health services.
Somalia’s future stability hinges not only on rebuilding its infrastructure but on healing the minds and lives of its people. As the international community and local authorities grapple with these pressing needs, prioritizing mental health within the humanitarian response is essential. The lives of millions hang in the balance, and failure to act could leave a generation struggling with the scars of trauma and loss.
