Anxiety, depression and access to mental health services among internally displaced persons in Mogadishu, Somalia: a cross-sectional survey

BMJ Open. 2024 Nov 7;14(11):e084275. doi: 10.1136/bmjopen-2024-084275.

Abstract

Objective: The study aims to evaluate anxiety and depression levels and access to mental health services among internally displaced persons (IDPs) in Mogadishu, Somalia.

Design: A community-based, cross-sectional survey was carried out in IDP camps. Face-to-face interviews were conducted using a modified Hospital Anxiety and Depression Scale. Data were analysed using SPSS V.25.0, incorporating univariate and logistic regression analyses.

Setting: The study was conducted in 10 IDP camps located in the districts of Daynile and Kahda in the Banadir region of Somalia between November and December 2023.

Participants: The study included 522 randomly sampled individuals aged 18-70 years living in the selected IDP camps.

Results: The study revealed high prevalence rates of anxiety (43.7%) and depression (35.8%) among IDPs in the selected districts. Of those with anxiety, 54% were categorised as borderline cases and 46% as severe cases. Similarly for depression, 72.7% were classified as borderline cases and 27.3% as severe cases. Significant associations were found between anxiety symptoms and variables such as camp residence (OR: 3.872, 95% CI 2.333 to 6.424), female gender (OR: 2.387, 95% CI 1.604 to 3.552), young age (OR: 6.319, 95% CI 4.309 to 9.267), marriage contract (OR: 4.569, 95% CI 2.850 to 7.325), lack of education (OR: 1.92, 95% CI 1.349 to 2.737) and past experiences of trauma (OR: 5.207, 95% CI 3.274 to 8.281). Depressive symptoms were significantly associated with younger age (OR: 1.536, 95% CI 1.069 to 2.208), lack of formal education (OR: 1.661, 95% CI 1.153 to 2.395) and history of trauma (OR: 3.695, 95% CI 2.529 to 5.400). Additionally, the study highlighted a grave shortage of mental health and psychosocial support (MHPSS) services. User evaluations of MHPSS services varied, indicating room for improvement.

Conclusion: The study revealed elevated levels of anxiety and depression among IDPs in the districts of Kahda and Daynile in the Banadir region of Somalia, underscored by a critical shortage of MHPSS services, emphasising the need for tailored mental health interventions.

Keywords: Anxiety disorders; Cross-Sectional Studies; Health & safety; Health Services; Health Services Accessibility; Health Surveys.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety* / epidemiology
  • Cross-Sectional Studies
  • Depression* / epidemiology
  • Female
  • Health Services Accessibility* / statistics & numerical data
  • Humans
  • Male
  • Mental Health Services* / statistics & numerical data
  • Middle Aged
  • Prevalence
  • Refugees* / psychology
  • Refugees* / statistics & numerical data
  • Somalia / epidemiology
  • Young Adult