Factors associated with self-reported mental health difficulties in Somalia: a national health and demographic survey analysis of populations aged 10 years and older
ABSTRACT Background Mental health is a neglected public health issue in post-conflict zones like Somalia. Objective(s) Given the absence of community-based data in Somalia, this study sought to determine the prevalence and associated factors with Self-Reported Mental Health Difficulties among individuals aged 10 years and older by utilizing a nationally representative sample. Methods We analyzed secondary data from the 2020 Somali Health and Demographic Survey of 49,389 individuals aged 10 years and older. We used descriptive statistics and multilevel logistic regression models to estimate prevalence and pinpoint socioeconomic and clinical factors. Results The overall prevalence of Self-Reported Mental Health Difficulties among Somali individuals aged 10 years and older was 0.83%. Multilevel analysis revealed that advanced age was a primary correlate, individuals aged 55 years and older had 14.30 times higher odds of reporting self-reported mental health difficulties compared with those aged 10–19 years. Significant clinical correlates included a history of stroke (AOR = 4.07), chronic back pain (AOR = 2.76), and high blood pressure (AOR = 2.57). Conclusions While reported prevalence is relatively low, likely reflecting severe impairment and cultural under-reporting, the burden is disproportionately high among elderly individuals and those with physical comorbidities. Policy interventions should focus on secondary prevention by integrating mental health screening into primary care for chronic diseases and developing specialized geriatric support services to bridge the treatment gap in Somalia.