(see Poster Gallery) Born in Displacement: Psychosocial and Mental Health Sequelae of Displacement Trauma Among Urban Somali Refugee Youth

Background and Purpose: Urban refugees face tremendous adversities during displacement that exacerbate mental health and psychosocial outcomes. With the continued trauma in host countries ranging from discrimination and chronic poverty to lack of legal and social protection, urban refugees are at high risk for mental health challenges. However, there are limited studies on how mental health in urban refugee youth manifests in protracted situations and whether displacement type impacts mental health experiences. This study examines the differential effects of birth country on trauma exposure and psychosocial factors that influence mental health experiences among Somali refugee youth in urban Kenya.

Methods: Collaborating with a community-based organization and local clinic in Eastleigh, Kenya, this research team recruited 15 to 25-year-old Somali refugee youth (N=303; female =173, male =121, unknown = 9). Participants completed a structured cross-sectional questionnaire (in English or Somali) comprised of four sections: trauma exposure, psychosocial factors, mental health symptoms, and demographic characteristics. Consultation with community partners led to a list of 12 trauma experiences that are common in this population (ex. experiencing war, loss of family, detainment etc.). Symptoms of PTSD, depression, anxiety and somatoform pains were assessed with PTSD Check List–Civilian Version (PCL-C), Hopkins Symptom Checklist-25 (HSCL-25), and locally developed somatic symptom checklist.

Results: Participants who were born in Kenya reported significantly more symptoms of PTSD, depression, and somatization (t=2.43, p=0.016*, t=2.65, p=0.008**, and t=2.65, p=0.010*, respectively). Linear regression analyses showed that gender (B = -3.41, p = 0.024), age (B = 0.67, p = 0.010), country of birth (B = -3.86, p = 0.021), community violence (B = 5.25, p = 0.003), childhood trauma (B = 3.48, p = 0.033), attitudes toward violence (B = 0.41, p = 0.042), sense of community (B = 0.87, p = 0.010), low social functioning (B = 3.37, p < 0.001), and substance use (B = 3.46, p < 0.001) were significant predictors of PTSD symptoms (adjusted R²= .376, F_13,223 = 11.93, p < 0.001). Similar patterns were found in predicting depressive symptoms and somatic pains, but birth country (being born in Kenya) was not a significant predictor for anxiety symptoms.

Discussion: Country of birth was a significant predictor of common mental disorders (except anxiety) despite no significant difference in trauma exposures and psychosocial factors (except attitudes toward violence) between Somali-born and Kenya-born youth. Such disparity in mental health outcomes implies that prolonged displacement is an important risk factor for negative mental health experiences and can be associated with long-term exposure to adversities related to displacement, disrupted development of social functioning, and uncertain status and uprootedness for those who live their entire life in protracted refugee situations. Particularly, cumulative traumas in urban settlement likely exacerbate psychosocial protectors and increase the risk of substance use as a method of (maladaptive) coping with forced migration and displacement trauma. Given the devastating effects of trauma and community adversities on CMDs, multi-pronged intervention approaches are requested. Further implications for social work research and practice/policy will be discussed.