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BMC Public Health. 2012; 12: 749.
Published online Sep 7, 2012. doi:  10.1186/1471-2458-12-749
PMCID: PMC3489604
Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study
Nasir Warfa,corresponding author1 Sarah Curtis,2 Charles Watters,3 Ken Carswell,1 David Ingleby,4 and Kamaldeep Bhuicorresponding author1
1Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London, E1M B6Q, UK
2Department of Geography, University of Durham, South Road, Durham, DH1 3LE, UK
3Rutgers University, Room 305, 405-7 Cooper Street, Camden, NJ 08102, USA
4Utrecht University, Heidelberglaan 2, 3584 CS, Utrecht, The Netherlands
corresponding authorCorresponding author.
Nasir Warfa: n.warfa/at/qmul.ac.uk; Sarah Curtis: s.e.curtis/at/durham.ac.uk; Charles Watters: c.watters/at/rutgers.edu; Ken Carswell: k.carswell/at/qmul.ac.uk; David Ingleby: J.D.Ingleby/at/uu.nl; Kamaldeep Bhui: k.s.bhui/at/qmul.ac.uk
Received December 16, 2011; Accepted September 4, 2012.
Abstract
Background
The discourse about mental health problems among migrants and refugees tends to focus on adverse pre-migration experiences; there is less investigation of the environmental conditions in which refugee migrants live, and the contrasts between these situations in different countries. This cross-national study of two samples of Somali refugees living in London (UK) and Minneapolis, Minnesota, (USA) helps to fill a gap in the literature, and is unusual in being able to compare information collected in the same way in two cities in different countries.
Methods
There were two parts to the study, focus groups to gather in-depth qualitative data and a survey of health status and quantifiable demographic and material factors. Three of the focus groups involved nineteen Somali professionals and five groups included twenty-eight lay Somalis who were living in London and Minneapolis. The quantitative survey was done with 189 Somali respondents, also living in London and Minneapolis. We used the MINI International Neuropsychiatric Interview (MINI) to assess ICD-10 and DSM-IV mental disorders.
Results
The overall qualitative and quantitative results suggested that challenges to masculinity, thwarted aspirations, devalued refugee identity, unemployment, legal uncertainties and longer duration of stay in the host country account for poor psychological well-being and psychiatric disorders among this group.
Conclusion
The use of a mixed-methods approach in this international study was essential since the quantitative and qualitative data provide different layers and depth of meaning and complement each other to provide a fuller picture of complex and multi-faceted life situations of refugees and asylum seekers. The comparison between the UK and US suggests that greater flexibility of access to labour markets for this refugee group might help to promote opportunities for better integration and mental well-being.
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