Mental health is health. But for millions of people,
stigma can become a barrier to receiving it.
Mental health conditions are among the most important public
health challenges of the 21st century. In 2025, the World Health Organization
(WHO) reported that more than 1 billion people worldwide were living with a
mental health condition, while most people affected still did not receive
adequate care.
Behind these numbers are people living with depression,
anxiety, post-traumatic stress disorder (PTSD), bipolar disorder, psychosis,
substance-use disorders and other conditions.
Yet the problem is not only a shortage of services.
For many people, stigma itself becomes a barrier to care.
Fear of being judged, rejected, discriminated against,
labeled as "crazy," considered weak, or excluded from family and
community life can prevent people from talking about their symptoms or seeking
professional support.
This is why mental health stigma should not be viewed merely
as a cultural or social problem.
It is a public health problem.
What Is Mental Health Stigma?
Mental health stigma refers to negative attitudes, stereotypes, shame and discrimination toward people experiencing mental health conditions.
It may cause people to:
- Hide their symptoms
- Avoid healthcare services
- Fear being labeled "crazy"
- Withdraw from family and community
- Delay diagnosis and treatment
- Experience discrimination at school or work
Stigma can therefore turn a health condition into a wider social and public-health problem.
Why Is Stigma a Public Health Issue?
When people are afraid to seek help, conditions may remain untreated for longer.
This can affect:
Mental health → Physical health → Family relationships → Education → Employment → Social participation
Stigma can also reinforce a cycle:
Symptoms → Fear of stigma → Silence → Delayed care → Worsening condition → Greater social burden
Reducing stigma is therefore part of improving access to healthcare.
WHO emphasizes that effective mental-health strategies exist, including community-based care, integration into primary healthcare and actions to reduce stigma and discrimination.
Self-stigma occurs when people internalize negative beliefs about mental illness.
A person may think:
"If I ask for help, people will think I am weak."
Or:
"I should be able to deal with this myself."
These beliefs can lead to shame, secrecy, social withdrawal
and delayed treatment.
What Does Research Tell Us About Somalia?
The evidence from Somalia is particularly important because mental-health stigma is documented in research rather than being simply an assumption about Somali culture.
A 2024 qualitative study conducted in Somalia explored perceptions and experiences of mental health after decades of humanitarian crises. Participants and key informants identified stigma, poor awareness and inadequate services as major barriers to care. The study also reported that people often seek traditional or religious forms of support before accessing formal mental-health services, influenced by culture, cost and limited availability of professional care.
The researchers concluded that Somalia needs greater mental-health awareness, more trained professionals and interventions specifically addressing stigma.
Mental Health Among Displaced People in Mogadishu
Research among internally displaced people (IDPs) in
Mogadishu also illustrates the scale of need among vulnerable populations.
A 2024 study involving 522 adults living in 10 IDP camps
in Daynile and Kahda districts of Banadir reported anxiety symptoms in 43.7%
of participants and depression symptoms in 35.8%. The study also
identified trauma, age, education and other factors associated with symptoms
and highlighted shortages in mental health and psychosocial support services.
Another study among 401 IDPs in Mogadishu found that
approximately 59% met the study's symptom criteria for depression and nearly
32% met criteria for PTSD.
Again, these studies are population-specific and should not
be generalized to all Somalis.
But together they illustrate an important public health
reality:
There is a substantial mental health need among some highly vulnerable populations, while access to services remains limited.
Evidence from Mogadishu
Research also demonstrates a substantial mental-health need among some vulnerable populations.
A 2024 study of 522 adults living in 10 internally displaced-person camps in Mogadishu found symptoms of anxiety in 43.7% and depression in 35.8% of participants. Importantly, this was a study of selected IDP populations and should not be interpreted as the prevalence of anxiety or depression among the entire Somali population.
This distinction is important: Somalia still lacks a recent nationally representative mental-health survey, so available studies should be interpreted according to their populations and methods.
Stigma and Somali Communities.
Research among Somali communities outside Somalia also provides useful evidence.
A qualitative study among Somalis in the United Kingdom found strong community stigma surrounding mental illness, with participants describing people with mental-health conditions as being viewed negatively and identifying stigma as a barrier to accessing healthcare. The researchers emphasized culturally appropriate services and stronger trust between Somali communities and healthcare professionals.
A 2024 study of Somali women in London similarly identified judgment, shame, stigma and secrecy as important influences on attitudes toward mental health and help-seeking. Participants also identified faith and family as important sources of support.
These findings should not be automatically generalized to every Somali community, but together they show that stigma and cultural understandings of mental health are important considerations in designing services.
Somalia's Mental Health Service Gap.
The stigma problem exists alongside a major shortage of mental-health services.
WHO's Mental Health Atlas 2024 Somalia profile reports only about 1.3 mental-health workers per 100,000 population, including approximately 0.1 psychiatrists, 0.4 psychologists and 0.2 mental-health nurses per 100,000. Less than 10% of primary-care facilities reported availability of essential mental-health medicines and psychosocial interventions.
This means Somalia faces two interconnected challenges:
People may hesitate to seek mental-health care, while appropriate services are also limited.
Addressing only one of these problems will not be enough.
How Can We Reduce Mental Health Stigma?
1. Improve mental-health literacy
Communities need accurate information about depression, anxiety, PTSD, psychosis, suicide prevention and when to seek help.
2. Integrate mental health into primary healthcare
People should be able to discuss mental health within ordinary healthcare settings rather than feeling that visiting a psychiatric service automatically identifies them as "mentally ill."
3. Train healthcare workers
Doctors, nurses, community health workers and other frontline staff need training in recognition, communication, psychological support and referral.
4. Engage communities and religious leaders
Faith and community structures are important sources of support for many Somali families. They can be engaged in awareness and referral while maintaining respect for cultural and religious values.
5. Listen to people with lived experience
People who have experienced mental-health conditions should participate in awareness campaigns, service design and policy discussions.
6. Use responsible language
Instead of saying:
"He is crazy."
say:
"He may be experiencing a mental-health condition and may need support."
Language can either reinforce stigma or help reduce it.
A New Way of Talking About Mental Health
Changing language can change attitudes.
Instead of:
❌ "He is crazy."
Say:
✅ "He may be experiencing a
mental health condition."
Instead of:
❌ "She is weak."
Say:
✅ "She may need support and
professional care."
Instead of:
❌ "Don't tell anyone."
Say:
✅ "Let's find someone
qualified who can help."
Instead of:
❌ "Mental illness is
something to hide."
Say:
✅ "Mental health is part of
health."
These may appear to be small changes.
But public health often begins with changes in how societies
understand health.
The Public Health Message
Mental health stigma is not simply a matter of changing people's attitudes.
It can influence whether a person:
recognizes a problem → seeks help → receives treatment → recovers → remains socially included.
For Somalia, the response needs to combine mental-health awareness, stigma reduction, stronger primary healthcare, trained professionals, community-based services and better national data.
Most importantly, mental health should be treated as an essential part of health — not something that should be hidden.
Mental health is health.
Reducing stigma means making it easier for people to speak, seek help and receive care with dignity.
Conclusion: Mental Health Is Health
The global mental health challenge is enormous.
More than 1 billion people are living with mental
health conditions, while large gaps remain between the need for care and the
services available.
In Somalia, the challenge is compounded by conflict,
displacement, humanitarian needs, limited services, workforce shortages and
major gaps in national mental health data. WHO's latest country profile reports
a very limited mental health workforce and no specific national anti-stigma
strategy.
But stigma is not an unsolvable problem.
We can change how mental health is discussed.
We can train healthcare workers.
We can strengthen primary healthcare.
We can engage communities and religious leaders.
We can protect people from discrimination.
We can listen to people with lived experience.
And we can treat mental health as an essential component of
public health rather than an issue that should remain hidden.
Mental health is not a luxury.
Mental health is not a weakness.
Mental health is not something to be ashamed of.
Mental health is health.
And protecting mental health is a public health responsibility.
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