Medical returnees: Somali Canadians seeking psychosocial and spiritual healing in East Africa

Background: The refugee experience has been associated with increased rates of psychosocial challenges. At the same time, evidence suggests that those who resettle in Western countries underutilize Western mental health services. The reluctance of refugees to use mental health services has been attributed to barriers to accessing services such as language, complexity of the health system, and differing explanatory models of illness. The same is true for Somali refugees in Western countries. Studies suggest that Somali refugees prefer spiritual healing for psychosocial illness and that some return to East Africa for healing. However, little is known about the mental health of the Somali community in Canada and the services they utilize for psychosocial problems. Objectives: In conducting original ethnographic study, I aimed to understand the psychosocial challenges faced by Somali Canadians, their health seeking behaviors, and their access and barriers to psychosocial services in Canada. Because some have sought psychosocial services at international destinations, I conducted fieldwork in Kenya to provide new evidence on the little-known transnational spiritual healing systems popular among diasporic Somalis. Methods: Ethnographic fieldwork and in-depth interviews were utilized. Thirty-seven in-depth interviews of about an hour each were undertaken in Canada and Kenya. Fieldwork focused on visiting spiritual and cultural healing centers in Nairobi for three to four hours each. Results: The findings show that some families struggle with childhood autism and youth substance use, while others deal with psychosocial and spiritual distress such schizophrenia, depression, and Jinn. The preferred treatment approaches ranged from holistic biomedical treatments combined with spiritual healing to only cultural and spiritual healing. Discussion: This study reveals important findings regarding psychosocial and substance use problems among Somali Canadians. I discuss psychosocial illnesses, challenges with accessing Canadian healthcare services, the role of spiritual healers, and seeking culturally appropriate services in East Africa. I further discuss substance use problems among Somali Canadian youth, the lack of culturally appropriate services in Canada, and the emergence of transnational cultural recovery programs in Kenya. I also highlight challenges associated with transnational rehabilitation programs.