Mental health in Somali youth in the United States: the role of protective factors in preventing depressive symptoms, suicidality, and self-injury

Objectives: Community, school, family, and individual factors protect against mental illness in general samples of adolescents. How these assets apply to Somali youth resettled to the United States (U.S.), a group with significant trauma exposure, remains unclear. We aimed to quantify which protective factors are associated with lower prevalence of depressive symptoms, suicidality, and self-injury among Somali youth in the U.S. compared with their non-Hispanic white peers. Design: Participants consisted of 8th, 9th, and 11th grade respondents to the 2016 Minnesota Student Survey, an anonymous school-administered statewide survey with 85.5% school district participation, who identified as Somali ethnicity (n = 1552) or as non-Hispanic white (n = 80,583). Multivariable logistic regression assessed odds of depressive symptoms, suicidal ideation and attempts, and self-harm, using eight protective factors (i.e. internal developmental assets, school engagement, empowerment, and family and teacher connectedness, caring adults and after-school activity frequency and quality) as independent variables. Models were run separately for Somali and white youth. Results: Somali youth reported similar rates of depressive symptoms, but lower levels of suicidal ideation or attempts and self-harm behaviors than their white peers (p < 0.001). All eight protective factors were associated with outcomes in the expected direction for white youth. For Somali youth, internal developmental assets (aOR 0.79, 95% CI: 0.65–0.97), empowerment (aOR 0.58, 95% CI: 0.45–0.73), family connectedness (aOR 0.60, 95% CI: 0.51–0.71), perception of caring adults in the community (aOR: 0.84, 95% CI: 0.76–0.92), and quality of after-school activities (aOR: 0.72, 95% CI: 0.61–0.86) were protective against depressive symptoms, with similar patterns for other outcomes. Other school factors protected Somali youth less consistently. Conclusions: Previously established protective factors against mental illness, particularly school factors, do not universally apply to Somali youth. Interventions that strengthen individual, family, or community factors, or that increase the relevance of school factors, should be explored for these youth.