Stigma, discrimination, or symptomatology differences in self-reported mental health between US-born and Somalia-born Black Americans

Objectives: We examined differences in self-reported mental health (SRMH) between US-born and Somalia-born Black Americans compared with White Americans.Wetestedhow SRMH was affectedbystigmatoward seeingamental health provider, discrimination in the health care setting, or symptoms of depression. Methods: Data were from a 2008 survey of adults in Minnesota and were limited to US-born and Somalia-born Black and White Americans (n = 938). Results: Somalia-born adults were more likely to report better SRMH than either US-born Black or White Americans. They also reported lower levels of discrimination (18.6%) than US-born Black Americans (33.4%), higher levels of stigma (23.6% vs 4.7%), and lower levels of depressive symptoms (9.1% vs 31.6%). Controlling for stigma, discrimination, and symptomatology, Somaliaborn Black Americans reported better SRMH than White and Black Americans (odds ratio = 4.76). Conclusions: Mental health programming and health care providers who focus on Black Americans' mental health might be missing important sources of heterogeneity. It is essential to consider the role of race and ethnicity, but also of nativity, in mental health policy and programming.