{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:47:45Z","timestamp":1790718465225,"version":"4.1.0"},"reference-count":28,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec id=\"S2056472426110163_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There are few mental health services in the Somali Regional State (SRS) of Ethiopia, and many people with mental health conditions turn to traditional healing. Also, little is known about perspectives on mental ill health and care in this sociocultural context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426110163_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The study explores the experiences and manifestations of mental health-related stigma in the SRS, to inform the development of mental healthcare systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426110163_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted 16 semi-structured interviews with health workers, aspirational leaders, users of mental health services and carers in Jigjiga and Kabridahar, two cities in the SRS, between April and July 2024. Translated transcripts were imported into NVIVO version 14 for coding and were then analysed using the thematic analysis method. We identified three main themes: (a) mental health stigma, (b) societal neglect and (c) misunderstanding of mental ill health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426110163_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants suggested that most people in the SRS view mental health in binary terms, in which a person is either \u2018mad\u2019 or sane; a corollary is that only severe conditions with overt behavioural manifestations were viewed as mental illness. Most people viewed mental health conditions as having spiritual causes. Mental health stigma was reportedly widespread and severe. These barriers contribute to care-seeking that is delayed and initially focused on faith-based providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426110163_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Any intervention to improve the provision of mental health services and the development of mental health systems must take into account the perspectives of service users and carers, and address the widespread stigma and lack of knowledge around mental illness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2026.11016","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T10:02:20Z","timestamp":1776074540000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["\u2018Since people who have mental illness are stigmatised, their service is also stigmatised. You get a massive hospital building and there is no mental health facility\u2019: exploring perceptions of mental health, stigma of mental illness, care-seeking and service use in the Somali Regional State of Ethiopia"],"prefix":"10.1192","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5004-2230","authenticated-orcid":false,"given":"Nasir","family":"Warfa","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033v2cg93","id-type":"ROR","asserted-by":"publisher"}],"name":"Jigjiga University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Hanlon","sequence":"additional","affiliation":[{"name":"University of Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elyas","family":"Abdulahi","sequence":"additional","affiliation":[{"name":"Jigjiga University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Abdi","family":"Wali","sequence":"additional","affiliation":[{"name":"University of Kabridahar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdifetah","family":"Abdullahi Sheikh","sequence":"additional","affiliation":[{"name":"University of Kabridahar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Medhin","family":"Selamu","sequence":"additional","affiliation":[{"name":"World Health Organization"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mussie Abdosh","family":"Hassen","sequence":"additional","affiliation":[{"name":"Somali Region State Health Bureau"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fowsia","family":"Abdulkadir Hashi","sequence":"additional","affiliation":[{"name":"Commission for Human Rights"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulahi","family":"Hussein","sequence":"additional","affiliation":[{"name":"Jigjiga University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashir","family":"Abdulahi","sequence":"additional","affiliation":[{"name":"Jigjiga University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Abdinasir","sequence":"additional","affiliation":[{"name":"Kebridahar University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdikarim M.","family":"Abdi","sequence":"additional","affiliation":[{"name":"Yeditepe University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"al\u2019Absi","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School \u2013 Duluth Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4434-3526","authenticated-orcid":false,"given":"Roxanne","family":"Keynejad","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology & Neuroscience, King\u2019s College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon","family":"Teferra","sequence":"additional","affiliation":[{"name":"Addis Ababa University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Willott","sequence":"additional","affiliation":[{"name":"King\u2019s College London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"S2056472426110163_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(23)00259-6"},{"key":"S2056472426110163_ref1","unstructured":"1 United Nations Data Portal, Population Division. Total Population by Sex. UN, 2024 (https:\/\/population.un.org\/dataportal\/data\/indicators\/49\/locations\/231\/start\/1990\/end\/2024\/table\/pivotbylocation?df=871c3a37-235a-4aa1-9629-2a90066fcec1 [cited 4 Dec 2024])."},{"key":"S2056472426110163_ref22","doi-asserted-by":"publisher","DOI":"10.1186\/s13033-022-00545-8"},{"key":"S2056472426110163_ref28","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-749"},{"key":"S2056472426110163_ref6","doi-asserted-by":"publisher","DOI":"10.1080\/14659891.2024.2312381"},{"key":"S2056472426110163_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-017-1352-9"},{"key":"S2056472426110163_ref7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0163103"},{"key":"S2056472426110163_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-006-0043-5"},{"key":"S2056472426110163_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(23)00259-6"},{"key":"S2056472426110163_ref5","volume-title":"9-Month Mental Health Service Report (Lotus Hotel, Jigjiga, Ethiopia, 22 May 2023)","year":"2023"},{"key":"S2056472426110163_ref18","volume-title":"Stigma: Notes on the Management of Spoiled Identity","author":"Goffman","year":"1963"},{"key":"S2056472426110163_ref24","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.31475"},{"key":"S2056472426110163_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-020-01295-0"},{"key":"S2056472426110163_ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s13033-022-00540-z"},{"key":"S2056472426110163_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2004.00494.x"},{"key":"S2056472426110163_ref10","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"S2056472426110163_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2005.08.016"},{"key":"S2056472426110163_ref2","unstructured":"2 Reliefweb. Ethiopia: Baseline Population Distribution (29 Jun 2023). Reliefweb, 2023 (https:\/\/reliefweb.int\/map\/ethiopia\/ethiopia-baseline-population-distribution-29-jun-2023 [cited 15 Apr 2025])."},{"key":"S2056472426110163_ref8","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/8427561"},{"key":"S2056472426110163_ref11","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.183.3.184"},{"key":"S2056472426110163_ref17","doi-asserted-by":"publisher","DOI":"10.1186\/s13033-022-00525-y"},{"key":"S2056472426110163_ref16","doi-asserted-by":"publisher","DOI":"10.1192\/bji.2019.14"},{"key":"S2056472426110163_ref19","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-017-0657-0"},{"key":"S2056472426110163_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/gmh.2024.55"},{"key":"S2056472426110163_ref21","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-08290-x"},{"key":"S2056472426110163_ref25","doi-asserted-by":"publisher","DOI":"10.1186\/s12991-018-0205-3"},{"key":"S2056472426110163_ref26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1999.tb10693.x"},{"key":"S2056472426110163_ref27","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-019-2281-6"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472426110163","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T10:02:25Z","timestamp":1776074545000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472426110163\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":28,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["S2056472426110163"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2026.11016","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e106"}}