BackgroundMental distress is a common finding among University students. Empirical research has confirmed that the University student population has a higher prevalence of mental disorder than the general population. However, no previous study has examined the mental health conditions of students in Somaliland.MethodsAn institution based cross-sectional study was conducted on a sample of 570 undergraduate students at the University of Hargeisa in October, 2013. Study subjects were selected using a stratified random sampling. The Self-reporting questionnaire (SRQ-20) was used to assess mental distress. Multiple logistic regression analysis was carried out to identify factors independently associated with mental distress.ResultsThe point prevalence of mental distress was found to be 19.8%. Mental distress was associated with being female (AOR = 3.52, 95% CI 1.94, 6.39), having a monthly income of 100 United States dollars (USD) or less (AOR = 2.19, 95% CI 1.12, 4.28), and not having a satisfying relationship with the family (AOR = 11.52, 95% CI 3.18, 41.72) and friends (AOR = 7.33, 95% CI 2.83, 18.93). Nearly one in five students (18.6%) has been using Khat in the previous 12 months. Khat use was also associated with greater likelihood of mental distress (AOR = 2.87, 95% CI 1.26, 6.56). In addition, financial difficulties and the poor prospect of finding a job were common sources of stress among the students.ConclusionsA significant proportion of the students at the University of Hargeisa suffer from mental distress which might have a detrimental effect on their academic performance. The mental health needs of the University students require attention with special emphasis on female students, students experiencing financial hardships, students who use Khat and those who have interpersonal problems.

In Somaliland, mental health has been a neglected sector since the inception of the country almost 30 years ago. Only two years ago, there was no office, no staff, and no funding for mental health. Public mental health services were confined to five public in-patient facilities within the regional general hospitals, with a total bed capacity of 216 beds for a population of 4 million people. All the facilities experienced severe shortages of human and material resources, and proper supervision or control by the ministry did not exist. Lack of adequate and good quality-public mental health services has encouraged the opening of a plethora of unregulated private mental health facilities with poor records of human rights and services. One of the major impediments to improving mental health in the country was a lack of financial resources. In recognition of the deteriorating situation of mental health in the country and public pressure to do something about the problem. In late 2020, the government decided to scale up mental health services through khat taxation. Tax collection started in January 2021, and the first funds were released for use in July 2021. A five-year national program on mental health was then launched on August 1, 2021 underpinned by four main objectives: 1) establishment of leadership and governance in mental health; 2) strengthening existing mental health services and their integration into primary health care; 3) development of human resources in mental health; and finally 4) setting up a mental health information and research system. In this paper, we present early program achievements and their relevance to public health for other countries with similar settings looking to improve their mental health through effective mobilization of local resources.