To identify and explore cultural dynamics influencing the psychiatric care of immigrant Somalis in the USA, we reviewed demographic data from Minnesota Departments of Human Services, and interviewed health professionals, exploring community perceptions of medical/psychiatric needs, cultural characteristics, barriers to care, and potential solutions. An informal survey of 37 members of the Mayo Clinic Department of Psychiatry and Psychology, to determine caregiver perceptions of care of Somali patients, cited language barriers (74%), and cultural misperceptions (68%) as the most frequent obstacles. Difficulties working within the patriarchal family structure, limited community resources, poor compliance, and financial issues ranged between 18 and 8%. Additional barriers mentioned were problems working with interpreters from ‘warring clan factions,’ patients' fears of being labeled ‘crazy,’ difficulties viewing illness within an emotional framework, and the need to address mental health from a physical framework through a focus on somatic symptoms. Somalis rarely acknowledge psychiatric problems and common traditional treatments have become ineffective in the new context. Recommendations include alternative health care approaches utilizing family values, ‘bargaining,’ and educational approaches to acculturation. © 2007, Sage Publications. All rights reserved.

culture Psychiatry Somali Immigrant Acculturation

immigrant Sick Role demography community care human immigration language ability Adaptation, Psychological family size mental health care Mental Disorders mental disease United States Humans traditional medicine Emigrants and Immigrants Acculturation social psychiatry caregiver burden socioeconomics cultural factor Article health care utilization patient compliance emotionality health care access Somalia Fear attitude to health health survey