Climate Change, Displacement, and Mental Health: Insights from Conflict-Affected Communities in Somalia

Background: Climate change, exacerbated by prolonged insecurity, profoundly impacts the mental health of vulnerable populations, particularly internally displaced persons (IDPs). This study aimed to investigate the prevalence and associated factors of post-traumatic stress symptoms (PTSS) among IDPs in Somalia. Methodology: A cross-sectional design was employed with 852 IDPs residing in the Banadir region of Somalia. The modified Harvard Trauma Questionnaire (HTQ) was used to assess PTSS. Multivariable ordered logistic regression was then utilized to identify factors associated with PTSS severity. Results: A substantial burden of PTSS was identified, with 55.1% of IDPs reporting moderate and 14.1% reporting high symptom severity. Factors significantly increasing the odds of PTSS included displacement from Hirshabelle (AOR = 2.11, 95% CI: 1.35–3.32) and Somaliland (AOR = 5.02, 95% CI: 2.17–11.57), a belief in climate change (AOR = 1.75, 95% CI: 1.20–2.56), perceiving climate change as the cause of displacement (AOR = 1.72, 95% CI: 1.22–2.43), frustration due to loss of places (AOR = 1.81, 95% CI: 1.16–2.84), and specific livelihood losses such as livestock (AOR = 1.79, 95% CI: 1.18–2.70) and business (AOR = 3.85, 95% CI: 1.32–11.21). Conversely, protective factors included being female (AOR = 0.71, 95% CI: 0.53–0.96), engagement in day labor (AOR = 0.62, 95% CI: 0.38–0.99), relatively better living conditions (poor vs. very poor; AOR = 0.36, 95% CI: 0.22–0.59), and critically, both community (AOR = 0.35, 95% CI: 0.19–0.62) and government support (AOR = 0.12, 95% CI: 0.07–0.21). Unexpectedly, self-reported harmful behaviors were associated with lower odds of PTSS (AOR = 0.69, 95% CI: 0.48–0.99). Conclusion: This study provides evidence of a strong relationship between climate-related displacement and PTSS among Somali IDPs, consistent with findings from other climate–conflict hotspots worldwide. Addressing this challenge requires integrated, context-specific approaches that combine mental health and psychosocial support with climate resilience and humanitarian programming. Strengthening Somalia’s mental health response should be viewed not as an adjunct but as an essential pillar of climate adaptation, disaster risk reduction, and peacebuilding.