Aim <p>This qualitative literature review examines Somali perceptions of mental health and illness in Western Europe, focusing on how cultural, religious, and biomedical frameworks intersect to shape experiences and help-seeking behaviors. </p> Method <p>Using a narrative literature review, we analyzed 11 qualitative studies from Scandinavia and Western Europe. </p> Results <p>Findings indicate that Somalis communities understand mental health primarily through cultural and religious perspectives. The relationship with God is considered crucial, while recognizing external factors such as war and migration that can affect mental health. Somalis conceptualize mental health along a continuum, often using culturally specific idioms of distress rather than biomedical diagnoses. Shame, stigma, and fear of discrimination within and outside Somali communities present significant barriers to seeking mental health care. Additionally, the challenges of migration, acculturation, and cultural differences with healthcare systems further complicate access to support. </p> Discussion <p>The discussion emphasizes the importance of cross-cultural competence in clinical care and identifies gaps in research, particularly regarding second-generation Somali immigrants and their evolving mental health narratives. Additionally, there is a need for qualitative data to better understand the perceptions and experiences of young second-generation Danish-Norwegian-Somali individuals regarding worries of the mind and their approaches to seeking help. Conclusion: Future studies should explore how generational differences influence mental health perceptions and help-seeking behaviors. Future studies must address these gaps to inform culturally responsive interventions for Somali communities in Europe.</p>