There is a mental health crisis in the Bristol Somali community with ten related deaths recorded

Somali-American imams fight stigma of mental illness

Somali-American imams have gathered monthly to learn how to spot the signs of mental illness and steer mosque members to professional help.



Imam Ahmed Ibrahim referred a depressed young man to a therapist. Later, the man was in better spirits. “When we make referrals, people take that seriously,” he says.

Imam Ahmed Ibrahim recently stepped in to help a young Somali-American man who’d grown increasingly withdrawn and gloomy.

At his south Minneapolis mosque, Ibrahim offered support he had perfected over almost 25 years as an imam: readings from the Qur’an and prayers to recite morning and night. But Ibrahim also did something new: He gave the man a list of local therapists and urged him to seek help.

In the past year, Ibrahim and other Somali-American imams have gathered monthly to learn how to spot the signs of mental illness and steer mosque members to professional help. Hosted by Fairview Health Services, the training enlists the imams as key allies in chipping away at the stigma of mental illness and skepticism of mental-health treatment among Somali-Americans.

“The reality is that when Muslims face problems, the first place they come is the mosque,” said Ibrahim. “When we make referrals, people take that seriously.”

The training is among a spate of new efforts nationally to recruit faith leaders — Muslim, evangelical Christian and others — to counter deep-rooted notions of mental illness as a sign of spiritual failing or demonic possession.

In 2012, the University of Minnesota Medical Center conducted an Affordable Care Act-mandated survey of community needs in Minneapolis’ Cedar-Riverside neighborhood. Mental-health issues emerged as a top concern.

Sahra Noor, the medical center’s community health director at the time, said some residents still deal with the fallout of fleeing a brutal civil war and with the stresses of starting over in America — from joblessness to family conflict.

A multiyear study of refugees from Somalia at a Minneapolis clinic published in 2010 found that more than 30 percent showed symptoms of psychosis and 15 percent suffered from depression, problems the study tied to war trauma and other factors. But Somali-Americans are often reluctant to seek professional help.

“In our culture, we think people are either crazy or well, and who wants to be called crazy?” said Noor. “But you feel comfortable talking with the imam at your mosque.”

However, said Osman Harare — a onetime physician in Mogadishu, the capital of Somalia, who now leads the nonprofit East Africa Health Project in the Twin Cities — imams’ time-honored prescriptions to pray harder and come to the mosque more often fall short for some struggling mosque members. Some local Somali-Americans turn to self-appointed healers who purport to exorcise the “jinn” they say cause mental illness, sometimes charging hefty fees.

Noting the disproportionately low rates at which Muslims seek out professional help, a national survey of 63 imams recently found lingering reservations about western treatments of mental illness.

Presented with a case study of a severely depressed person, imams often saw stress, but they also cited a religious crisis and a weak personality as likely culprits. They rated more active participation in the mosque as most effective and medication as least helpful.

These attitudes are by no means unique to Muslim communities. Efforts are underway nationally to spur more open conversation about mental illness in evangelical Christian congregations, more education about mental health in seminaries, and new partnerships between clergy members and clinicians.

In fact, Noor said, the outreach to imams she envisioned in response to the Fairview survey was modeled on similar initiatives in African-American Baptist congregations.

When she ran the idea by Somali elders, they warned that imams would balk. Instead, all 10 south Minneapolis imams that Harare approached signed on and — except for one who returned to Somalia last year — they’ve stuck with the project in its second year.

Spotting the red flags

Dr. Farha Abbasi, a Michigan State University psychiatry professor, said similar training projects are gaining traction in several Muslim communities across the country. The university hosts an international Muslim mental-health conference. It brings together faith leaders and mental-health professionals who tackle “prickly topics,” including challenges faced by gay Muslim youth.

“The mental-health movement is becoming really vital in the Muslim community,” said Abbasi, adding, “Faith can be a strong tool to promote resilience if used correctly; if perverted, it can be fatal.”

Since late 2013, the Minneapolis imams have covered a wide range of topics — depression, addiction, bipolar disorder, and treatment options from cognitive behavioral therapy to medication — in monthly sessions led by a Somali therapist, Ahmed Hassan. During case-study readings and role play, the imams wave red napkins when they hear a “red flag” for mental illness.

Ann Ellison, Fairview’s community and church relations director, said the imams also got guidance on how to weave discussion of mental health into their Friday prayers in a bid to fight stigma. Several mosques hosted workshops after Friday prayer, attended by an estimated 400 people. The project inspired one participant, Imam Sharif Mohamed, to become the first Muslim religious leader to join Fairview’s Clinical Pastoral Education program as resident chaplain.

Fairview has mostly anecdotal evidence that imams are making referrals. But training organizers point to a 50 percent increase in Somali-speaking patients seeking addiction treatment at Fairview’s Riverside campus since 2013.

Cawo Abdi, a Somali-American sociology professor at the University of Minnesota, said that single-handedly combating the stigma of mental illness and treatment in the community would be tough even for an influential group like the imams. They can face suspicion that they are taking money from hospitals in exchange for referrals. Still, the training effort is a start, she said.

Imam Sheikh Sa’ad Musse Roble said the training has been eye-opening. He used to think of mentally ill people as running down the street, shedding their clothes and raving. He has come to realize that a mosque member can dress well and speak coherently, but quietly grapple with “a small mad.” He has also come to believe that mental-health professionals can be key partners to “spiritual doctors” like him.

‘A scientific perspective’

Ibrahim, one of the imams, has shared a list of mental-health providers with several members of his modest storefront mosque, where a smartphone buzzes often from the skirts of his traditional garb. The depressed young man who consulted him did seek out treatment, and in the following months, Ibrahim noticed he was in better spirits.

Another man had declared he was “dying” under the burden of job stress and marital problems. The man also followed Ibrahim’s advice to seek professional help, but the imam couldn’t prevail upon him to take the anti-anxiety medication he was prescribed or make the recommended lifestyle changes, such as more exercise.

Mohamed, the Fairview chaplain, recently got a call from an acquaintance whose sister had seen a traditional healer who prescribed Qur’anic readings and herbal medicine. But she was still refusing to eat, sleeping fitfully and exploding in screaming fits. Did the imam know of any other techniques to drive away the woman’s jinn? Mohamed told the man that he would meet with the woman to offer spiritual support — but that she should also see a mental-health professional.

“Religion is still important, but it’s also important to seek help from a scientific perspective,” said Mohamed. “They are not against one another.”

http://www.startribune.com/somali-american-imams-fight-stigma-of-mental-illness/295440541/

towerheist said:

How can you still keep going after all these negative news??

Yaab badanaa waxaan kama daashid miyaa??

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@towerheist

What you call negative news is raising awareness of mental health among the Somali community and if triggers you somehow, please post whatever you perceive as "positive threads" and kindly, don't derail this one.

Jaydaan said:

His xabashi mom has poisoned his mind

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@Jaydaan

I'm not surprised that you even went after my mother. How low!!!!

Luciddreamer said:

That imam is the real mvp. Using his position to give good advice instead of going the route of jinni and black magic.

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@Luciddreamer

Indeed, it is not only that Imam, but all the Imams they approached are now part of the project.

"When she ran the idea by Somali elders, they warned that imams would balk. Instead, all 10 south Minneapolis imams that Harare approached signed on and — except for one who returned to Somalia last year — they’ve stuck with the project in its second year."

This kind of a result has to be applauded and this program should be adopted by the Somalis in other countries.

" But training organizers point to a 50 percent increase in Somali-speaking patients seeking addiction treatment at Fairview’s Riverside campus since 2013."

New developments in Bristol related to the initial story on this thread.

Young Somali Bristolians come together to challenge mental health stigma in their community.

“As the largest ethnic minority community in Bristol, we have seen patterns of death and suicidal cases recently. We are at a crisis point."


Somali mental health event - sport day held at City Academy Abir Shirdon, Shona Jemphrey (Labour Cllr candidate), Mohamed Elsharif, Mayor Jos Clarke, Mohmed Abdi Sayaqle, Moestak Hussain and Said Burale.

Members of the Somali community in Bristol have started a campaign to challenge a crisis in mental health.

Culturally mental health issues are often ignored or dealt with in a very different way than in the west, and community leaders are starting a conversation.

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The Break The Stigma campaign is led by Bristol Somali Youth Voice, who want to tackle and normalise mental health issues in their community in Bristol.

They want to educate young people to have the confidence to talk, and get symptoms diagnosed early before they reach crisis point.

The Easton based organisation held a football tournament at City Academy on Saturday October 19 to raise awareness of their campaign.

A report conducted in March 2017 by the Council of Somali Organisations in the UK, outlined what people in Somalis believe the different "causes" and "treatments" for people experiencing mental health to be.

It stated mental health conditions were predominantly seen as ‘God’s will, poor practice of religion, evil eye, evil spirits and sorcery.’ The traditional methods of treatment in Somalia were described as usually providing ‘religious and social support’ which included methods such as ‘ritualistic dancing, visiting local shrines and healing.’

The western model of psychiatry can be viewed with suspicion by elders in the community, and the report pointed at significant barriers Somali people faced when encountering mental health issues in the UK, with many traditional ideas still holding weight. This resulted in a culture of silence particularly amongst men; a stigma of being labelled; a fear of mental health services; and a lack of mental health literacy.

It also highlighted a lack of well trained Somali professionals in the sector of mental health, and suitable information about the availability of services leading to a cultural misunderstanding, from both sides.


Somali mental health event - sport day held at City Academy Mohamed abdi Sayaqle works for Bristol Somlai Youth Voice.

In Bristol, this has manifested in a number of serious incidents, including ten related mental health deaths in the last few years. With settlements of Somali people in the city dating back to the mid 1990s, following civil war that devastated their homeland, the younger generation like many new migrants can feel trapped between two worlds. Some of the traditions and attitudes to mental health adopted from the elders are, however, being challenged by young people and supporting organisations. One is Bristol Somali Youth Voice , who have conducted some of their own research in the city.

The research revealed that as much as 40 per cent of British Somalis in Bristol say they have suffered from some form of stress or depression, but as much as 82 per cent are unlikely to contact their GP. In terms of the services available to them 96 per cent of the people they spoke to had not heard of CAMS (Child and Adolescent Mental Health Services) and Off the Record, a mental health organisation that supports young people.

Manager Mohamed Abdi Sayaqle said: “Mental health is a real issue that some of us deal with in silence without seeking proper help, especially ethnic minorities, and even more so in the Somali community.

“As the largest ethnic minority community in Bristol, we have seen patterns of death and suicidal cases recently in Somali community in Bristol. We are at a crisis point,” he added.
He sees the problem as two-fold as culturally their own community and the services themselves don’t always understand one another. He continued: “There is a big stigma, and culturally we feel embarrassed talking about mental health issues, and this has prevented a large number of community members using and accessing available primary mental health services.”


Somali mental health event - sport day held at City Academy

Mohammed wants to focus on young people , as he sees the next generation as crucial to playing a real part in changing things. He explained why: “We opted to work with young people predominantly from BAME background (majority from Somali background) who have less of a stigma, and are more open-minded than older generations. We want to involve them, and get them to lead a culturally appropriate awareness campaign about bridging and overcoming this stigma. About how to overcome the embarrassment attached to mental health illnesses and seeking help.”

One approach is using sport, especially football due to its particular popularity in the Somali community. He said: “We wanted to empower community members at grass root level to improve their understanding, and to normalise talking about mental health. So doing this alongside football makes sense, young people are mad on it. So we use it as a tool to engage, and kick start the campaign,” he added.”

At City Academy on Saturday October 19 up to 60 young people attended the tournament. It began with a series of talks about the issues of mental health in the community. One from Mohammed himself, Lord Mayor Joss Clarke , and Deputy City Mayor Asher Craig.


Musab Ali at Football tournament at City Academy

Many of the young people Bristol Live spoke to were acutely aware of what needs to happen in their community. One was 16-year-old Musab Ali from Barton Hill. He said: “Today we are all here to raise awareness of mental health issues. We don’t talk about it enough in our community. When people are depressed, anxious we should help more.”

For him playing football is something that can help his peers if they are struggling with any condition, he continued: “It’s a great physical release, and it also offers a support system. You are with your friends who you can talk to.”

Liverpool fan Mubarak Ismail is 16 and lives in Lawrence Hill, and he wanted to see more events like this. He said: “Things like today are vital. We need to speak out more, and show that it’s ok. That it doesn't make you odd or different, that mental health issues are normal.”

Playing football made the message more accessible to everyone, “When you play football, you are not alone. So playing with friends you can open up to them. We do have an issue in the Somali community, and we aren't always open to speak. But my generation want to change that, and that's why we are here,” he added.

One of the volunteers from Bristol Somali Voice is Abiir Shirdon, 32-year-old cycle instructor for the project, focusing on supporting young women. She feels using sport and physical activity is a key part of breaking down the stigma, but honest conversations need to be had. She said: “It’s a lot to do with a lack of education in our community, it's a cultural thing. The stigma of mental health means that in Somalia many people don’t get any treatment at all, and that has carried on here in the UK for many.


Somali mental health event - sport day held at City Academy

“It’s often not seen as an issue, and people make excuses for odd behaviour. They don't always understand symptoms or warning signs, so it's good to get people understand things more,” she added.

Abiir wants to see both communities engage more effectively. She said: “In our community we need more awareness, but so do mental health practitioners too. I think they need to understand the cultural legacy of how our community thinks about mental health. Understand why people won't always come forward, and to get out and connect more effectively, particularly with children at school age and under, so we can catch it early,” she added.

To find out more about Bristol Somali Voice you can visit their Facebook page

https://www.bristolpost.co.uk/news/mental-health-crisis-somali-community-3454855

Didn't know that Somalis were the biggest ethnic group (other than whites) in Bristol.