Engaging the Wider Community in Healing

Kahin Adam, MPH, MSW, LGSW, is Somali community educator and psychotherapist at CVT St. Cloud.

For many of my clients in St. Cloud, Minnesota, meeting me is the first time they’ve ever seen a Somali therapist. They’re often in disbelief at first that I’m a clinician. They’ll ask me, “Are you an interpreter? Where is the therapist? Where’s the white therapist?”

It’s a huge thing for them to find a therapist who speaks their language, who understands their cultural background. My clients come to my office with hope that I will bring normalcy to their lives and provide more culturally informed services than white therapists in the area.

Some of them get emotional, not about their own experiences, but about the fact they’re working with someone who also has a refugee background. They are comfortable communicating and can be vulnerable with me because there is no interpreter or third-party communication. I play a critical role in helping clients gain control over the feelings and symptoms they experience as a result of going through war and/or torture, displacement and migration. I provide culturally competent therapy that incorporates Islamic religious references and practices/movements to affirm and better assist my clients in healing.

I’m told by my clients that I’m one of the few psychotherapists, perhaps the only, who speaks Somali in the St. Cloud area. CVT’s St. Cloud program is also one of the few mental health programs focused on trauma survivors, asylum seekers and the immigrant and refugee community. It offers culturally-sensitive services and culturally-modified care, which means we try to adapt therapeutic principles to our clients in a way that makes sense, a way they understand. We also try to create an environment free of judgment and fear.

I am in a unique position of understanding this issue from both the perspective of a provider and a refugee – I immediately understand the need for mental health treatment. As part of my work in the past with refugees in Seattle as a refugee and immigrant coordinator focused on transitional housing, I realized that there were many refugee immigrant support resources. However, I noticed a huge gap in mental health care due to high demand and lack of culturally-specific mental health services. I brought to my co-workers’ attention that refugees not only need shelter but they also need understanding of their cultural and emotional needs. Because of this experience, I went back to school to pursue clinical social work. When I was at Columbia University, my dream was to work with victims of torture and those inflicted with war trauma —before I even realized CVT existed. I am so glad to be part of this great organization and to have a very supportive and caring team.

It’s important to note that CVT’s St. Cloud program includes three components: First, to provide mental health care to asylum seekers, torture survivors and the refugee community. Second, to conduct community outreach sessions—giving presentations, bringing the community together and partnering with other organizations to increase CVT’s visibility. Then there’s the third component: community education, which includes our 12-week parenting classes and trainings for Somali students at local community centers. We also partner with the local healthcare system to do mental health workshops for refugees, and we recently reached out to other nonprofit organizations and government institutions in the area. We’re trying to see if we can bridge the gap, maybe even offer culturally competent, trauma-informed trainings for organizations who work with our client population. 

One thing I consider in my work is that the western way of treating mental health is new to refugee communities, especially Somalis. They have a traditional way of dealing with mental illness. Some don’t understand how important it is to seek help. There’s a lack of awareness, and there are cultural and language barriers to learning how to navigate the system, as well as stigma.

Often people turn to their tradition when there is a traumatic event and they try to find meaning in their traumatic event. Most of our clients are from cultures that often cope with calamities by conducting rituals and ceremonies. The Eurocentric way of approaching mental health treatment is new to them. There’s a common misconception that if you’re diagnosed with a mental illness or disorder, you might not get your citizenship. Or it will stay on your record forever; you’ll be excommunicated. I understand their concerns because mental illness is highly stigmatized in many communities or traditions. There are a number of people who hide it because they don’t want to be outcasts. In many cultures, mental illness is considered to equate to spiritual illness, not a psychological or physical illness. The belief is that it can only be treated through traditional healing. In Somali culture, there’s only one word to describe mental illness: Wali, which means “crazy” and has a negative connotation. So if you display any psychological symptoms, you’re a crazy person. People are afraid that if they’re seen that way, there’s no coming back from it.

Previously, people suffered in silence or went to a mosque, church or to a traditional healer.  But it’s beginning to change. There are increasing numbers of mental health practitioners of color and this is also increasing mental health awareness in the community. Many people within the community are starting to see things differently and seeking help.  

Many of my clients came to America for safety and to find a place to call home. Instead of feeling safe, however, they often experience great disappointment. Refugees who are from war-torn countries at times confront racism, discrimination and Islamophobia in St. Cloud. Every week when they come in, they always have a story about discrimination. When you see that your clients are struggling, and you’re coming from the same place, it’s extremely difficult. You want to help them, but at the same time it’s difficult, because it resonates with you so personally. As a therapist, of course that affects me. So it’s imperative to create a safe place for our clients and understand that they’re not just recovering from trauma back home –they’re experiencing trauma here.

There are also stories clients share about feeling welcome in St. Cloud. For example, a refugee client shared with me that she was going into a store on a cold day without a coat. A stranger saw her and bought her a new, warm coat, saying “We are so glad you are here.” She unexpectedly accepted the generous gift and told me she now felt safe and welcome in ways she had not experienced before.

I would like the larger world to recognize that we’re a program working with a community who has been traumatized by, and lived through, war for multiple generations. Having that kind of a community in an area like St. Cloud isn’t easy. That’s why I don’t just want to continue working only with my community; I want to engage others in the area. Together, we can build a more welcoming and healing environment for not only refugees but all community members. A community in which all forms of difference are celebrated and used for the betterment of all is one that moves beyond surviving to thriving.