Somalis in Minnesota are under pressure. Meet the therapist trying to help them.
Ahmed Hassan’s mental health clinic is small. It rests inside the large, labyrinth of an office building in St. Paul, Minnesota. A relaxing light-green color coats the walls, where images of African landscapes greet his Somali clients.
He is a psychotherapist who faces an uncommon challenge: how to treat a community of people who may wonder what therapy is in the first place.
“Whenever a client comes to me, I explain what I do and how is it going to help them,” he said. “So at least from the beginning, they will understand what is it that I do.”
Hassan helps people from Somalia in the Twin Cities cope with problems related to mental health. He is one of four licensed professionals in Minnesota who speaks Somali, he said. He too came from Minnesota from Somalia.
Somalia has been in civil war since 1991. Some 40,000 Somali refugees fleeing that conflict were admitted to the US between 2010 and 2015 — several suffering loss of loved ones, violence and political persecution.
Hassan said incidents like the recent attack in St. Cloud where a young Somali man stabbed 10 people at a mall feed anti-refugee and anti-Muslim sentiment nationwide and put the community on edge. They bring up painful memories of the violence they fled.
“When things like this happen it kind of triggers that fear that they already have in their brain,” he said. They think “everybody is looking at them twice, is kind of after them.”
Hassan was part of the earliest waves of Somali refugees entering the US in the 1990s. He was in his late teens when he first arrived. At first, he worked as a janitor and then in a factory.
One of Hassan’s earliest challenges was getting comfortable speaking in English. The process hurt his self-esteem.
“That was very difficult,” he said. “A lot of people think that you don’t know anything just because you don’t speak English.”
It took Hassan almost five years to learn the language. He went on to get his degree in psychology and his license as a mental health professional. He set up his own small clinic five years ago. Now, six other counselors also offer services there. The practice has two therapy rooms and a conference room.
Somali Refugee and Mental Health Provider Helps Community Cope With Trauma
Hassan said many of his clients expect medication from him and don’t understand why they need to delve into deep personal issues.
“It is very challenging to explain what therapy is and how it’s going to help the person,” he said.
Patients treated at a Minneapolis clinic between 2007-2009
Therapy can help people with mental health problems identify triggers and stressful memories, according to the US Department of Veterans Affairs. It can also help find ways to cope with trauma or stress and increase self-esteem. But, Hassan said, all this can sound very strange to someone with no notions of therapy.
There are almost 30,000 people who have immigrated from Somalia to Minnesota, according to the Minnesota Historical Society. There are more Somalis here than in any other state. Other sources place the population at twice that number.
Like Hassan, many struggle to acclimate to the culture, learn the language and tolerate the discrimination that comes with being black and Muslim.
A 2010 clinical study of patients at the Community-University Health Care Center in Minneapolis found nearly half of their Somali patients suffered from a combined diagnosis of depression and Post-Traumatic Stress Disorder. About five percent of the the non-Somali patients struggled with these mental health problems.David Schuchman, a mental health consultant, participates in an African mental health providers’ network with Hassan. He said that local public and private organizations offer some resources for refugees, but many refugees don’t realize they may need help.
“Partly, it is their perspective of either not recognizing it as a problem or a problem that something can be done about,” he said. “Or they don’t know about the resources, or there is a huge issue with stigma in the community.
Schuchman said that the lack of Somali representation in mental health professionals can also be a factor in why some don’t seek therapy. That is what makes therapists like Hassan so important.
“I believe the Somali community needs people like him who are bicultural, who can see mental illness from both perspectives,” Schuchman said.
Hassan can understand African cultures, and he tries to complement African spiritual beliefs with western mental health concepts.
“A lot of clients that get diagnosed with bipolar or schizophrenia or depression will resist the medication and will say, ‘No I don’t have this, I have a spirit possession or some other things,’” Hassan said.
Many Somali refugees seek religious guidance, instead of or in addition to therapy, he said.
Hassan oversees the Imam Training Project, which educates religious leaders in the Somali community about mental health. The program, sponsored by Fairview Health Services, was introduced three years ago. Since its launch, Hassan said, it has been blurring the lines that divide western treatment and African concepts. Religious leaders are referring more community members to therapy, and local Somali radio and television outlets have invited Hassan to spark discussions on refugee mental health.
“An insane man, his brother is sane
– A roughly translated African proverb, It highlights the importance of family in mental health.Ahmed Hassan
Most recently, Hassan has been experimenting with ways to better clarify concepts like depression or anxiety to people from Somalia. He has identified about 100 ancient African proverbs that communicate these psychological concepts. Using that research, he co-wrote a short children’s story that he plans to publish.
“This is all about giving the community a sense of ownership about these concepts and saying, ‘these are universal concepts and you should seek treatment and seek help,’” he said. “And this is how you can even find within your culture ways to cope.”
Hassan’s psychology degree hangs in one of the therapy rooms in his clinic along with his counseling license. That room was his office when he first opened the clinic. Now, he shares the space with six other counselors. He said he is not looking to move to a bigger space. He is more interested in personal growth, and he is thinking about adding a third degree to that wall in his old office: a PhD.