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Why is the number of Somalis entering the Minnesota mental health care network continuing to grow?

Photo: Craig Lassig | AP 2014 MPR
Mohamoud A. Hussein

Mohamoud A. Hussein

Over the past two decades, there has been a vast influx of Somali refugees and immigrants making their new homes in Minnesota, with the overwhelming majority residing in the Twin Cities of Minneapolis and St. Paul.

While official estimates indicate that less than 60,000 Somalis are in Minnesota, it is well accepted that there are, in fact, closer to 70,000  85,000. It is difficult to pinpoint the exact number due to limitations in census data collection and the continual growth resulting from such factors as secondary migration.

Since Minnesota has welcomed African immigrants, family members who live in other states within the U.S. and Canada continue to join many newly arrived families already in St. Paul and Minneapolis. The prospect of Somali immigrants and refugees returning to their homelands is unlikely.

Continuing war, civic strife and economic crises make the outlook for return to Somalia bleak indeed. Therefore it is important that Minnesota continue to embrace and welcome Somalis into the community and assist in their acculturation process.

Health and Acculturation

The challenges facing Somali immigrants and refugees in the Twin Cities are complex and their needs are great. Besides facing enormous cultural and language differences, African immigrants and refugees contend with racism, often have limited literacy skills, and hold jobs where they barely earn minimum wage and have difficulty providing for their families.

It is particularly difficulty in cultures such as Somali where adults are not accustomed to learning from children. When children have English language proficiency and parents don’t, this creates an imbalance of power in the family, which makes parenting and acculturation very stressful and confusing.

Another dynamic in families occurs when a parent, usually the father, has lost his stable role as primary breadwinner. When resettling in a different culture, previous work skills are often not easily transferable.

As a result it is often very difficult for a parent with little or no English language ability to secure a job. When parents require financial assistance from the government they usually feel distressed that they are not providing for their families. This can lead to feelings of guilt, humiliation, and worthlessness.

Social Isolation

Many Somalis with mental illness are socially isolated. The pain of this isolation is felt intensely because Somali culture is traditionally communal and family oriented. While a person with mental illness may be ostracized from the community, their fear of stigma may be even more powerful.

Whether the ostracism is created by the community or self-imposed due to anticipated negative responses, social isolation creates a profound worsening of mental illness. This social isolation can be very disorienting and can make the process of healing very difficult. In fact, even without prior mental health problems, isolation from community alone can contribute to the development of depression and mental illness.

Impact of War Trauma

The U.S. Surgeon General’s report Mental Health: Culture, Race, Ethnicity – Supplement highlighted the overwhelming burden of mental illness that racial and ethnic minorities face compared to their American counterparts.

Immigrants and refugees often have encountered additional stressful events that contribute to mental illness or adjustment problems. Immigrants and refugees experience multiple losses including loss of homeland and loss of loved ones.

Immigrants, and most certainly refugees, have likely endured one or more of the following traumatic events prior to resettlement: malnutrition or famine, violence, political persecution and torture. Often trauma goes untreated until long after resettlement. Past trauma and current adjustment challenges increase the risk of developing behavioral and mental health problems.

Conclusion

Psychosocial support during the acculturation process increases the likelihood of positive adjustment and cultural adaptation. Providing mental health treatment in the context of culture and religion creates a familiarity important for engaging the community and has proven to be effective.

The need for more effective mental health services for Somalis is great. Expanding the capacity of Somali and mainstream mental health providers should continue to be a primary focus for our mental health service systems here in Minnesota. Improving our ability to meet the needs of the Somali community is principal as we hold them as legitimate and permanent members of our community.

by Mohamoud A. Hussein MA Health and Human Service Administration

Clinical Social Worker (LGSW)

Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: Author.

Photo credit: Mohamoud Hussein, empowermagazine

 

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