1. IMAM’S ROLE IN PROVIDING PSYCHO-SOCIAL SUPPORT TO MUSLIM REFUGEES AND IMMIGRANTS IN VANCOUVER, CANADA. Mohamed Ibrahim, RN,MSW, PhD Cand. Instructor, Faculty of Health, Kwantlen Polytechnic University Mental Health and Addiction Clinician—Vancouver Coastal Health Authority Nouf AlKusayer, BSc (SFU), Graduate student at Memorial University of Newfoundland. 8th Annual PCAF Pan-African Psychotrauma Conference; Nairobi. 13 the -16 th July 2015.

2.  Center for the Study of Gender, Social Inequities and Mental Health (CGSM) for scholarship support towards this research project.  CGSM was funded by Canadian Institute for Health Research (CIHR)  Research Participants Acknowledgement

3. Muslims in Canada

4. In numbers … Canada: 1 million Muslims and growing Muslims constitute the largest group of refugees resettled in Canada—From Somalia, Iraq, and now Syria. British Columbia (BC): >200,000 mostly in Metro Vancouver BC welcomes about 1200 refugee families per year with 60% coming from Muslim countries (ISSBC,2013).

5. Muslims and Mental British Columbia Muslims Mental Health Islam, Muslims & Mental Health Global Mental Health Issues

6. Muslims and Mental Health Mental illness in countries devastated by conflict is higher compared to other countries (Mollica, R, Mclnnes, K, Sarajlic, N, Lavelle, J, Sarajlic, I & Massagli, P,1990) WHO estimates 1 in 3 Somalis suffer from one form mental illness due to over 20 years of war, drought, poverty etc. (WHO,2010). Similar statistics reported for Afghanistan, Iraq and Palestine.(children in Palestine have one of the highest psychological trauma).

7. Studies in USA shows Muslims showing increasing rates of anxiety, paranoia and other forms of mental health issues after 9/11 ( Abu-Ras, W,. Gheith, A,. & Cournos, F, 2008) Muslims in Western countries –among lowest group to utilize mental health services due to discrimination (real and perceived), different concept of understanding and other barriers faced by immigrants ( Hansson E, Tuck A, Lurie S and McKenzie K, 2010)

8. Roles of Faith & Spiritual Instituition

9. Roles of Spiritual Leaders https://www.youtube.com/watch?v=IN05jVNBs64

10. Islam and Mental Health Studies show Muslims in North America overwhelmingly seeking psychosocial needs from imams and mosques. The Holy Qur’an states: “We reveal from the Qur’an that which is healing and a mercy for the believers”, (Qur’an, 17:82) Hadith “Allah does not send any disease but He also sends down a cure for it” Al-Saheeehyn as quoted by Ameen, 2005). Stigma It’s no fault in the blind, nor one born lame, nor one afflicted with illness,,,,,,,,,,,(sura 24:61)

11. BC Muslims MH Study Looking into the perspectives of Imams and Mental Health (MH) professionals regarding BC Muslims mental health issues Understanding the role imams play among the Muslim community in Vancouver in respect to psychosocial needs. Addressing the unique mental health needs of Muslims from Muslim leaders perspectives.

12. Methods Ethnographic in-depth one-one-interview with imams across six mosques in Vancouver, Canada. Field work (Active participation) Data Analysis through thematic qualitative analysis Total respondents N= 8 (5 Imams & 3 Health professionals).

13. Research Findings 1. BC Imams highly educated compared to what the literature says in other regions/cities—counsellors, health professionals, doctorate etc. “I decided to study psychology because of the high needs for counselling for persons/families visiting the mosque” Imam 1 “I am qualified marriage officer and counsellor” Imam 2

14. Roles of Imam … “In many cases, when they come to us, they feel very depressed, very weak. They feel they cannot do anything and many times they’re in bed they don’t eat well they don’t sleep well, so their relatives bring them. we face many cases very many cases like this.” Imam 2 “we need more family counsellors not only welfare cheques” Imam 4. (Psychiatrist) --Client’s engage actively in spiritual activities as a form of mental health treatment

15. Research Findings  Imams providing significant psychosocial support to community members  Respected and trusted by the community  Members increasingly seeking MH services from the institution of the mosque.  Imams holding regular therapy sessions (mostly with families).

16. Research Findings 2. Family Conflict—All the respondents stated this as the single most important issue in the community. Family dysfunction, conflict, divorce more prevalent among families coming from conflict countries i.e. Somalia, Iraq and Afghanistan. Correlation between post-war effects and family dysfunction/conflicts. Imams view psycho-trauma from family and community perspective rather than individual and Tx focused on the same.

17. Research Findings 3. Youth problems—delinquency, drug gangs/addiction, and school problem - tied to family conflict and disruption 4.Women Mental Health—Depression and stress - Tied to family dysfunctions, Lack of extended family supports, Financial stress and lack of opportunities, Post-traumatic stress among persons from conflict countries.

18. Research Findings 5. Lack of culturally appropriate services for the elderly –although Mosques play important role but still more need to be done. 6. Difficulty in navigating complex health care system-due to medical illiteracy, language barriers etc.

19. Research Findings 6. Different explanatory models of mental illness—somatic, metaphysical and spirits causation—God’s will, Jinn, sihr, evil eye— common in all the regions. 7. The institution of mosque playing cultural brokerage –MH awareness events, fundraising for MH services across Metro Vancouver.

20. Recommendations 1.Fostering better communication and working relationship between Mosques/Imams and health/social services 2.Module designed for training Imams – Provide them with the resources they need – Make communication with health and social services easier

21. Recommendations 3.The need for more collaboration between resettling and receiving agencies (UNHCR, IOM) 4.Imams, community leaders and Ministry of health/health authorities to jointly address strengthening families and education in culturally appropriate ways.

22. Discussion

23. شـــكــــراً Thank you!