1.  Sahra Noor, PHN, MS Ahmed Hassan, MA Pa Chia Vue, MPH

2.  We have no relationships to disclose

3.  Describe the Mental Health Needs of Somali Muslim Immigrants  Discuss Methods used to train Muslim religious leaders on Mental Health disorders and treatments.  Identify opportunities to integrate faith into mental health outreach efforts

4.  85,700 Somalis live in the United States.  Nearly one in three people with Somali ancestry in the U.S. live in Minnesota.  0ver 95% of Somalis are Sunni Muslims Source: 2010 American Community Survey

5.  Mental Health (Depression/PTSD/Substance Abuse) o Stigma o Isolation and reduced social connectedness Source: 2012 Fairview Community Health Needs Assessment

6.  Stigma is defined as “the situation of the individual who is disqualified from full social acceptance” (Goffman, 1963, p. 9).  “Stigma hurts individuals with mental illness and their communities, creating injustices and sometimes devastating consequences.”

7.  Mental illness is perceived as a test or punishment from God or an opportunity to remedy disconnection from Allah  Imams (faith leaders) are seen as indirect agents of Allah’s will and facilitators of the healing process (Abu-Ras et al., 2008; Padela, Killawi, Heisler, Demonner, & Fetters, 2010; Padella et al., 2012).  Research shows imams may play central roles in shaping family and community attitudes and responses to illness (Padella et al., 2012).  In a study of 62 imams from across the U.S., Ali, Milstein, and Marzuk (2005) found that 95% reported spending significant time each week providing counseling to their congregants.

8.  Reduce stigma by: o Engaging Imams in a dialogue around mental health o Increasing their knowledge of mental health symptoms and treatment options o Providing them with skills and resources necessary to promote better access to care.

9.  Recruited 10 Imams from four mosques in Minneapolis  Monthly trainings o 8 trainings in 2013 o 10 trainings in 2014  Facilitated by MH Therapists

11.  Iterative, hands on, and discussion based workshops  Visual tools Used regularly  “Red Flags”  Focus on the role of imam as educator/advisor Learning conditions, causes, risk factors and treatment methods Recognizing signs and symptoms Discuss and identify resources and tools to help families

13.  “Since the training we have realized how to deal with people who come to the mosque for help. Some accept help but some postpone. We have recognized signs of depression.”  “This training has benefited us tremendously; we have recognized many signs of mental illness.”  “Before the trainings, I thought someone with mental illness meant someone is crazy and there were only very few of them. Now, I see the big spectrum and know this can happen to normal people who are functioning fine.  “Now I can help. This disease has prevention and treatment. I can help contain the issue.”  “I educate about this (addiction) in sermons.”

14.  Connecting the dots  They see MH as treatable condition with social implications  When asked how they can help the person feel better. They said they can: Refer to doctor if needed Help the person get a job Help person join a social group Help motivate the person Help the person find a spouse if of age

15.  One of the imams is in residency at Fairview to become first Somali/Muslim chaplain in upper Midwest  All imams hosted at least 1 BH workshop at their mosques attended by over 400 people Strong interest in spiritual health and family health in relation to mental health o Anecdotally imams report increased incidences of people being referred to treatment and evaluation.  Fairview’s riverside campus report 50% since 2013 in number of Somali speaking patients seeking treatment for substance abuse

16.  Continue monthly trainings in 2015.  Determine content based on feedback from Imams and mental health workgroup committee.  Continue to conduct focus groups with imams to gather input of how they are reducing stigma in the community.

17.  Faith leaders play a critical role in educating the community and reducing stigma  Faith leaders are eager to learn about BH and general physical health.  Be flexible in training approach and encourage consistent dialogue  Explore partnerships with mosques and community based organizations.  Faith leaders can be a great resource for culturally appropriate care

18.  Thank you