Community Mental Health Programs See Results for Minnesota Immigrants

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Photo of Fatuma Ali at a History Theatre performance. Photo Credit: Justin Cox

By: Bonnie Harris, Freelance Journalist

It’s clear that the pandemic has contributed significantly to already rising rates of mental illness in our communities of color.  A recent brief by the Kaiser Family Foundation (KFF), using analysis of Census Bureau data and other research, reported Black and Hispanic or Latino adults were nearly 50% more likely to report symptoms of anxiety or depression in the past year.  KFF Tracking Polls conducted in July of 2020 also found that people with lower incomes are more likely to report major mental health issues as a result of the coronavirus. 

For people like Fatuma Ali, mental health recovery can be an even longer and tougher journey because,  as Mental Health America and other organizations have often reported,  certain aspects of immigration itself can have a greater impact on mental health  due to the trauma and lack of social supports often associated with migration.   

Fatuma’s family immigrated to the U.S. from Somalia when she was 13. Her personal story is reflective of the ways in which people within immigrant communities often experience greater barriers to receiving mental health care. Clinical studies show that rates of PTSD among immigrant populations range between 40 and 100% (compared to 1% of the general population) with rates of depression as high as 72%. 

Fatuma’s story helps highlight the actual and psychological journeys that can make mental health recovery so challenging for people within our immigrant populations. “The civil war in Somalia was terrible. By the time I was 10, I was experiencing anxiety and depression, and crying all the time,” she says. “There’s still a lot of stigma around mental illness for Somalians, and we can be pretty embarrassed to admit there’s a problem.”  Like many immigrant families, Fatuma’s parents tried non-psychiatric treatments through religion, for example, before a major crisis landed her in the emergency department at age 23.  

While some politicians would have us believe that the problem is in large part due to stress related to the undocumented status of some immigrants, in reality immigrants often face barriers to mental health supports that are both structural and cultural. A lack of insurance, language barriers, relying more on informal networks or delaying treatment due cultural stigma are all factors that contribute to higher rates of mental illness for immigrants. 

For Fatuma and others, the impacts of immigration add to what has historically been a problem for many people with serious mental illnesses, who often experience what can seem like an endless cycle between home and the emergency department. The problem has worsened as barriers to mental health care and issues with insurance, among other things, have made hospital emergency departments the de facto treatment for mental health crises over the past several years, increasing the incidence of these kinds of visits by over 40% in the past decade.   

For Fatuma, however, this story has a happy ending. After years of feeling isolated and alone as she was referred to a psychiatrist as a result of that crisis, one who is still her doctor today. And she found Vail Place, a community-services organization that provided a new source of friendships, work and service that has become the cornerstone of her continued mental health recovery. 

“At Vail Place I met regular people who were kind, intelligent and friendly,” she says. “They loved me and respected me for who I was. I learned that the stigma around mental illness was actually a lie.” 

Fatuma’s story and others like hers are proving the importance of community-based mental health services, particularly for immigrants who often face not just greater trauma but also cultural barriers to receiving help.  In Minnesota specifically, however, an emphasis on building bridges into the community for people with mental illnesses is making a difference. 

Vail Place staff, for example, work within emergency departments and other areas of healthcare providers like North Memorial Health, providing a bridge back into their communities and providing ongoing support so that crises like the ones Fatuma experienced can be reduced or avoided completely.  Many of the programs operate out of two Clubhouses in the Twin Cities, where members like Fatuma meet to share their stories, find social services and work opportunities, and share meals. Vail Place programs and others at nonprofit agencies are part of a larger effort by the State of Minnesota Department of Human Services to support a broader range of services for people suffering from mental illnesses.  

“The Twin Cities is really an innovation hub for mental health care, and we’re seeing a lot of the benefits of a cooperative, community-based model,” said Vicky Couillard, Executive Director for Vail Place. “Sometimes the barriers are very high for people with serious mental illnesses within communities of color, and immigrant communities. Our connection within emergency departments, and our relationships with referring providers and other partners are making a difference in terms of stopping what can seem like an endless cycle of crisis.” 

Fatuma found a new community of support where she was able to find not only mental health care but work and a new sense of purpose. Today, Fatuma is one of the main speakers for Vail Place, telling her story at events like the recent fundraiser Tour de Vail, and at a History Theatre performance on July 13th.   She was named to the Vail Place Board of Directors this year. 

“I have found my purpose in life, to share a message of hope and recovery,” Fatuma says. “We need to get rid of the stigma of mental illness. It just gets in the way of getting better.” 

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Bonnie Harris is a communications consultant and writer living in St. Paul. 

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