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1. Matters of the Mind: Addressing Mental Trauma in Muslim CommunitiesApril 22, 2013, 2-3:00 pm Eastern Second in a webinar series exploring the behavioral health concerns, challenges, and successes for today’s Muslim American communities. Co-hosted by American Muslim Health Professionals Islamic Society of North America U.S Dept of Health and Human Services Center for Faith-Based and Neighborhood Partnerships

2. Acacia Salatti, Acting Director Center for Faith-based and Neighborhood Partnerships, U.S. Dept of Health and Human Services Welcome! WWW.hhs.gov/partnerships

3. Khizer Husain, PresidentAmerican Muslim Health Professional Where Faith and Communities Come Together http://amhp.us/

4. Nancy C. Lee, M.D.Deputy Assistant Secretary for Health-Women’s HealthOffice on Women’s Health U.S. Department of Health and Human Services Matters Of The Mind: Addressing Trauma In Our Communities April 22, 2013

5. Rukhsana M. ChaudhryClinical Psychologist www.wellnessthroughcounseling.com

6. The Universal experience of trauma: physical, social, psychological, spiritual, and economic. An “Invisible Wound” Trauma in the Muslim Community: A Universal Experience within Diverse Communities

7. What Does Trauma in the Muslim Community Look Like? A Case Study Soheil A 28 y/o Somali male who migrated to the United States in approximately 2009. He recently confessed to his local Imam of his Mosque that he has had difficulty maintaining a job consistently since his arrival and believes that others around him intend to hurt him. He wants religious guidance from his Imam to cope with the stress of others aiming to cause him harm. Soheil has difficulty attending each of his case management appointments with a refugee agency helping him to find work. He frequently loses his paperwork, has excessive difficulty focusing in order to complete his documents, and he has told his case manager that he has increasing trouble sleeping--often only four to five hours a night.

8. Factors Continued Aisha Witnessed violence against her mother inflicted by her father for many years during her upbringing. She recalls her mother frequently recovering from injuries which she sustained from her father's abuse. The only person she speaks about the abuse to is her sister. She is completely financially dependent on her husband and fears being unable to financially support herself if she decided to leave. She is also afraid that her family will blame her for the end of her marriage for not obeying her husband properly.

9. Factors • Cultural and historical context • Expressions of trauma • Current social context • Level of Religiosity • Age at which trauma is experienced • Ongoing violence • Inter-generational transmission of trauma • Early coping styles • Co-morbidity

10. Barriers to Treatment • Lack of community knowledge about the availability of mental health care. • Having strong reservations about modern psychiatry, while mainly seeking traditional healers. • Stigma attached to mental health problems and the lack of familiarity with the concept of counseling or psychotherapy including a perception that treatment may override religious beliefs. • Social stigma and family honor prevent many clients from seeking treatment. • Discomfort discussing personal (sexual) information with providers of the opposite sex.

11. Barriers to Treatment • Fear that treatment of trauma-related symptoms will worsen symptoms. • Difficulty differentiating one's everyday experience from symptoms in need of professional care. • Difficulty managing their children within the American social system and fear that Child Protective Services will take their children away for discipline and care practices. • Economic and occupational difficulties. • The lack of culturally competent mental health professionals.

12. Bilal Ansari, ChaplainWilliams College www.williams.edu

13. Boston Trauma: Student A 19 yr. old Chechen male who migrated to Boston in approximately 2003. He recently confided in school administrators of a small Massachusetts public college (hours from home, one hour from the nearest mosque and no other practicing Muslim on campus) that he needed religious guidance from an imam. He wants religious guidance from an Imam to cope with the stress of students blaming his people for the Boston Marathon tragedy and accusing him of secretly wanting to cause them all harm. Zain isolates himself in his room and listens painfully for hours to all the news about two individuals he knew personally and that came from his country. He frequently looks online for guidance, has excessive difficulty in being pure enough in his environment, and he has told this chaplain that he has increasing difficulty trusting anyone now, and needs to be with the believers.

14. Prisons in America

15. Muslim Community

16. Trauma in Prisons • Gang Violence- outside and inside • Sexual abuse • Drug abuse • War on Drugs- Police and Community trauma • Cultural Gender trauma • Religious Gender neglect

17. Muslim Woman Prisoner Khawla A 45 yr old black woman sentenced to life in prison for transporting crack cocaine in her body and refusing to turn federal witness. She immediately converts to Islam in prison. She files lawsuits due to barriers practicing her religious beliefs of covering her head and body, not to be cross gender pat searched and to follow a male imam in congregational worship. Khawla wins all three from the law but no imam would accept her for several years. She is frequently placed in isolation, has extreme difficulty with relationships with peers and staff, and constantly gives female Muslim volunteers hard times. She accepts and listen submissively when a male imam is contracted.

18. Muslim Woman Prisoner Khawla Grew up in New York as a survivor of rampant gang violence during the government declared War on Drugs. Survivor of prevalent family sexual abuse which forced her to flee and struggle to make it on her own at a young age. She came of age under the co-dependent relationship of a male drug lord which required that she bear his supplies in her body. She avoided selling sex and using drugs instead became a 'mule' or transporter of drugs for her living. She had no family to support her at all and she felt this was the lesser of the evils.

19. Pastoral Concerns • Religious formation that develops on resistance to authority. • Community lack of compassionate response to Muslim women. • Cultural and religious collusion. 4. Textuality as spirituality. 5. Emotional immaturity. 6. Isolation preference. 7. Alienation mentality.

20. Community Response Lack of a compassionate community response about the religious and spiritual care of Muslim women. Promotion of literal interpretations in the absence of alternative ways to seek traditional means of healing. Stigma attached to mental health problems and the absolute reliance on religious belief and theology.

21. Community Response • Discomfort discussing personal (sexual abuse) information with anyone due to religious shame and veiling ones shortcomings. • Fear that treatment of trauma-related symptoms (depression due isolation) will be a sign of weak faith.

22. Resources Handbook of Mental Health Issues and Interventions,ed. Sameera Ahmed, Mona M. Amer, (New York: Routledge, 2011) The Nathan Kline Institute (NKI) Center of Excellence in Culturally Competent Mental Health;http://ssrdqst.rfmh.org Asian and Pacific Islander Institute on “Domestic Violence- Directory of organizations all over the U.S. serving Muslim communities” (http://www.apiidv.org/resources/programs-serving-muslims.php) The Journal of Muslim Mental Health (www.Muslimmentalhealth.com) Islamic Networks Group (ING) is a non-profit organization whose mission is to counter prejudice and discrimination against American Muslims by teaching about their traditions and contributions in the context of America’s history and cultural diversity, while building relations between American Muslims and other groups; (http://www.ing.org) The International Society for Traumatic Stress-Studies; http://www.istss.org Search PILOTS database for free access to abstracts of the Published International Literature On Traumatic Stress. Help & Support is available from this link; An Electronic Index to Traumatic Stress Literature produced by the National Center for PTSD; (www.ptsd.va.gov/professional/pilots-database/pilots-db.asp)

23. Matters of the Mind This series is co-hosted by American Muslim Health Professionals http//amhp.us Islamic Society of North America www.isna.net U.S Dept of Health and Human Services Center for Faith-Based and Neighborhood Partnerships www.hhs.gov/partnerships