Hiiraan Online

We all have mental health, and anyone can become unwell due to mental health problems. Some are more at risk due to genetics, biological, social, and environmental factors, but this does not mean you have a weaker faith. As Somalis, like other Muslim communities, we tend to go to spiritual healers or imams first, but, unfortunately, they do not tend to signpost or attend mental health services due to stigma or even, in some cases, exploitation when some are running a business charging £100 plus, it is not in their business interest to tell people to get treated, unfortunately, especially in the West where medical and psychological treatment is easily accessible, unlike back in the motherland where there are only a few mental health professionals and a lack of access to psychotropic medication which is expensive for ordinary people to upkeep.

Statistics

Statistics by NHS Digital [1] have revealed that Black people in the UK access mental health services the least, a percentage of 6.2. I would not be surprised if statistics were broken down by ethnicity if Somali people had the lowest access rates. Low access follows similar trends with people of shared faith in Islam. There are higher rates of depression in the British Muslim community than in the general population, and Muslims are less likely.
 to seek treatment [2]. Furthermore, there is evidence that racism, including Islamophobia, can affect an individual's mental health, impacting not only adults but young Muslims too. Nearly half of religious hate crimes recorded by the police in England and Wales targeted Muslims [3]. 

A recent report has found that more than half of young British Muslims have suffered poor mental health, and around 64% have had suicidal thoughts. 32 % of young British Muslims have suffered suicidal thoughts at some point. 52 % of young British Muslims have suffered from depression, and 63 % have struggled with anxiety [2]. Somali refugees and immigrants are at higher risk of having PTSD and suicide rates in London and the USA but seek treatment least [4].

The deep stigma in the Muslim community saddens me as a mental health professional, as Muslims are initially at the forefront of medicine, psychology, and psychiatry. As a registered Nursing Associate, I look after people of all races irrespective of creed, colour, religion and disability. The world's first and oldest psychiatric hospital with free mental health care was established in Baghdad, Iraq, in 705CE [5]. However, unfortunately, in this day and age, stigma runs deep due to cultural impact, which even affects marriage proposals in some cultures if you have a close relative with mental health problems.

How can you support your mental health and those of loved ones, friends and acquaintances?

I would advise people on the five ways of well-being: [6] improving sleep hygiene, [7] going to bed before 22:00 and walking daily for at least 30 minutes, connecting you to nature. Journal your thoughts in a diary and rate your mood out of 10 (10 being your happy self). Notice patterns and write down what triggers a dip in the mood, e.g., poor sleep, argument, skipping meals, anxiety, worries, or someone crossing your boundary and respecting you. You do not have to keep ties with somebody terrible for your mental health. Seek support from university, work or health provider. Try therapy sessions, which you can self-refer to yourself [8]. If you do not fancy to have therapy problems. If that fancy you, you could try mentoring or (life or career) coaching sessions.

You can educate yourself for free on the internet from reliable sources and YouTube. Mind Charity is a great website to start, and I would recommend Dr Rabia Awaad (Clinical Associate Professor of Psychiatry at the Stanford University School of Medicine) on YouTube [9] for an Islamic perspective on mental health. I recommend listening to or reading the Qur'an daily and limiting social media and TV as negative news and procrastination can increase worries and stress. Do not compare yourself with others, as your life is already written for you, and people are testing in different ways, which includes wealth.

If you live in London, you can attend the Hayaan Project, part of Mind in Harrow [10], which holds fortnightly workshop sessions at Shepherd Bush and Harrow led by a Somali psychiatrist and Project Coordinator with a Counselling degree background. If you live on the other side of London, check out the amazing Coffee Afrique, the first Somali Crisis Café and more outreach services they provide [11].

My perspective

I also believe mental health services should better provide culturally and spiritually sensitive treatments and train more healthcare professionals who reflect underserved communities. No community is 'hard to reach' only services are. However, Islamically, as we say, we rely on God, but we should tie our camel first. We must seek to become more educated to recognise symptoms in ourselves and those close to us. We have to stay connected and advocate for better resources and funding. We must connect with people shunned from the community and make them feel safe and supported. Healing is collective as an oral society.

I have worked in Addictions Community Service, where I rang a young Somali client recognised by the traditional name and asked them towards the end if they minded if they had a Somali key worker, and they said no. I asked because I am aware of the deep stigma and did not want to send anyone into a panic when they come in. My name is not a typical Somali name when I introduce myself. Nevertheless, there are addiction problems in the Somali community, and I am currently writing up a report from my mixed-method research. Whether it is Khat, alcohol, weed, shisha, cigarettes, gambling, or opioids, it is becoming more common in Somalia [12]. However, it is hidden, and Somali people do not seek treatment, and many are unaware of the long-term effects and risks, such as alcohol-related dementia. When Somalis drink alcohol, they binge, unlike Westernised societies, which tend to start off drinking in a smaller amount and then gradually increase.

Nevertheless, on a positive note, I have helped Somali people because of Somalinimo despite the initial scepticism and worries. I have seen initial worries visible through body language transformed into a smile and sincere dua (prayer) as a thank you. Unfortunately, it is just a job for some mental health staff, and mental health services are historically underfunded. We need more Somali professionals and advocates in the mental health sector to increase awareness and access. The mental health sector is not scary, and our community needs it more than ever, especially those suffering in silence or chained in the motherland and left destitute.

References:

1.   1.   https://webarchive.nationalarchives.gov.uk/ukgwa/20180328140249/http:/digital.nhs.uk/catalogue/PUB21748

 2. https://bcbn.org.uk/reports/

3. 3. https://www.gov.uk/government/statistics/hate-crime-england-and-wales-2021-to-2022/hate-crime-england-and-wales-2021-to-2022

4. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-020-01295-0

5. http://www.inquiriesjournal.com/articles/1673/the-history-of-mental-illness-from-skull-drills-to-happy-pills

6. https://www.mind.org.uk/workplace/mental-health-at-work/five-ways-to-wellbeing/

7. https://thesleepcharity.org.uk/information-support/adults/sleep-hygiene/

8. https://www.england.nhs.uk/mental-health/adults/nhs-talking-therapies/

9. https://www.youtube.com/watch?v=Q94iY5tw4QI

10. https://www.mindinharrow.org.uk/our-services/culturally-specific-services/hayaan/

11. https://www.coffeeafrique.co.uk

12. https://www.bbc.com/news/world-africa-64032267

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