Farha Abbasi M.D, Assistant Professor, Psychiatry Department, Michigan State Univverisity
Imagine being alone in a new country — unable to speak the language, surrounded by an unfamiliar culture, and forced to leave your entire life behind. This is the reality for many immigrants around the world.
In the year 2000, I left Pakistan to come to the U.S. Although I immigrated willingly to pursue a career in medicine, the experience was painful and frightening nonetheless.
As I embarked on my subsequent career as a psychiatrist and professor, I came to realize I was not alone in my experience. Immigration, even when it’s by choice, can cause serious trauma, and for many it becomes a significant risk factor for mental health concerns. In addition, faith — a powerful force for many immigrants — is often overlooked or ignored by care providers.
As we deal with rising immigrant and refugee populations across the world, we must work to bridge the gap between mental and physical health, and help our spiritual and religious patients harness the power of their faith.
Immigration as Trauma
Trauma, as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA), “results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”
In many respects, immigration is trauma. It is a complete loss of identity and familiarity, and immigrants are often left without the proper tools or resources to help them cope in a new environment. That transition in itself, even if it ends well, can leave deep scars.
In addition, immigrants coming from war-torn countries have often faced violence, rape, or the loss of family members, and immigrant children are often at risk for exposure to violence. Immigrants also face higher risks for health issues like diabetes, strokes, substance abuse, etc. In an intergenerational context, children of immigrants tend to show higher rates of anxiety and depression.
Helping these populations to heal requires an acknowledgment of the impacts of mental trauma on physical health, and a treatment plan that involves all aspects of care.
Integrated Care & Faith as a Factor in Healing
Many immigrants can present mental health issues as physical symptoms, appearing with vague stomach pain, headaches, and other complaints, which often lead them to primary care settings. Unfortunately, providers too often address physical issues as separate from mental health.
In addition, many physicians aren’t trained to question patients about their faith. Medical facilities frequently lack any support for patients of faith, despite the fact that faith and faith-based communities play a major role in the prevention of, treatment for, and recovery from mental illness.
I’ll offer this as an example: in many inpatient psychiatry units, there is no place to pray. Practicing Muslims, however, need to pray five times each day. The inability to do so can cause added stress for the patient and exacerbate their condition, whereas employing their faith could potentially aid recovery. This simple change could be implemented in facilities nationwide.
As a Assistant Professor, I’m teaching my medical students to make the faith conversation a part of every patient evaluation.
The Power of Faith-Based and Community Initiatives
One exciting new program that addresses faith, mental health, and healing is Faith-Based and Community Initiatives (FBCI), an effort by SAMHSA designed to help promote faith-based partnerships and programs. FBCI offers training and assistance so faith-based organizations can help to deliver effective behavioral health and community-based social services. Faith leaders and stakeholders learn about the Adverse Childhood Experiences (ACE) questionnaire (which identifies potential traumas) as well as how to utilize resiliency tools and other potential avenues of assistance.
We recently had a training for Imams, incorporating the concept of ACES. The goal is to develop trauma-informed congregations – faith-based neighborhood partnerships – in conjunction with Health and Human Services (HHS).
Ensuring the wellbeing of immigrant populations benefits everyone. A healthy, resilient individual leads to a healthy, resilient family, community, and society. As immigrants and refugees enter new communities across the globe, this is a crucial point to consider.
The medical community should offer a comprehensive health initiative including religion, spirituality, mindfulness, yoga, or alternative treatments. We must move towards integrated care for at-risk immigrant populations and all others we treat, making that connection among mental, spiritual, and physical health.
Given what’s going on in the world today, this issue is more important than ever. It’s so important that we work to assist populations in need and see faith as positive factor in the healing process.
- What changes need to be made, and by whom, to better serve the mental health needs of people from different cultures and people of faith?
- How can communities support better coordination of mental health care and religious and spiritual needs?
- What experiences have you had at the crossroads of religion and mental health care? What lessons can be learned?
Farha Abbasi, M.D., is Clinical Assistant Professor in the Department of Psychiatry at Michigan State University and Staff Psychiatrist at the University’s student health center. She emigrated from Pakistan and settled in the United States in 2000. Dr. Abbasi was awarded the American Psychiatric Association SAMSHA Minority Fellowship and used the grant money to create awareness about cultural competency, to redefine it as not just tolerance for others but rather acceptance. Her areas of interest are cultural psychiatry and teaching medical students how to provide culturally-appropriate care to Muslim patients. She works directly with the Muslim-American community to encourage integration rather than isolation from main stream society. Dr. Abbasi recently received the Pioneer Award from the Michigan All Pakistan Physicians of North America. She has established the Muslim Mental Health Conference and is the managing editor for the Journal of Muslim Mental Health, hosted at Michigan State University.