Why do we continue to stigmatize people with mental illnesses?

By Suheir Kafri

May/June 2023

When I first started my job at the ADAMS (All-Dulles Area Muslim Society) mosque, I was very elated that I would be working with my own beloved community in Islam.

I had recently graduated with a degree in social work. However, in between graduating and getting a job, I went through an immense bout of depression, anxiety and grief. In May 2013, I sat among my fellow George Mason University graduates, waiting for my moment to walk across the stage and receive my diploma. Although I had waited for this pivotal and important moment for six years, another parallel moment held even more significance in my heart — my mother and children were in the stands, cheering me on as I started walking. She proudly held up a sign that said, “That’s my daughter!” 

I had married young and had my children. After my youngest got on the school bus, I enrolled in college. By the time I was a senior, my eldest daughter was freshman at the same college. It was a time of joy and such accomplishment. My support system included my mother, my biggest cheerleader. I would call her before every exam and ask her to pray for me.

A dialysis patient for 13 years, my mother went to her treatment center four times a week. I watched her endure her own depression after realizing what the future held for her as she waited for a kidney donor to match. Unfortunately, she never received a transplant. The doctors initially told us that without a donated kidney, she would live only another year because of other preexisting conditions. By the grace of God, she survived for longer than that.

The summer after graduation, I traveled. I made umra and visited my home country to see family and three months later, in August 2013, came back to the U.S. to begin job hunting. Six days after arriving, my mother went into cardiac arrest and returned to her Creator. I’ll never forget the grief that overtook me and the collapse of everything that was light in life. It felt as if someone had turned the lights off and I was in bleak darkness, unable to see forward or to process and function. If I didn’t have my children to care for, I think I would’ve been in a state of nonexistence and trying to hide from the world, for grief and depression had set in.

After six months, I woke up and prayed that God would remove me from this darkness. I looked for a job. The first one I saw was for a social worker at a mosque. After a few interviews, I was hired and told myself that day, “This will be my turning point! I’ll begin to utilize my skills to empower and enhance the lives of others.”

On my first day, I was instructed that some people would be asking for zakat assistance. But to my surprise, my first phone call was from a woman seeking help in reaching out to the community to get a donated kidney for her father, who had gone into kidney failure. I was immediately triggered and taken aback, because now I would have to re-enter the despair I had just recovered from. I took it as a sign that I was where God intended me to be. I promised to hold this community close to my heart, as my own pain was speaking to me through this woman. 

Determined to look deeper into my community’s issues, I greeted each client and listened to their stories. I helped them complete their applications for assistance and reveal how their hardships had begun. Knowing that I’d have to advocate for them, I began writing down my assessments of what resources they would need. 

Some of them were caretakers of their family, so earning a living and having a regular job everyday was nearly impossible. Others said they were taking care of family members with various mental health illnesses — schizophrenia, bipolar disorder and suicidal ideation — and that leaving their loved ones without daily supervision posed a safety risk. I’d hear them clients say, “If I leave my loved one alone for the day, I’m afraid of what will happen to them while I’m working.” 

Many said they had tried to work; however, they’d lose their jobs because they had to take so much time off. This scenario was very present in the community. I’d listen to the families and caregivers saying that they felt so helpless that they’d started developing anxiety and depression. After expressing my concern about their own well-being and suggesting therapy so they’d have a safe space to process what they were experiencing, I was often surprised by their replies.

After suggesting therapy as part of a holistic wellness approach, they’d reply, “No, I’m not sick, I don’t need a therapist” or “No, I can’t see a therapist because people will say that I’m crazy.” One of the most heartbreaking comments came from a woman who’d endured depression for an extended period of time. When I suggested therapy, she said, “No, I cannot go see a therapist, although I want to, because my husband will divorce me and tell his family. They’ll think I’m crazy.”

I had to think of other ways to convince them to get the help they needed. I advised them to share the symptoms — all mental health related — they were experiencing with their primary care doctor. I thought perhaps this would lead them to seek help. But many refused this option as well.

I felt helpless. How could I help my community beat the stigma associated with mental health?

I began thinking about how I could convince them to see mental health care in a new light. One evening as I reviewed the events of my workday, it came to me. I would bring the needed care to them. I’d enable them to seek help within a familiar sanctuary: their mosque. I created a Mosque Mental Health Model and, together with the imams, collaborated on ensuring that it would incorporate spirituality and the clinical aspect of care. 

Once the model was satisfactory, I asked the local Muslim mental health professionals to contract with the mosque and take the referrals I would send. I was so humbled by all of the therapists, professional counselors, social workers, psychiatrists and psychologists who agreed to help me destigmatize mental illness and treat the community, many of whom had been struggling alone for years.

As this model went into effect in 2015, the community slowly became more comfortable with this arrangement. I watched as client after client said “Yes.” Not only did mental health professionals treat them for depression and other mental health issues, but they also treated victims of domestic violence and various traumas.

As the number of professionals grew, our work continued with specialists who could shed light on those adverse childhood experiences that lead to mental health illnesses. We continued to educate the community through seminars and workshops on such topics as depression and PTSD, especially in terms of refugees, addiction and domestic violence. Our imams played a most supportive role by speaking about mental health in their Friday sermons and expressing the importance of seeking treatment for all such ailments while utilizing spirituality and the help of mental health clinicians.

Seeking to improve our model even more, in 2018 our mosque opened its first counseling office utilizing the living room model, an approach that makes clients feel like they’re sitting in their own living room. We have coffee, tea and snacks, and they can come to the mosque and see an onsite therapist.

By 2020, as Covid took a toll on the world, our dedicated team of mental health professionals addressed the rise in depression and isolation by switching over to a telehealth model of therapy via face-to-face Zoom meetings or phone calls. Many clients told me that this continuation of service was lifesaving, as the initial pre-therapy problem was their inability to seek support within their homes.

Although the effects of Covid linger on and many families have lost loved ones, their ensuing grief and depression would have become unbearable without the mosque’s mental health professionals who reached out and kept their clients on the path to healing.

Combining spirituality and mental health treatment provides hope, and this invaluable resource should be available for every Muslim struggling with mental illness. When you enter the mosque to speak with your imam about your troubles, you should be able to walk into the next office and receive mental health care. I would say that we, as Muslims, are getting stronger in this cause. We will continue striving to destigmatize mental illness and create a better quality of life for those who reach out.

In my mosque, mental health is as important as physical and spiritual health. There is no wellness without mental wellness. “Verily, with hardship comes ease” (94:5).

Suheir Kafri, BSW, QMHP-T, is social worker at the All-Dulles Area Muslim Society, Sterling, Va. bio

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