Many immigrant and refugee women in Minnesota are struggling with their mental health. Here's what their community is doing to help.
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International Women’s Day is a day to celebrate women’s triumphs, but also a day to raise awareness of problems affecting women around the world. MPR News host Cathy Wurzer spoke to two guests who are confronting the obstacles that get in the way of immigrant and refugee women taking care of their mental health.
Rehan Dunkal is manager of mental health services for Isuroon, an organization that serves Somali women in Minneapolis and Burnsville. Elizabeth Ruskin Shanklin is a Clinical Supervisor for the organization.
The conversation includes mention of suicide. If you or someone you know is at risk of harming themselves or others, call the suicide and crisis lifeline at 988.
Use the audio player above to listen to the full conversation.
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Audio transcript
CATHY WURZER: Today is International Women's Day. It's a day to celebrate women's triumphs, but also a day to raise awareness of problems affecting women around the world. Our next two guests are confronting the obstacles that get in the way of immigrant and refugee women taking care of their mental health. Now, this conversation is going to include mention of suicide. So if that's going to upset you, you might want to turn away for a little bit.
Rehan Dunkal is manager of mental health services for Isuroon. That's an organization that serves Somali women in Minneapolis and Burnsville. And Elizabeth Ruskin Shanklin is a clinical supervisor for the organization. Rehan and Elizabeth, are you with me?
REHAN DUNKAL: Yes.
ELIZABETH RUSKIN SHANKLIN: Yes.
CATHY WURZER: Thank you so very much for being here. We appreciate your time. Rehan, I'll start with you. I know that you are very worried about the rates of suicide among immigrant and refugee women in Minnesota. What's going on? What are you hearing and seeing?
REHAN DUNKAL: So, especially for me, being in the Somali community and helping the East African, we're seeing the number rise this year in the amount of suicide, so we just wanted to put awareness out there to educate our communities to better understand the suicide rates and how to prevent it if their family members are going through a mental health crisis.
CATHY WURZER: What do you think is behind the rising numbers of individuals dying by suicide? Is it stress? Is it something going on? What's going on? What do you think is happening?
REHAN DUNKAL: There's a lot of factors into that, and I think Elizabeth could talk more about it. And more like the factors are family stressors, depression hitting, and just getting out of the COVID and readjusting back to society right now. Everybody is having a hard time and falling behind on how to become social again.
CATHY WURZER: Elizabeth, what do you think?
ELIZABETH RUSKIN SHANKLIN: I think that's true. And there's another piece connected to suicide, and that is human relationships with one another. Isolation is a really big issue for people who are encountering suicidal thoughts. And one of the issues is that 54% of general practitioners are surprised by the suicide of their patients, which means that we're not connecting with people who need assistance.
CATHY WURZER: I'm wondering about stigma around mental health and mental health care in some communities. Rehan, do you want to address that?
REHAN DUNKAL: Yes. Especially in the African community, stigma is the biggest thing. We don't want people to know that we have mental health problems. We don't want to share our problems with anybody. We want to keep it personal. An idea of somebody knowing that you might be facing something and having the community know about it is the biggest fear that our community has. And the reason a lot of them don't want to seek help is the whole stigma behind everything, that they believe the whole mental health is a trouble inside of that person and that reading the Koran on them should relieve that pain. Seeking professional help or getting professional help is out of the question.
CATHY WURZER: Mm. And how do you convince individuals to seek help?
REHAN DUNKAL: Now the younger generation are telling their parents, that they need help, and parents are having that tough conversation with their kids about what is mental health. And now we're putting it out there that mental health exists, and we're putting it as the same as a person who has a physical health that needs extra help. So relaying both of them and helping them understand the brain also is an organ that does need protection, that does need care, and understanding what is mental health and what is the whole HIPAA against people sharing their information is actually helping a little better with the stigma behind it.
But now it's like the older generations are the toughest generation to break that barrier.
CATHY WURZER: I'm also wondering, and, Elizabeth, maybe you can address this, is there an issue with cultural competency among professionals, just a lack of cultural competency among mental health professionals?
ELIZABETH RUSKIN SHANKLIN: Yes, there is, and there are two new programs that have been developed that are centered around a narrative approach with clients. And there's something that we can do as professionals with clients, and that is to establish a collaborative conversation. And collaborative conversation is the one where the telling of the story is one that's handed to the client, and the therapist assists that client in being able to speak to the story.
We know that when someone has had suicidal thoughts enter their lives, that in that moment, they are making a decision not to commit suicide, and it's that decision that is part of that collaborative conversation because that is the unfolding of all the things that this person values in life. So it's that creating of the story.
And I think, as Rehan indicates, sometimes I think people feel fear about the mental health system, and it's this initial conversation that's so important for us to learn how to do.
CATHY WURZER: Before you both go, I'm wondering what your message to women who need help might be. Elizabeth, I'll begin with you and then, Rehan, would you please chime in? Elizabeth?
ELIZABETH RUSKIN SHANKLIN: My message to them is their story of strength. It's their bringing this statement that they have had suicidal thoughts enter their lives, that they are also reacting with strength, and it's that strength that we need to celebrate with them.
CATHY WURZER: Rehan, what's your message to women who might need some help?
REHAN DUNKAL: That getting help doesn't mean that your family is going to break away or that child protection is going to get involved, that there shouldn't be a fear of that, that your family won't be protected just because you're not getting the help that you need to better yourself.
CATHY WURZER: All right. I appreciate talking with both of you. Thank you so very much for your time and your work.
ELIZABETH RUSKIN SHANKLIN: Thank you. Thank you.
REHAN DUNKAL: Thank you.
CATHY WURZER: We've been talking to Elizabeth Ruskin Shanklin and Rehan Dunkal, who help connect Somali women with mental health services. They are speaking on a panel later today as part of Isuroon's International Women's Day Conference. And a reminder that if you or someone is in distress or having suicidal thoughts, you can call the suicide and crisis lifeline at 988.
Rehan Dunkal is manager of mental health services for Isuroon. That's an organization that serves Somali women in Minneapolis and Burnsville. And Elizabeth Ruskin Shanklin is a clinical supervisor for the organization. Rehan and Elizabeth, are you with me?
REHAN DUNKAL: Yes.
ELIZABETH RUSKIN SHANKLIN: Yes.
CATHY WURZER: Thank you so very much for being here. We appreciate your time. Rehan, I'll start with you. I know that you are very worried about the rates of suicide among immigrant and refugee women in Minnesota. What's going on? What are you hearing and seeing?
REHAN DUNKAL: So, especially for me, being in the Somali community and helping the East African, we're seeing the number rise this year in the amount of suicide, so we just wanted to put awareness out there to educate our communities to better understand the suicide rates and how to prevent it if their family members are going through a mental health crisis.
CATHY WURZER: What do you think is behind the rising numbers of individuals dying by suicide? Is it stress? Is it something going on? What's going on? What do you think is happening?
REHAN DUNKAL: There's a lot of factors into that, and I think Elizabeth could talk more about it. And more like the factors are family stressors, depression hitting, and just getting out of the COVID and readjusting back to society right now. Everybody is having a hard time and falling behind on how to become social again.
CATHY WURZER: Elizabeth, what do you think?
ELIZABETH RUSKIN SHANKLIN: I think that's true. And there's another piece connected to suicide, and that is human relationships with one another. Isolation is a really big issue for people who are encountering suicidal thoughts. And one of the issues is that 54% of general practitioners are surprised by the suicide of their patients, which means that we're not connecting with people who need assistance.
CATHY WURZER: I'm wondering about stigma around mental health and mental health care in some communities. Rehan, do you want to address that?
REHAN DUNKAL: Yes. Especially in the African community, stigma is the biggest thing. We don't want people to know that we have mental health problems. We don't want to share our problems with anybody. We want to keep it personal. An idea of somebody knowing that you might be facing something and having the community know about it is the biggest fear that our community has. And the reason a lot of them don't want to seek help is the whole stigma behind everything, that they believe the whole mental health is a trouble inside of that person and that reading the Koran on them should relieve that pain. Seeking professional help or getting professional help is out of the question.
CATHY WURZER: Mm. And how do you convince individuals to seek help?
REHAN DUNKAL: Now the younger generation are telling their parents, that they need help, and parents are having that tough conversation with their kids about what is mental health. And now we're putting it out there that mental health exists, and we're putting it as the same as a person who has a physical health that needs extra help. So relaying both of them and helping them understand the brain also is an organ that does need protection, that does need care, and understanding what is mental health and what is the whole HIPAA against people sharing their information is actually helping a little better with the stigma behind it.
But now it's like the older generations are the toughest generation to break that barrier.
CATHY WURZER: I'm also wondering, and, Elizabeth, maybe you can address this, is there an issue with cultural competency among professionals, just a lack of cultural competency among mental health professionals?
ELIZABETH RUSKIN SHANKLIN: Yes, there is, and there are two new programs that have been developed that are centered around a narrative approach with clients. And there's something that we can do as professionals with clients, and that is to establish a collaborative conversation. And collaborative conversation is the one where the telling of the story is one that's handed to the client, and the therapist assists that client in being able to speak to the story.
We know that when someone has had suicidal thoughts enter their lives, that in that moment, they are making a decision not to commit suicide, and it's that decision that is part of that collaborative conversation because that is the unfolding of all the things that this person values in life. So it's that creating of the story.
And I think, as Rehan indicates, sometimes I think people feel fear about the mental health system, and it's this initial conversation that's so important for us to learn how to do.
CATHY WURZER: Before you both go, I'm wondering what your message to women who need help might be. Elizabeth, I'll begin with you and then, Rehan, would you please chime in? Elizabeth?
ELIZABETH RUSKIN SHANKLIN: My message to them is their story of strength. It's their bringing this statement that they have had suicidal thoughts enter their lives, that they are also reacting with strength, and it's that strength that we need to celebrate with them.
CATHY WURZER: Rehan, what's your message to women who might need some help?
REHAN DUNKAL: That getting help doesn't mean that your family is going to break away or that child protection is going to get involved, that there shouldn't be a fear of that, that your family won't be protected just because you're not getting the help that you need to better yourself.
CATHY WURZER: All right. I appreciate talking with both of you. Thank you so very much for your time and your work.
ELIZABETH RUSKIN SHANKLIN: Thank you. Thank you.
REHAN DUNKAL: Thank you.
CATHY WURZER: We've been talking to Elizabeth Ruskin Shanklin and Rehan Dunkal, who help connect Somali women with mental health services. They are speaking on a panel later today as part of Isuroon's International Women's Day Conference. And a reminder that if you or someone is in distress or having suicidal thoughts, you can call the suicide and crisis lifeline at 988.
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