By Amy Harris 

Ninna dab buu ka baqaa, ninna dambaas buu ka baqaa

One man fears fire; another man fears ashes

— Somali proverb

Ahmed Hassan, licensed therapist and program director of Summit Guidance, presented a day of professional training on December 12 at the University of Southern Maine at the invitation of Gateway Community Services, Generation Noor, and the Community Organizing Alliance. Summit Guidance is a mental health agency that provides individual, group, and play psychotherapy to children and adults in Minnesota. 

Abdullahi Ali, Chief Executive Officer of Gateway Community Services, said he wanted to bring Hassan to Maine because “it is important to bring knowledge and understanding of the culture of [refugee and immigrant] communities, and how this affects the treatment and support of their mental illness.” 

  Summit Guidance “is dedicated to providing culturally competent mental health and other social services to families, including refugees and immigrants with multiple layers of complex needs, exposure to violence and trauma both in their current environment and in their native countries, and weakening intergenerational relationships,” according to the website. 

Ahmed Hassan’s practice centers on a belief that cultural understanding needs to be the bedrock on which mental health treatment strategies are built, and according to him, proverbs and metaphors can help bridge differences in culture regarding mental health treatment. 

Traditional music was provided before and after the discussion program by Brian Shankar Adler (L) and Hadith Bani-Adam (R). | Photo Mark Mattos

In the morning session, Cultural Perceptions and Expressions of Mental Distress, Hassan explained that in Somalia, folk healers – rather than therapists – are the ones who often provide mental health diagnoses. Folk healers use terms such as jin (demon or evil eye) or the stigmatizing waali (crazy).  

  Somali Proverbs: Revelation of Culture and Attitudes, was the afternoon session, also led by Hassan. He discussed the difficulties in engaging Somali people in therapy and shared the story of an elderly Somali client who was referred to him for treatment. After his first hour-long counseling session, the client asked Hassan, “Where is my prescription?” Hassan explained that he did not prescribe medication, just talk therapy. The client replied, “Talk therapy? All you do is talk? You wasted your time. You should have gone to medical school!” Hassan explained to the audience that a large part of his therapeutic process is teaching clients that psychotherapy is a process. Through psychoeducation, he said, clients can learn to trust and heal. He proudly shared that the same man who was so skeptical went on to be his client for the next three years. 

Hassan, who was born in Somalia, said proverbs and metaphors are important in Somali culture, and can help with mental health treatment. Some proverbs relate specifically to thoughts, beliefs, and attitudes about mental health. He identified proverbs relating to some mental health concepts from Western cultures: post-traumatic stress and trauma, gambling addiction, substance use disorder, the development of personal identity, social support, mindfulness, and the mind-body connection. 

Amran Osman discussing mental health issues facing the immigrant and refugee communities. | Photo Mark Mattos

Fire and Ashes: An African Boy and a Proverb is a book Hassan has written for children, ages 5 to 13. The book tells the story of Warfa, a Somali refugee who struggles to adapt to his new elementary school. Haunted by distressing memories, he turns to his grandmother, and the Somali proverb “One man fears fire; another man fears ashes.” This describes the concepts of rational fear (fire) and irrational fear (ashes), Hassan said. He explained that asking clients about their thoughts or feelings is challenging because these are abstract concepts, but using a proverb such as fire and ashes helps make those concepts concrete and accessible. 

Hassan hopes to continue sharing proverbs in two more children’s books he is writing to help parents, teachers, and mental health providers teach social and emotional learning to immigrant and refugee children. Through his picture book series, he hopes to bring the relevance of African proverbs to the modern world, and help destigmatize mental illness in refugee, immigrant, and asylum-seeking communities . 

Deqa Dahlac, Assistant Executive Director of the nonprofit arm of Gateway Community Services, said she believes it is critical to create culturally and linguistically competent safe spaces for healing from mental health trauma. A Somali immigrant herself, Dhalac holds a master’s degree in social work (MSW) from the University of New England, and is the first Black mayor of South Portland

Amran Osman, founder of Generation Noor, observed that “as a society, regardless of your culture, we need to learn to take mental health more seriously.” A Gateway employee, Noor started Generation Noor to destigmatize substance use disorder and mental health within refugee and immigrant communities. 

Gateway Community Services has two service branches providing support and opportunities for immigrant, refugee, and asylee community members and their neighbors in greater Portland and Lewison. 

Training attendees included representatives of a number of organizations, including Hope Acts, Lewiston Public Schools, Maine Association for New Americans (MANA), MaineHealth, South Portland Schools, and the YWCA, according to organizer Krista Hall, Director of Clinical and Program Development at the for-profit branch of Gateway Community Services.