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St. Cloud-based advocate approaches mental health care ‘from the inside out’

Kahin Adam’s razor-sharp focus on the mental health needs of the Somali diaspora inspired him to pack up his life and move to St. Cloud.

Kahin Adam: “I wanted to study clinical mental health. I want to help the refugee community. When I got here, when I found this job, my dream came true.”
Kahin Adam: “I wanted to study clinical mental health. I want to help the refugee community. When I got here, when I found this job, my dream came true.”
Photo by Ahmed Laari

Kahin Adam’s razor-sharp focus on the mental health needs of the Somali diaspora inspired him to pack up his life and move to St. Cloud. More than 15 years ago, Adam and his large family had all fled Somalia during their country’s bloody civil war; in the following years, he’d lived around the United States and the world, working and earning an undergraduate degree and then a dual master’s degree in social work and public health.

In 2018, he was living in Italy working with an international nonprofit focused on asylum seekers and refugees when he learned that members of St. Cloud’s Somali community lacked access to mental health professionals familiar with their distinct cultural practices. Adam felt a call.

“I read an article about the mental health crisis in the refugee community and minority community in St. Cloud,” he recalled. “I had been trying to move back to the U.S. anyway, so I decided to look at opportunities in Minnesota. I knew there was a big refugee community there and a lack of culturally competent mental health services. I thought I could help.”

Once Adam made his way to St. Cloud, he took his role as a community helper seriously. His first job was at the Center for Victims of Torture’s (CVT) new satellite office. He helped the organization open the office, and then began supporting the mental health of members of the local refugee community who’d experienced torture and were seeking asylum in the United States.

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The job was fulfilling, Adam said, but it didn’t take long to see that there was even more he could be doing to help. When he learned about an opportunity to work as a community health specialist in CentraCare’s Feeling Good MN initiative, connecting members of the local Somali community to culturally informed mental health care, he jumped at the chance.

This work, Adam said, “is not only a profession. It is also personal. I can understand what community members are going through because I went through it myself.” When he made it to the U.S., he decided he wanted to go to college and learn about helping other new Americans in their struggles: “I wanted to study clinical mental health. I want to help the refugee community. When I got here, when I found this job, my dream came true.”

With CentraCare’s support, Adam jumped in head first, building connections with community leaders and working to help struggling local residents get more comfortable with the idea of seeking mental health care. This role of educator, supporter and counselor can be all-consuming at times, but he said he finds the work exhilarating.

“I wear multiple hats in the community,” he said with a laugh. “I do a million different things. I hope you won’t think I’m crazy.”

Adam’s busy schedule includes: “One-on-one therapy on Monday and Tuesday. The majority of my clients are from minority communities or are refugees and immigrants. On Wednesdays, Thursdays and Fridays I do community education and community outreach and capacity building.”

He also hosts groups for Somali parents, helping guide them through the complexities of the school system. “I help parents connect with resources in the community,” Adam explained. “I ask lawyers and teachers and school administrators to come and talk about how to navigate the school system.”

This approach is key, Adam said: “I am doing this to empower parents, to connect them with community resources. Not only are there health disparities in the Somali community, there are also information disparities. The majority of them don’t speak the language. Many don’t read or write. The only way that they can get information is by me bringing somebody in to talk to them.”

Adam also holds meetings designed to explain cultural norms around parenting. “I’ve been talking to a group of refugee families about how to discipline their children in American culture,” he said. “The way they discipline children in Somalia is different than how they do it here.”

Adam’s work in the state has already earned him attention and praise. Earlier this year, he was named a 2021 Bush Foundation fellow, and in July, the Minnesota Department of Human Services honored his work with an Outstanding Refugee Civic Engagement award.

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While he said he is honored by the all the recognition, Adam wanted to make it clear that he is motivated by something much bigger.

“The work that I do here it is close to my heart,” he said. “It is something that I love and something I am passionate about. The reason I’m doing this work is not to get awards or recognition. I am doing it to help the community.”

A tough sell

Despite Adam’s infectious enthusiasm and commitment, getting members of St. Cloud’s Somali community to consider seeking mental health care has been tough.

“It wasn’t easy at the beginning,” he admitted. “Mental health is highly stigmatized in refugee communities. People tend to avoid the topic.”

Adam had only worked at CentraCare for a short time when he went to a meeting attended by a group of Somali elders. When it was his turn to speak, he brought up the idea of seeking professional help for mental health concerns, especially for the trauma that is often a byproduct of the refugee experience.

Kahin Adam, far right, accepting his Outstanding Refugee Award.
Minnesota DHS
Kahin Adam, far right, accepting his Outstanding Refugee Award.
“As soon as I started talking about mental health, people there said to me, ‘We are not interested in talking about this.’”

Adam expected resistance, but this response left him flabbergasted.

“I’m like, ‘Oh my God. What should I do now?’” he recalled. He asked to come back to the group’s next meeting, and tried a different approach: “I tried not to use the words ‘mental health’ or ‘mental illness’ or ‘trauma.’ Instead I started asking them questions, like, ‘How do you feel during the day?’ ‘Do you feel sad?’ Then, they started saying things like, ‘I can’t sleep.’ ‘I’m always tired.’ ‘I’m always sad.’ ‘I cry easily.’ ‘I have nightmares.’ I listened to them and then I said, ‘I know what you’re talking about. I’ve felt the same way.’”

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After that shared experience was established, Adam worked to encourage participants to consider meeting with him in person. “I said, ‘If anyone wants to meet one-on-one, you can always come and talk to me,” There were no takers.

Adam came back to the group’s next meeting and tried a different approach: “I started talking to them about stress management and emotional regulation. I shared some tips and techniques. Some people came up to me later and said, ‘Can I come to your office and have one-on-one therapy?’”

Adam said he understands people’s reluctance around seeking help for their mental health. In Somalia, mental health treatment is rare, and the idea of asking someone to help work through your internal struggles feels foreign and even dangerous. “Most of the time, in Somalia, when people are mentally ill, they go to the imam, to the mosque or to traditional healers,” Adam said. “The Western way of treating mental health is not something they are familiar with.”

The fact that Adam is willing to take the time needed to gain trust, that he has lived through similar refugee experiences, helps community members feel more comfortable coming to him for aid. He thinks he’s made significant progress in the short time he’s been in St. Cloud.

“I’m in a place where I have a trust in the community and the community trusts me,” Adam said.

Hani Jacobson
Hani Jacobson
Hani Jacobson is a community health and wellness nurse at CentraCare. She works closely with Adam on the Feeling Good MN initiative, and had heard good things about his work at CVT before that. A Somali refugee herself, she believes that Adam’s personal experience fleeing his home country and living around the world helps build trust among people who often feel suspicious of the traditional Western approach to care.

“Being a nurse, I’ve seen cases where some of our therapists didn’t know what to do when they worked with a patient who’s a refugee,” she said. “They can struggle to communicate, and even get things wrong.”

Adam’s innate understanding of cultural mores and his ability to speak Somali and Arabic gives him a leg up in the community, she added. “Kahin has experienced war and trauma himself. He has that cultural and language background and that personal experience. It puts him at an advantage to be able to really help people.”

When Pam Beckering, CentraCare’s trauma-informed care program manager, met Adam during a meeting at CVT, she knew she wanted him to come and work for her one day. “I needed to find people who had different skill sets, who could meet all of the different pieces I needed to successfully work in this community,” she said. “Kahin had the background and interest. I thought he would be perfect.”

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Eventually, Beckering was able to lure Adam to CentraCare. She created a position for him, and let him define his responsibilities.

“I hired Kahin to do what he thought was best because he knows the community and had to develop those relationships,” she said. “He is able to just really approach mental health in a way that is nonthreatening, that meets cultural expectations. Kahin has done it all on his own. I created a job description, but he made the job.”

Pam Beckering
Pam Beckering
One program Adam and Jacobson have established is a regular series of community teas, where members of the Somali community gather to talk about issues that are important to them. Often mental health is a topic at the meeting, but Adam and Jacobson take care to let the conversations develop organically, to let participants make their way to the subject on their own. The two have also completed mental health first aid training certification training courses. They are now helping other community members get their certifications as well.

“The work that he does with community teas it is not about mental health,” Beckering said. “It is about telling stories. It is mental health, but just with a different way of approaching it. It’s more from the inside out.”

Jacobson said she feels fortunate that Adam is her coworker. His skill set is rare, and he brings a talent, passion and drive that St. Cloud has long needed.

“Finding a mental health professional that is not only trained in Western medicine and counseling but also shares life experience with the people, that’s incredible. I wish we had more people like Kahin here because I know that even though he does a lot, there’s still a lot more people that he could help. I wish he could be cloned five times.”

Learning from his past

Though he’s made a successful life for himself in the United States, Adam’s path hasn’t always been smooth. He grew up in Mogadishu, in a large family with eight brothers and two sisters. The country’s civil war upended their lives, and eventually they all fled to different parts of the world, including Dubai, England, Germany, Egypt, Canada and Australia.

“It wasn’t safe to live there anymore,” Adam said of his home country. “Before that, my father was a political prisoner. He was in jail because of his political views. We knew we all had to leave.”

Before the war, Adam said his parents were respected, successful leaders in their community and tribe. People often turned to them for help. “My mother and my father are my inspiration for helping people and for being there for the community,” Adam said.

Adam’s first stop in the United States was in Dallas, where he was sent by a refugee resettlement agency. He struggled to find a place for himself there. “It was me, alone,” he said. He recalled empty days and frightening nights: “I went through all the things that members of refugee communities go through, like a lack of resources and not knowing how to navigate the system.”

Being on his own was frightening. “When I got here I had a fear of everything,” Adam said. “It was a new society, a new country. They didn’t understand. I was feeling all those emotions which can really stress you out and can lead to depression.”

Though he knew that coming from a powerful family gave him advantages that other refugees did not have, Adam still struggled. After three months, he left Texas for Richmond, Virginia, where he earned his B.A. at Virginia Commonwealth University. After that, he eventually made it to New York, where he attended Columbia University and earned his master’s degrees, but it was still years until his life truly settled down. Though from the outside it looked as though he was happy and successful, there were plenty of days where Adam struggled on the inside.

“When I look back, I realize I could’ve benefited from mental health care because I had cultural shock, being in a new country, a new society,” Adam said. “The food, the weather, everything was difficult. I had distress. I had a strong emotional reaction to that. Unfortunately, there wasn’t anyone who could help me at that time.”

When he finally arrived in St. Cloud, Adam discovered struggles of a different kind. His biggest hurdle was the unwelcoming attitude expressed by some of the city’s white residents. “This was is the first time I faced real racism since I came to the U.S.,” he said. “People have come up to me in St. Cloud and called me the N-word. Unfortunately, there is a small group here who are hateful, who don’t want refugees to be here. Sometimes, they can be really loud and mobilized.”

But he said that other white residents have also gone out of their way to make him feel welcome in his new home: “There are people here who help you and tell you, ‘We are so glad you are here,’ people who invite you to their house for dinner or lunch.” The city has, he continued, “both good and welcoming and loving people and people who don’t want you to be here — but I believe the majority of people in St. Cloud are good and loving.”

Jacobson said she’s also experienced racism in St. Cloud, and she knows all too well how it feels to be “the only one” in professional situations. “Kahin is the only Somali therapist in our system,” she said. That reality can be hard. Sometimes, people see the color of her or Adam’s skin and make assumptions about their professional status. “People mistake you for an interpreter,” she said. “Kahin doesn’t always get that level of respect he should.”

Beckering said that Adam already plays a key role in the larger community. He’s earned respect and is known as someone who sincerely wants to help make life better for everyone. He gives people his cellphone number and tells them they can call whenever they are in crisis, and they do — sometimes in the middle of the night, Jacobson added. He always picks up the phone.

“Kahin is an amazing person,” Beckering said. “He’s passionate. He cares about his community and he puts them first, before anything else. I can’t emphasize how important that is.”

This all-in approach works for Adam because it comes naturally. He can’t imagine living his life any other way.

“One of the questions they asked me during the interview for the Bush Fellowship was, ‘If you don’t get this fellowship, are you going to continue helping your community?’” Adam recalled. “I said, ‘Yes. This is an important part of my life. This is what I love.”