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A Stanford psychiatry professor found herself in a strange position at the start of 2017.
The Trump administration had just banned travel to the United States from seven Muslim-majority countries, and Stanford’s Muslim community was in despair. Realizing that extra help was needed, the university asked Dr. Rania Awaad to hold therapy-like office hours with Muslim students. She’s a psychiatrist, but had been working in the classroom, not as a therapist.
Yet she could see that therapy was what many students desperately needed. She recalls one student sharing that her therapy options on campus seemed to be either a provider who knew nothing about Islam and the trauma she had experienced or one who was “oozing with empathy.”
At Stanford and at colleges Awaad visited, students told her again and again that when they needed care, they didn’t want to go to the campus counseling center because they didn’t see Muslim therapists, or therapists who they felt could understand them.
The data she collected during those 2017 sessions boosted research and student activism at the University of California, Berkeley, where she had helped launch the first Muslim Mental Health Initiative the year before, and at Stanford, where the model was first developed in the Muslim Mental Health and Islamic Psychology Lab. Now, the MMHIs on both campuses work alongside a nonprofit called Maristan to place Muslim-identifying therapists on college campuses.
“To me, it’s like night and day,” Awaad said, referring to the availability of the resource to the campus community. “The students, when they know that support is there, there’s something to fall back on, they feel a sense of belonging, which is really, really important.”
Religious groups on college campuses that have long counseled students grappling with issues of faith or spirituality are now adding mental health clinicians in campus religious hubs, and training religious leaders to know when to refer students to psychological care.
People between the ages of 18 and 25 are more likely than those in any other age group to experience mental illness, and most mental health conditions develop by the age of 24. Most colleges offer some type of mental health services on campus, but students’ need for mental health care has intensified dramatically throughout the pandemic.
Religion and spirituality can contribute to good mental health, but people with strong religious affiliations can and do suffer from mental health issues and experience life stress like everyone else. And people who experience religious discrimination are more likely than others to suffer from common mental health disorders.
Not every therapist is equipped to understand the nuances of different religions. A Muslim student may need to talk about the difficulty of coordinating class schedules with daily prayer times. Or a Jewish student may want to discuss the struggle of keeping kosher in the dining hall. These gulfs of understanding can make it more difficult for some religious students to get help.
“Having a space where there’s already a shared worldview, even if it’s not completely agreed upon, just gives people a sense of reassurance and belonging,” said Stephanie Winkeljohn Black, an assistant professor of psychology at Pennsylvania State University Harrisburg who studies the intersection of religion and spirituality with mental health.
To better serve these students, the Muslim Mental Health Initiative has placed therapists in at least three universities and has plans to keep expanding. To better serve Jewish students, therapists, social workers or staffers dedicated to well-being have been added to at least 15 campus Hillel centers, as part of a mental health and wellness pilot program that is scheduled to expand to other campus Hillels. These strategies focus on students who are part of minority religious groups that have been historically discriminated against, and who might have trouble finding therapists who share their identity.
Colleges that have foundational affiliations with Catholic, evangelical or other Christian faiths tend to offer both religious resources and counseling and psychological services on campus. The Catholic Campus Ministry Association, which has members at religious and secular colleges, noticed an increase in student mental health needs during the pandemic and has begun training nonclinical campus staff members to better understand and respond to student mental health issues. Even if Christian students don’t attend a religiously affiliated college, they are more likely to find a provider who understands their religion because it is the majority religion in the country.
Advocates say that in addition to helping Muslim and Jewish students feel more comfortable with providers, adding therapists in religious hubs reduces the stigma around getting help, and makes it easier for busy students to find the care they need. These therapists can also alleviate the scheduling pressure on campus counseling centers, which often provide a limited number of sessions to students and can have long wait times.
While these models can help, it’s also important that both therapists and religious leaders stay within the bounds of their expertise and know when to refer someone to another type of care, Winkeljohn Black said.
“As a clinician, you have to be very careful not to interpret religious texts, or speak to a particular faith doctrine. I wouldn’t even do that for my own religious group, if I were working with someone from the same faith tradition,” Winkeljohn Black said. “My primary concern is the person across from me, their mental health. Being able to know when to refer to a clergyperson is really important for that reason.”
A framework to serve Muslim student mental health
Muslim students, like other college students, are trying to care for their mental health as they juggle academic stressors and new relationships, often while being away from home for the first time. But these issues are complicated by experiences of racialization, discrimination and generally feeling like a member of a minority group, said Abiya Ahmed, associate dean of students and director of the Markaz Resource Center at Stanford.
“I’m not saying it can’t be addressed by other clinicians, but it can be addressed more effectively, efficiently and more appropriately by Muslim-identifying clinicians,” Ahmed said.
Mahnoor Hyat, a recent Stanford graduate who began researching Muslim mental health issues on campus after hearing about the immense need from her friends, said no single approach would solve all the problems members of her community face.
Many students wanted the option of having a Muslim therapist, she found, while others said they’d prefer to talk to someone with whom they identify in another way, but who is slightly removed from their religious community.
Hyat recalled learning in focus groups that students who had previously tried to get help “had spent literally 30 to 40 minutes in the session explaining where they were coming from, like, explaining the cultural significance of something they were talking about.” She added: “And they were talking about just feeling so exhausted by the time the session ended, because they basically had to teach their therapist.”
Now, through the Muslim Mental Health Initiative and Maristan, the university contracts with Muslim therapists to better meet the needs of Muslim students.
Hyat, now a doctoral student in clinical psychology at the University of Washington, said she is grateful that the response to her research has been positive so far, and she hopes Stanford will be proactive in the future about meeting the needs of historically marginalized students.
There are now chapters of the Muslim Mental Health Initiative at the University of California, Berkeley and Northwestern University in Illinois, and students on other campuses are pushing to establish more chapters, Awaad said. Student groups at other schools have received training from these Muslim Mental Health Initiative chapters, and some groups partner with local organizations such as the Khalil Center, which offers psychological services rooted in Islamic principles.
But Muslim students at most colleges across the country do not have access to these resources.
Nimrah Riaz, the chair of the board of the Muslim Students Association National, said that if she had unlimited resources, she would ensure that every MSA chaplain was trained in mental health counseling.
For now, Riaz encourages students in Muslim Students Associations on various campuses to go through a Mental Health First Aid course, which teaches nonprofessionals about mental health warning signs and how to help someone who is having a mental health crisis.
A multipronged approach at Hillel
Hillel organizations, which serve Jewish college students, are also adding mental health providers. The therapists are funded through partnerships with local Jewish groups and Jewish family service organizations.
“For those students who are having difficulty just wrapping their minds around the fact that they might benefit from therapy, walking into a campus mental health facility is different than walking into a Hillel building,” said Amee Sherer, the executive director of Hillel at the University of Washington. “This is a safe space for them, we hope. We hope that it’s less stigmatized.”
Hillel at the University of Washington had a part-time therapist for many years, dating to the 1990s, but when the pandemic hit, Hillel staff saw the greater need for student mental health support. With the Jewish Family Service of Seattle, the campus Hillel eventually hired a licensed clinical social worker to serve as Hillel’s full-time, in-house therapist.
Sheri Davis, who served in that role for the last two years, said students often came to her grappling with anxiety or depression. But they also had issues related to the Jewish faith and culture, such as the struggles of interfaith dating, being away from home for the High Holidays for the first time, antisemitism, or the loss of loved ones during the pandemic, when the need for social distancing made it difficult to observe the mourning ritual of sitting Shiva.
Besides using typical counseling methods, Davis reminded them of Jewish values and encouraged them to engage with Hillel and its events to help fight off isolation. Sherer said she thinks part of the value is the “cultural flavor of familiarity.”
Leah Siskin Moz, the senior director of student and staff well-being at Hillel International, said the mental health and wellness pilot program includes therapy, mental health training so that Hillel staff members who are not therapists know when their students need help, and wellness activities to encourage connectedness.
Students often build strong relationships with Hillel staff, and come to them to share what is going on in their lives, Siskin Moz said. Those relationships are the foundation that will make the mental health and wellness program successful, she said.
Some of the colleges in the Hillel pilot program have a staff person dedicated to wellness rather than a licensed mental health provider; some have both. At the University of Southern California Hillel, Leenie Baker’s job, separate from the work of the on-staff therapist, centers on planning events and training for students designed to foster connectedness and help them establish a sense of belonging. In addition to holding regular Hillel events such as Shabbat meals on Friday nights, Baker recently ran a gardening-themed workshop where students planted succulents, an open mic night and a meditation workshop.
“When you’re in a pressure cooker kind of environment, you have a lot of expectations to be very good at the things you do, and I think the more we can promote activities where it actually just encourages students to express creativity and try something new or something they are actually not good at, it’s very helpful to our holistic well-being,” Baker said. “It’s allowing you to just be a person, rather than having to strive to fit some expectation.”