Before the pandemic, a group of 6 to 10 Muslims would gather every Tuesday and Thursday evening for 90 minutes at the green-walled Mosque of Islamic Brotherhood in New York City. Every meeting began with a recitation of the Quran followed by a discussion of their addiction to drugs or alcohol.
The participants are taking part in a program known as Islami Milati, which integrates the Islamic faith with borrowed elements from the 12-step Alcoholics Anonymous and Narcotics Anonymous recovery programs to empower Muslims to use spirituality and prayer as part of the broader strategy to beat drug and alcohol addiction.
“We have our own language. At AA and NA, the people struggling say they suffer from ‘addiction’ whereas we say we suffer from ‘fallen human condition,” says Abdul Wakil Muhammad, New York regional chairman of the Islami Milati program.
Muhammad, who has been sober for 27 years, used to attend AA meetings at the YMCA until one of his friends took him to an Islami Milati meeting, after which he converted to Islam in 1995. He has been involved in the organization ever since.
The Mosque of Islamic Brotherhood is using the Islami Mitali program to address the problem of substance abuse in the Muslim community — an issue often ignored by members of the Muslim community since any use of drugs or alcohol is forbidden in Islam.
To combat the stigma and normalize the conversation about addiction, the Mosque of Islamic Brotherhood makes an announcement after Friday prayer about the program (provided Friday prayer is not canceled due to COVID-19). While such ministries are common in other faiths, the service is gaining momentum in America with the conversations happening more and more across the country — in places like Atlanta, Dallas, Miami, Cincinnati, Pittsburgh, San Diego, Washington, D.C., and Tucson.
But the reality of the pandemic and social distancing rules to slow its spread has meant these meetings have been suspended for more than six months and each chapter has been left to decide how to stay connected. Islami Milati’s national support line, which holds conference calls three times a week, has seen a slight increase in attendance, with an additional 2-3 regulars joining every month.
Islami Mitali is just one of a growing number of organizations on the front lines trying to reduce stigma and provide culturally sensitive mental health services to Muslims. The Khalil Center, which opened in midtown Manhattan in 2017, is one of seven around the country dedicated to providing help for conditions like anxiety, depression, social phobias, substance abuse and family dysfunction by focusing on spirituality as well as behavioral change. The center welcomes everybody, even non Muslims, and receives referrals from a number of different organizations including the Muslim chaplains of both New York University and Columbia University.
In March, Dr. Venus Mahmoodi was the only therapist at the Khalil Center, seeing an average of 35 patients a week. At the time, there were over 25 people on the waiting list and the center was working hard to secure additional offices.
There has been an “uptick” in appointments since the pandemic began with both new patients and those wanting to restart their sessions, says Mahmoodi. The response to COVID-19 has presented unique challenges, including “problematic family dynamics, people spending a lot of time with family, having to move back in with family” as well as increased anxiety and depression due to the “uncertainty in the air and isolation from people.”
For the center, all sessions are now held online on weekdays and weekends. The virtual consults, which comply with government privacy requirements, have allowed the center to accommodate everyone on the waiting list. Two additional therapists have been hired to serve the average of 50 patients a week and the center expects that weekly number to rise to 60-75 patients in the near future.
While the interest at the Khalil Center is encouraging, Mahmoodi says the stigma and misinformation surrounding mental health is pervasive in the Muslim community. In some cases, people are “really concerned” about confidentiality because they do not want anyone to know they were there or what they discussed. In other cases, people don’t understand what mental health services look like.
“Some patients often expect to feel better right away, the way you would if you took a course of antibiotics, and when they don’t get that immediate relief, they often don’t stay very long,” says Mahmoodi.
Islamically integrated mental health services are not just about “copying and pasting” aspects of mental health training and religious training together, says Dr. Hooman Keshavarzi, executive director of the Khalil Center. Instead, it has to be a “holistic and person-focused” approach of prayer, therapy and medication working in tandem so you don’t have to choose one over the other.
Christian, Jewish and other faith communities have similar programs, understanding the connection between religion and mental health. Holly Oxhandler, associate dean for research and faculty development and an assistant professor at Baylor University’s Diana R. Garland School of Social Work, has extensively studied the role an individual’s faith plays in their mental health. She recently emphasized the importance of tending to spiritual health during difficult times, noting that “healthy, positive spiritual practices have the potential to support our mental and physical health.”
But there are challenges. Religiously sensitive mental health services can vary from organization to organization, even within the same faith groups. There are other potential issues, too. An individual may receive one message at a therapist’s office and another at their place of worship. For members of the LGBTQ community, for instance, the first may be one of acceptance and the latter, one of condemnation.
In April 2016, Omar Shareef, a psychiatry resident at Nassau University Medical Center and Sayed Bhuiyan, a community health coordinator for the city, started Muslims Thrive, an organization modeled off ThriveNYC — a widely criticized billion-dollar initiative started by Chirlaine McCray intended to offer free mental health and first aid to all New Yorkers.
Despite the criticism, Shareef says the idea of providing mental health literacy and awareness across every community has been key to creating a more “robust mental health service for Muslims.” The organization provides an 8-hour certification course and has certified over 2,000 people across mosques, schools and community centers in the five boroughs.
Since the pandemic began, Shareef says people’s mental health has taken a toll due to the general “feeling of entrapment, restriction and distancing” that they are feeling. There has been a spike in the number of patients seeking help for “worsening depression, anxiety, emotional meltdowns, grief from loss of family members and even loss of productivity.”
Despite initiatives to serve the mental health needs of Muslims, many obstacles to treatment exist, including feelings of shame and being misunderstood, not knowing who to talk to for help and the cost of treatment itself.
In New York, 33-year-old Sharaf Rizvi has experienced those feelings. His father physically abused him from elementary school through high school. When Rizvi was 13, his father punched him in the face for getting a math problem wrong.
Father and son have worked on their relationship and are in a good place now. However, when Rizvi shared his story with a serious girlfriend in 2017, she broke things off saying she could not marry into “that kind” of family.
“It felt like I was being punished twice in a sense because I was the one who suffered through the beatings as a child and now I was paying the price for that again,” Rizvi said.
The experience, Rizvi believes, caused him to fall into a depression. He struggled with a low mood, an inability to focus, fatigue and difficulty doing routine things. He stopped playing basketball, a staple in his life, and ultimately ended up leaving his job as a product manager. Rizvi has since pulled his life back together and is determined to reduce the stigma around mental health in the Muslim and South Asian community by sharing his story.
Even when a person can overcome the social and financial barriers to seeking help, their family members and community members may not be supportive or they may downplay the issue.
“‘We don’t have these types of problems’ is the mentality we are up against — so it’s either suppressed or labeled something different,” says Shareef.
Also in response to COVID-19, Shareef and Bhuiyan started a social media series on Instagram featuring different mental health professionals going “live” discussing different topics during the peak of the pandemic. The idea was to allow health care workers to engage directly with viewers and set up an entire mental health curriculum educating people on important COVID-19 related issues.
The “silver lining”, according to Shareef, is that health care providers have been forced to adapt to the increased demand for mental health services by figuring out online solutions to reach more people.
“We are trying to raise a mirror to the Muslim community. Just because you believe in God doesn’t make you immune from mental health problems,” says Shareef. “You don’t tell a person with a broken leg ‘to pray the broken bone away,’ you treat it immediately. We need the same approach with mental health especially as we continue to navigate the pandemic.”