Mental & Behavioral Health

Axis serves the mental and behavioral health needs of the community in a culturally appropriate manner. Providers are ARMHS certified (Adult rehabilitative mental health services) with the goal of assisting patients to develop and enhance psychiatric stability, social competencies, personal and emotional adjustment, and independent living and community skills. Providers instruct, assist, and support in medication education and monitoring, basic social and living skills in mental illness symptom management, household management, employment-related challenges, and transitioning to community living. In cases of patients who require more accommodation because of confusion, fear, and other forms of immobility, ARMHS certified providers are trained to provide services in the home of the recipient, relative, or significant other.

For the Somali and East African population that comprises the majority of the Axis Clinic’s patient base, mental health care is largely unavailable because of a lack of providers who have the necessary cultural understanding and language skills to work well with this population. In order to best respond to the needs of Somali clients, it is important to understand their unique experiences and circumstances. This is even more critical in mental health therapy than in primary health care. This is where Axis excels.

There are four principal causes of degraded behavioral/mental health among this population:

Acculturation and PTSD

Somali immigrants and refugees in the Twin Cities face enormous cultural and language differences, must sometimes contend with racism and a sense of societal rejection, often lack literacy skills, and suffer economic deprivation. Clinical studies show that rates of Post-Traumatic Stress Disorder (PTSD) among immigrant and refugee populations range from 39 percent and 100 percent (compared with 1 percent in the general population) while rates of depression range between 47 and 72 percent. The impact of war trauma, social isolation and change in social status make acculturation difficult. These have a significant impact on psychosocial adjustment.


Trauma of War and Displacement

Immigrants and refugees often have experienced stressful events that contribute to mental illness or adjustment problems, including the loss of homeland and loved ones. Immigrants, and especially refugees, have likely suffered malnutrition or famine, violence, political persecution and torture. Often trauma goes untreated. Past trauma and current adjustment challenges increase the risk of developing behavioral and mental health problems. The recent U.S. Surgeon General’s report Mental Health: Culture, Race, Ethnicity highlights the disproportionate burden of mental illness that racial and ethnic minorities face.

Stigmatism and Social Isolation

Many Somalis with mental illness are stigmatized and socially isolated. The pain of this isolation is felt intensely because Somali culture is traditionally communal and family oriented. While a person with mental illness may be ostracized from the community, their fear of stigma may be even more powerful, and prevent them from seeking intervention. Social isolation is not only disorienting, but it makes the process of healing difficult. Unaddressed isolation from community can contribute to the development of depression.

Loss of Social Place and Status

Family situations where the children speak English better than their parents and are more acculturated can result in the degradation of parental standing and authority. In Somali families, the children often take care of necessities such as paying the rent or speaking with the landlord. This is particularly disorienting in a culture where adults are not accustomed to learning from children. Furthermore, immigrants may suffer a loss of their accustomed honor and/or standing once separated from their tribal communities. Skillsets needed to thrive in Minnesota may be different and confusing to new immigrants, exacerbating a sense of worthlessness and loss of honor.

The medical need in the AXIS area is by no means limited to the East African immigrant community. The sizeable homeless population brings needs for mental and behavioral health care and a relatively high rate of injury. The percentage of homeless people who have suffered some form of brain trauma is now believed to be extremely high, and appropriate health care requires understanding and expertise in this area. Other demographics of pressing needs in the area include recent Hispanic and Karen immigrants. These groups face the same linguistic barriers that have confronted the East African populations.

With the goal of expanding services, Axis initiated a relationship with Dignity Center, four blocks from the Axis main clinic, which assists homeless people achieve and maintain stability. More recently, Axis has begun a collaboration with Mary’s Place, an organization that offers a shelter and transitional housing to up to 600 people at a time. Mary’s Place encourages participants to establish a relationship with a primary health and mental and behavioral health professionals at Axis with a view toward overcoming the principle obstacles to the transition into successful independent living.

Axis providers serve your mental and behavioral health needs in a culturally appropriate manner.