Somalis with mental health concerns are benefiting from St. Scholastica initiative which brings social work students to medical settings

Chris Roemhildt, a student at the College of St. Scholastica, asks a question during a class at Essentia Heath-St. Mary's about accessing medical records. Roemhildt and fellow students are working on their Master's in Social Work degrees, which includes an internship at Essentia in the ROBUST program. Bob King / rking@duluthnews.com

 As a social work intern in the Twin Cities, Najma Mohamed hears traumatic stories from her fellow Somali immigrants every day.

"These are clients that are coming from war-torn countries," said Mohamed, 26, who came to the U.S. when she was in her early teens. "They witnessed a lot of violence, a lot of robbery, a lot of burning houses. ... I had one client, she said she was raped by 10 men."

Her desire to help people with such horrific backstories led Mohamed to obtain a bachelor's degree in social work at The College of St. Scholastica's St. Paul campus. Now, as she works toward her master's degree from St. Scholastica, Mohamed is getting support from a program for which the school received a federal grant of $1.3 million over four years.
The program goes by the acronym ROBUST, for Rural Optimization of Behavioral Health for Underserved Settings, and it's being used to support six-month internships for 20 St. Scholastica graduate students in social work.

The buzzword for the program is "integrated." It means placing social workers alongside other professionals in helping clients with multiple needs.

"I really hope to see this become a way of our practice where we have physicians and nurses and social workers working cooperatively on a singular treatment plan versus a handful of individualized treatment plans," said Julie Seitz, clinical director at the Center for Alcohol and Drug Treatment in Duluth.

Seitz already was working on her master's at St. Scholastica when faculty member Paula Tracey encouraged her to apply for a ROBUST internship. She did, she got it, and she's using it particularly to look at ways to reach people outside of Duluth who are seeking to overcome opioid addictions.
That can include working to help more rural physicians obtain the waivers needed for them to prescribe medication to assist in recovery and providing counseling via telehealth, said Seitz, who has worked at the Center for Alcohol and Drug Treatment for almost 20 years.

Different perspectives

For Colleen Wheeler of Chisholm, the internship has her working alongside other health professionals at Fairview Range in Hibbing. Wheeler, 40, has been assigned to several different departments since beginning her internship shortly after the grant was awarded in October. The doctors and nurses she works with are open to her views, Wheeler said.

"It's really an environment of, 'I respect you, but this is my perspective,'" she related. "'I see where you're coming from, but look at it this way as well.'"

The biggest participant in the program is Essentia Health, which has just begun training the 12 interns who will serve in Duluth, Superior and Virginia, said Diane Holliday-Welsh, operations administrator for emergency medicine and behavioral health.
Essentia's participation is driven by the emotional and behavioral baggage many patients bring with them when they come to the hospital, Holliday-Welsh said.

"Thirteen percent of our patients who present to our St. Mary's Duluth emergency department are presenting with a mental health concern," she said.

'The best thing'

A ROBUST internship comes with a stipend of at least $10,000 plus allowances for gas money and books, said Lee Gustafson, who chairs the Department of Social Work at St. Scholastica.
The money made a big difference to Mohamed, who worked hard to pay off the loans that helped her get a bachelor's degree.

"I was able to pay off some of my tuition, and then as soon as I was supposed to apply for loans, this was offered to me," she said. "It was just like, out of nowhere, it was the best thing."

With a population largely clustered in the Twin Cities, a student focused on Somalis might seem an odd fit for a grant that begins with the word "rural." But Gustafson said it does fit the program's emphasis on disadvantaged groups. Also, he pointed out, their native Somalia is largely rural.
Most of the clients Mohamed sees have post-traumatic stress disorder, depression, anxiety, or a combination of the three, she said.

About 150,000 Somalis live in the U.S., according to a 2015 United Nations estimate, and more live in Minnesota than in any other state. "They all come here," Mohamed said. "Even if people come to other states, they end up moving here to Minnesota just because they need the help from the community."

Extreme challenges

While many of her peers chose to seek nursing careers, Mohamed opted for social work because it deals with all aspects of a person's life, she said. She feels especially called to her own community because it's a population that's underserved and has experienced so much trauma.
The woman who was gang raped 25 years ago still experiences physical effects as well as nightmares and flashbacks, Mohamed said. A man told her he was restrained and beaten while being forced to watch other men rape his wife. "Another client said, 'My two sons were shot right in front of me.'"
She's still learning how to help people who have been through such extreme circumstances, Mohamed said. But she has learned to keep her emotions under control as she listens.

"I have to remain strong, because that's the only way I can help them through it," she said.

Whether in the state's Somali community, on the Iron Range or in a drug treatment program in Duluth, participants in the ROBUST program say they hope to be better-equipped to meet the broad needs of underserved populations.
"This grant goes far beyond the walls of any of our health care organizations," Essentia's Holliday-Welsh said. "It's really going to pay dividends for our community."

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