Many things changed in Abdullahi Ali’s life when he came to Maine after growing up for nearly two decades in Kenyan refugee camps.
An unexpected shift, however, came in how he viewed mental health.
Ali, a native of Somalia, said he came to the U.S. in 2009 with the idea that mental health care was only for “people who are outcasts” or “crazy.” But his work here proved him wrong.
“I realized my views towards mental health changed positively over the years because of my interactions with people,” he said last week.
Ali is the founder and chief executive officer of Gateway Community Services Maine, an organization he formed to support refugees in greater Portland and Lewiston.
Gateway Community Services Maine, established in 2016, is the nonprofit arm of Gateway Community Services LLC, which already provided mental health services, case management, and in-depth support for qualifying immigrants, refugees, and asylum seekers.
Ali founded the LLC in 2014. He said it provides five programs: mental health counseling, case management, services for children with developmental and intellectual disability, personal care services, and behavioral health homes.
Ali was also hired as the executive director of Gateway Community Services Maine by its board. The LLC operates through health insurance, he said, while the nonprofit was formed to address the needs of people who were not being served.
Kate Fahey, director of programs for Gateway Community Services Maine, said via email Feb. 1 the nonprofit does not provide clinical services. The work is more about connecting people with resources, events, and others who may have shared experiences.
The pandemic has posed a new set of challenges for the people Gateway serves, many of whom Ali said already carry stigmas about seeking mental health care from their home countries.
Many refugees he has worked with struggle to trust mental health professionals, he said, and worry about potential consequences of seeking help, like being put in an institution or having the government take away their children.
Ali settled in Lewiston for a year before moving to Portland. He studied sociology at the University of Nairobi and then at the University of Southern Maine, and later earned a Master’s of Science in Justice Studies from Southern New Hampshire University.
His experience working with humanitarian agencies in Kenya lent itself to the work he started doing here in Maine. In Portland, he started working with Catholic Charities in its case management program for refugees who are survivors of torture.
He said he realized there were no local services designed specifically for refugee communities in Maine aimed at “keeping their cultures, their experiences (and) their journeys to the United States in mind.”
One of the reasons he launched Gateway was to provide a safe place for local refugees to go that also has what he called “cultural competence” and the capacity to educate them about how the American mental health system works.
According to data from the nonprofit immigrant research firm New American Economy, between 2011 and 2016 the immigrant population in Portland grew by 3.9 percent, while the general population in Portland’s metropolitan area grew by 1.6 percent.
Most of those immigrants were from Canada, followed by eastern Africa and China. Immigrants from the Philippines, Somalia, and Iraq made up smaller percentages.
In June 2019 alone, 250 African migrants arrived in Portland; most were asylum seekers from Angola and Congo, according to a report in The New York Times. Hundreds of asylum seekers were sheltered at the Portland Exposition Building, and their homelessness was compounded by laws barring them from working for at least six months after filing asylum applications.
Less than a year after hundreds of those asylum seekers arrived in Maine, COVID-19 swept the world, which has created more hurdles for the refugees. Recently settled United States refugees may experience living arrangements or working conditions that put them at greater risk of getting COVID-19, according to the CDC.
While demand for mental health services has been high during the pandemic, Ali said, many people experienced barriers to accessing care, including asylum seekers without health insurance.
Health-care services being moved online became another barrier for many refugees.
“Many people in these communities had trouble with technology or internet connection, or many of them never used online (health) services,” he said.
The nonprofit wing of Gateway responded by employing three community health workers to work with families who were quarantined, or had a loved one who was quarantined and experiencing mental health issues.
Ali said the health workers were trained to provide psycho-social support to the families as well as health-care services.
Gateway also launched its COVID-19 Youth Coalition last year, which comprises 20 young people of color between the ages of 14 and 24 trained to provide psychosocial support to members of the community.
Helping new Mainers navigate mental health care with empathy is a key part of Gateway’s mission, including through the COVID-19 crisis.
“(Gateway) is a place where when they walk in they see people that look like them,” Ali said. “Someone who has had a similar experience.”