Coming out of covid

In the past year, ReWA has helped over 200 immigrants and refugees in the Puget Sound access mental health counseling. Most suffer from depression, PTSD, or just have trouble adjusting to a new country.  All of these are exacerbated by the pandemic.

Azmi Jafaar is the clinical supervisor of ReWA’s Behavioral Health program. He was trained in Iraq as a medical doctor, and psychiatrist before coming to the US in 2016 where he became a certified Mental Health Professional in the state of Washington.

“I became interested in mental health when I was in high school. I read [Sigmund] Freud’s theories and learned how he treated his clients through ‘talk therapy’–which was revolutionary at the time.” Dr. Azmi said he was fascinated to learn how Freud classified the human mind, between the conscious and unconscious. “About 90% of our mental processes are unconscious. Most trauma can traced back to childhood trauma that often deeply buried deep in unconscious. Through talk therapy we can bring it to the surface and we can understand ourselves better. This is the first step to heal from trauma.”  

Increase in Calls

Over the past year, Dr. Azmi said the number of calls coming into ReWA has doubled. Although he said offering counseling by phone or video calls is less effective than in-person services, maintaining contact with clients during the pandemic was essential.

Dr. Azmi meets with clients by video and phone during the pandemic.

“In a crisis, it is normal for paranoia or superstition to increase, so keeping social connections, even by phone is crucial.”

Dr. Azmi knows about working during a crisis. He spent 15 years of his residency in general practice and surgery in Iraq and Libya, both sites of war and its aftermath. He decided to specialize in psychiatry and returned to Iraq where he studied for four more years.

Vaccine Hesitancy

For the past year, the main mental health complaints among ReWA clients were anxiety over the pandemic or losing their job, and dealing with illness of a family member. On top of this, Dr. Azmi said the spread of misinformation, coupled with social isolation, has led more people to believe in conspiracy theories. Dr. Azmi said when the vaccine was announced earlier this year, widespread conspiracy theories shared over social media led many of his clients to become hesitant about receiving the vaccine.

“My response was to get vaccinated. And to make sure my clients knew I was vaccinated. Over the past few months, this has encouraged most of them to also get vaccinated.”

ReWA’s counselors have also used this year to increase training in topics such as abnormal psychology, developmental psychology, trauma-informed care, and how to help clients deal with grief.

At the same time, Dr. Azmi was training staff in a new model of service delivery required by King County. Instead of a monthly cap for services, clients can receive what is deemed medically necessary. “This means the greater the stress and functional impairment the person experiences, the higher level of care is needed.”

ReWA is one of a handful of mental health providers in the Puget Sound who counsel immigrants and refugees in their native languages. ReWA counselors speak Arabic, Somali, Pashto, Turkish, Kurdish, Farsi and Dari, and often share cultural background with their clients.

Dr. Azmi said, “This can help establish trust in communities where many hesitate to talk about mental health issues. But when they get help, it can change their life.”