The walls inside Bridge Healing Center in St. Cloud are painted soothing hues of blue and green, a deliberate effort to help visitors feel relaxed and welcome. 

The hallways are lined with colorful paintings by a local artist featuring people in East African dress, with encouraging phrases in both English and Somali.

“A lot of people, when they walk in, they see these pictures and they feel welcome, because it kind of reminds them of their culture,” said Lul Nur, the center’s program director.

Nur and Ali Aden are a husband-and-wife team of licensed mental health counselors. They moved from the Twin Cities more than a year ago to provide culturally specific mental health services mainly for the East African community, which St. Cloud lacked. 

Before the center opened, people were driving to the Twin Cities for services, which disconnected families and hindered them from being involved in their loved ones’ treatment, Aden said.

“We saw a need to bring that service from the cities to here,” he said.

Minnesota has a shortage of mental health providers of color, especially outside of the Twin Cities metro area. In St. Cloud, that means members of the region’s large Somali community can face language and cultural barriers to getting treatment.

Bridge Healing Center began offering mental health counseling in June 2022. It recently added addiction treatment services, with lodging for up to six people.

The couple said their own backgrounds help them relate to their clients. Aden is originally from Somalia and moved to Minnesota in 2007.  Nur was born in Somalia, but raised in Egypt before coming to the U.S. 

Counselors at the center speak Somali, English, Spanish and Arabic. Talking with clients in their native language, instead of through an interpreter, is critical to establishing trust and reducing the risk of a misdiagnosis, Nur said.

“A lot of mental health concepts are Western, so we might not even have a name for it,” she said. “It could really get messed up if the person who was translating doesn’t really understand the word.”

Aden said there’s a need in the St. Cloud area for culturally specific treatment for substance use and addiction. The opioid crisis has hit Minnesota hard, and the Somali community is no exception, he said.

But for many East African families, addiction is taboo and unfamiliar, complicated by religious prohibitions on the use of alcohol and drugs. 

“What’s adding to it is the stigma,” Aden said. “It’s hard for the families to open up and seek services. A lot of times we get a lot of calls — ‘My son is struggling. My daughter is struggling. I don’t know what to do.’”

Some Somali parents still have unhealed trauma from their own past — from fleeing a war-torn country, being separated from loved ones and losing a sense of belonging in a new country.

Hani Jacobson is a community health nurse with St. Cloud-based health care provider CentraCare, which refers patients to Bridge Healing Center. She said some refugees survived traumatic experiences such as war, famine and torture.

“When your whole life has been fight or flight, it becomes part of your normal daily life,” Jacobson said. “So it takes a lot of effort and education, and just letting our community know that it doesn’t have to be like this. You don’t have to live in survival mode anymore, and there’s help out there.”

Meanwhile, the younger generation sometimes experience secondary trauma from hearing about those experiences from their parents. And they may feel torn between their Somali and American identities, feeling like they don’t fit in either one, Aden said.

“The parents are not equipped enough to address the current stressors that their kids are going through,” he said. “So the kids will feel isolated. They will feel distant from their parents. They will have less connections.”

That can lead to mental health issues or substance use. Often, the first instinct in East African culture is to keep such struggles within the family until it becomes too much to handle, Aden said.

“It’s very critical to provide education to the families,” he said. “There’s help. There are people you can seek out, and don’t wait until it becomes a crisis.”

In the collectivist Somali culture, a family’s opinion or fear of judgment can be obstacles to getting help, Nur said, but their involvement and support also can help the client succeed. So a lot of their work involves educating families that addiction is a disease that changes how the brain works, she said.

“When they understand that piece, it’s easier for them to be supportive than neglecting the child and saying, ‘You brought this on your own,’ she said. “That mentality needs to change.”

Word of mouth is helping generate more calls from people seeking help. Nur and Aden hope to expand their services and add lodging for women seeking addiction treatment.

Aden said he’s encouraged when he sees clients graduate from treatment, find a job, stay stable and repair broken family relationships.

“That’s what makes success. That’s how we measure it,” he said. “It’s the number of clients who graduate from here, change their life, make an impact on their life and make an impact on their society as well too.”