She experienced depression when she arrived in Chicago from Iraq. Now, she helps others spot mental health challenges among immigrants

May 16, 2023

Ekram Hanna wrote those dates in the fall, when she learned she would have funding for a daylong mental health training she hoped to coordinate.

Hanna is an Iraqi immigrant who is certified as a mental health first aid instructor. She trains others on how to recognize signs and stigmas of mental health among immigrant populations.

She was one of about 15 people who became certified to lead mental health first aid trainings, in part through an Office of Refugee Resettlement grant, said Isabelle Darling, a clinical mental health consultant for the National Partnership for Community Training, a program of Gulf Coast Jewish Family and Community Services based in Clearwater, Florida.

“We recognize that refugees need to be at the forefront of the conversation,” Darling said. “We knew that this was an area where we would need advocates from within the community to advocate for mental health, for delivering the language and purpose for this work.”

“We tend to think that the refugee experience of fleeing is where the challenges start, but a lot of times it starts even beforehand,” she said, like when a person’s home country begins to feel unsafe or his family is at risk or separated. “All of these experiences end up building.”

Darling said Hanna brought a clear passion for connecting the right language about mental health to immigrants.

“She was definitely one of the standouts,” Darling said.


The eight-hour trainings that Hanna now provides cover topics such as providing help to people experiencing depression, anxiety and post-traumatic stress disorder, and understanding the stigma of mental health. Many immigrants are hesitant to share difficulties, much less seek help through a therapist.

“For us, we don’t even talk about that,” Hanna said. “We really need to talk about that.”


Many immigrants and refugees arrive in the U.S. after experiencing trauma in their own country, and then confront mental health challenges as they try to adjust to a completely different culture and language. Often, they are doing all of this while trying to find employment and enduring separation from their families.

At the first training that Hanna held, which she said included a representative from the federal Office of Refugee Resettlement, she trained colleagues at the Middle Eastern Immigrant and Refugee Alliance, where she is a community engagement manager, and staffers at other service agencies.

Ekram Hanna, center, and Josefina Alvarez, right, conduct a mental health training at MIRA office on Dec. 7, 2019.

Hanna understands how hard it can be to adjust to a new country and a new life. When she arrived from Iraq in 2012 with her husband and two children, then ages 6 and 4, she experienced depression. Even though she felt confident in her education, she said having the confidence to speak the language was her biggest barrier.

“You have to learn everything as a baby,” she said. “When it comes to speaking, this is a big thing.”

Hanna didn’t leave the house for several months when she first arrived in Chicago because she wasn’t able to communicate well.

“It was really hard for me,” she said.


Ultimately, finding a job and a routine, and a community, helped, she said.

The experience gave her a passion for nudging others to leave the home and learn English. Right now, she runs a group for women, many of whom are refugees from countries including Afghanistan, Jordan, Egypt, Iraq and Syria. It is something she has dreamed about for years. A decade ago, she worked with a group in northern Iraq focused on empowering women.

“I felt like that’s the thing that I wanted to do,” Hanna said.

Often, she said, she encounters women who stay home for years without speaking English. Many of the women do not feel comfortable with everyday activities like taking the bus.

“I have passion to help these ladies,” Hanna said. “A lot of people, they came as immigrants or refugees, but especially for a woman, in our community, they don’t have the courage to go out and do stuff by themselves. So they just stay home, even for years.

“I want to change the way that these ladies think,” she added. “Because when you think that you are less than a man, you will feel like you are limited.”


The most recent training she facilitated included 17 people who work with immigrant service groups, and counseling students, and a doctor.

“It was an amazing group,” she said. “That was really encouraging.”

Hanna hopes participants will take the lessons they learned and teach others. Even if they check on people around them, they will have taken something away, she said. “Sometimes just showing other people that we care about them, that helps a lot,” she said.

Ultimately, she would like to translate the entire training to Arabic. That will require funding to pay professional translators. But that way, she can give the training to many in her group of women too.

“I want people to know, it’s OK if you feel like you don’t feel good,” she said. “But just try to take that courage to ask for help first.”

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