Photo by Bethany Firnhaber

When Father James Soliman was first ordained as a priest for the Coptic Orthodox Church in Los Angeles, he knew it would be his duty to hear his parishioners' confessions, month after month.

What he didn't know was that often times, instead of a list of sins, he would hear about how Miriam can't seem to cope with her sadness, or how Omar and his wife are fighting all the time.

“They come for confession and they end up talking about their problems,” said Father Soliman, who is also a licensed psychologist. “Those issues should be addressed at counseling rather than at a confessional.”

Soliman said the need for mental health services in the Coptic community is greater now than ever.

Concern for Egypt's future in the aftermath of a revolution and among continuing political upheaval in North Africa and the Middle East, coupled with centuries of on-going religious persecution – 23 were killed when an Alexandria church was bombed in January – has left the Coptic community reeling. But more often than not, cultural taboo keeps many of them from divulging their psychological needs.

Raised in an Arabic-speaking Egyptian family, Soliman is in a prime position to help his community overcome the cultural and religious hurdles that might keep many of them from otherwise seeking help.

“Because of the stigma that's attached to mental health issues, our population tends to be under served because they don't speak out,” said Soliman. “They try to hide these issues under the carpet, if you will. They keep it in their families.”

The Arab community's tendency to hide or ignore mental health issues is ingrained in a culture that has yet to fully embrace modern psychological science. In the Arab world, mental illness is often seen as shameful or embarrassing.

“I think all of us are taught to, in a sense, repress any issues or any obstacles that we're facing,” said Heba El-Haddad, mental health program coordinator for Access California Services, a family resource center for Arab-American communities in Los Angeles. “We're not supposed to talk about them to anyone. So I think just getting out of that shell and exposing yourself and seeking help is a huge hurdle for them to overcome.”

Soliman said that mental health services in Egypt are primitive, especially when compared to US standards of care. The usual course of action for someone diagnosed with something like depression or anxiety in Egypt, he said, was more a practice of pill-pushing to quash the symptoms than of getting at the root cause of the issues and making life changes. And if the symptoms were severe enough, you might just get locked up in hospitals without any real treatment.

For the last 30 years, Egyptians have been immigrating to the United States at increasing rates, fleeing from conditions of oppression and persecution. During the 1990s, according to a 2003 Census Bureau report, the Egyptian population in the United States increased numerically more than any other Arab-speaking group.

In 2005, the Coptic Orthodox Diocese of Los Angeles began holding meetings of its clergy to address the rising need for mental health services in the community.

“[Bishop Serapion] recognized that need and he wanted to develop a clinic catering to our Coptic community, but also catering to any others that wish to receive mental health treatment,” said Soliman.

The clergy decided then to form the Coptic Integrated Family Services program, which provides free psychiatric and psychological services to members of the Coptic community. Since then, the program has been run out of the cluttered church office at the Holy Virgin Mary Church in Highland Park, where Soliman works, and from a small one-room office in Glendale. The services are provided by a small group of mental health professionals, students and interns from the Coptic community who volunteer their time and expertise.

Maggie Ateia is one such professional who has been offering her services as a clinical psychologist since the program's inception. She sees patients referred to her by Soliman in her South Pasadena practice, where she opts not to charge them, even if they have insurance that might cover the services.

“Having the cultural component of me being Coptic, it's like there's an unspoken connection,” said Ateia. “They know that I come from the same culture as them. It's really helpful to have that in common.”

What expenses CIFS does have are paid for by funds donated to the diocese under the larger umbrella of the Santa Verena Charity.  Annual fundraising banquets pull in the bulk of the money, though a number of smaller, more focused fundraising efforts are made, too.

May, who did not reveal her last name for fear of recognition, is a member of the Los Angeles Coptic community who has recently started using the services offered by CIFS. She said she is grateful to have someone to talk to who understands so well her cultural background.

“I grew up very sheltered, and I've struggled lately with where I want to be in life,” said May, 30. “My culture expects me to be more financially stable than I am, married and with a family by now.”

Like many who struggle with mental health issues, May was hesitant at first to ask for help.

“A lot of people in the Coptic community think you have to go completely crazy to seek help, or they think the mental health professionals are crazy. But I think I always needed it,” she said. “We can all use someone to talk to.”

Contributing to the Coptic community's core of misinformation about mental health is the fact that many of the older clergy – about 10 of the 50 ordained in Los Angeles – don't “buy into mental health at all,” said Soliman.

Instead of therapy or medication, they advise prayer and a stronger commitment to God.

“I love their faith,” said Soliman, “but I know that there are very debilitating psychiatric illnesses. Depression is a medical illness that, if left unchecked without medication, can cause someone to have suicidal thoughts, and then God knows after that.”

May too had some initial misgivings about how to reconcile aspects of her faith with her need to seek professional help. But when she found out she could work with a mental health professional who shared her faith, she was relieved.

“I wouldn't trade my religion for the world,” she said.