This story is Part 2 of a two-part series on opioid addiction in Minnesota’s Karen community. Part 1, about families struggling to get help for their children, can be found here.
When Kaziah Josiah began her role as one of four St. Paul Police Department community engagement specialists, she started handing out her phone number.
Born in Thailand as a member of a Karen refugee family, Josiah came to Minnesota in 2004. Fluent in Karen, Thai and English, she has first-hand understanding of the needs of Karen families, and she wanted to help them build bridges with the police, something she believes can help them navigate the addiction crisis among young people in their community.
To put it lightly, Josiah’s phone is busy.
“I get a lot of calls from Karen families,” she said. “These calls can be anything from, ‘How do I file a report of a runaway teen?’ to, ‘What do I do when my child is going through substance abuse and addiction?’”
Josiah believes that her Karen heritage gives her credibility with families struggling with opioid addiction. “I think the community feels more comfortable just reaching out to me,” she said. “Let’s say if there’s a child that’s on probation and the family doesn’t know how to navigate through the court system or needs an explanation of what something means and how they go about doing it. That is something I can help them out with.”
Many Karen parents struggle with English, Josiah said, limiting some of their most basic interactions with police. She’s there to help.
“Sometimes, with the language barrier, it is hard for families to call 911,” she said. “I try to reassure them that when you call 911 you can just say the word, ‘Karen’ and they will connect you with an interpreter. Or,” she added, “they can call me.”
Being a linchpin between Karen families and the police is a lot of work, but Josiah is convinced that having a person who understands Karen culture as a guide is key to addressing this crisis.
“My role with the St. Paul Police Department is to help the community build that trust,” she said. As the only civilian Karen employee in the department (there are some Karen officers on the force), Josiah, a graduate of St. Olaf College, said she applied for the community engagement job because she thought that with her background she could help make a difference. “The community needs a lot of help now because they are new immigrants, and they really need additional guidance,” she said. “I joined because I want to help build that bridge.”
Community bridge building, or tapping the indispensable expertise of people who have lived experience in a specific culture, is one approach that has shown some success in addressing the opioid addiction crisis among Karen youth in the Twin Cities. At the center of it all is the Karen Organization of Minnesota, a multifaceted social services agency that assists the Karen refugee community.
Karen Organization of Minnesota staff have created programs focused on youth addiction, partnered with faith leaders and churches, advocated for families in the public school system, and supported young Karen people interested in mentoring their peers. The organization’s mission of enhancing the quality of life for all of the state’s refugees from Burma is evident in its work and focus on respecting and understanding the Karen culture and way of life.
At Humboldt High School in St. Paul, where some 40% of students are Karen, cultural bridge building has been one important approach to addressing the opioid addiction crisis, said Kati Vaudreuil, a member of the of the school’s social work team. A few years ago, seeing an increase in drug addiction and truancy among Karen students, she and her colleagues asked St. Paul Public Schools’ Office of School Support for financial assistance so they could partner with the Karen Organization of Minnesota to provide culturally and linguistically appropriate services to students and families at the school.
“They gave us a grant to fund an outreach worker to work on site with us three days a week,” Vaudreuil said. For the last two years, that outreach worker has been Mar Htay, a Karen Organization of Minnesota youth case manager. He has been invaluable in increasing communication between the school and Karen students and their parents.
Mar Htay, Vaudreuil said, is “really able to engage with the parents. He can do a home visit with me so we can engage. And many of the students feel comfortable talking to him. I don’t know what we’d do without him here.”
She’d like other high schools in St. Paul, especially those with large Karen populations, to have someone who fills Mar Htay’s role. “I think if all the schools could have Karen outreach workers that would really help,” Vaudreuil said. “I worry that this community does not have a loud enough voice. This is a huge problem within a huge community here in St. Paul.”
Mar Htay explains that he sees his role at Humboldt as that of a guide and explainer. “I help navigate the system and translate and work with youth and mentor them, encourage them to get treatment, encourage them to make better decisions, even help them with homework.” While he emphasizes that youth opioid addiction is still at crisis levels in in the city, he believes that his personal history — he was born in Myanmar and fled persecution with his family to a Thai refugee camp where they lived for eight years before coming to the United States — helps give him credibility with Karen students at Humboldt.
“I feel like youth interact better with Karen staff because we understand their background,” Mar Htay said.
Many of the young people Mar Htay works with at Humboldt are hard to reach, but some have grown to trust that he understands where they are coming from and he has their best interest in mind. “All the youth are different,” Mar Htay said. “Some want help and they come and ask for advice on what to do. Some youth, they are gang affiliated. Some are also very addicted to drugs. Many of them don’t want my help. That’s been the part that’s been pretty hard about this work.”
Many of his students’ struggles remind him of his own history, Mar Htay admits: “When I’m working with these kids I see a lot of myself in them.” His own mother struggled for years after the death of her husband, and Mar Htay and his siblings were left to take care of themselves when her mental health deteriorated. He thinks that generational trauma from years of persecution plays a role in some of the struggles that Karen parents and families are facing today. “These kids don’t have a role model. There is no support system at home. Their parents are not being role models. They are navigating life by themselves.”
Still, Mar Htay said he has been able to help some Karen families at Humboldt. He recalls one kid in particular who he was able to help get into an addiction treatment program and has since managed to stay sober. “I think he’s doing well because of how much his mom is involved,” Mar Htay said. “She always checks in with me and the kid. That’s the reason it is a success. She is involved. He’s in school right now doing regular student stuff. He comes into my office to ask for help with homework. He’s doing really good now. I’m proud of him.”
Youth led, youth focused
Not so long ago, Josiah was approached by a group of Karen young people who were interested in starting a culturally specific mentorship program for at-risk youth called Asian Youth Outreach.
Josiah offered to help organize the program, and as a vice chair of the Karen Organization of Minnesota’s board of directors, she was able to get the organization to sign on as fiscal sponsor. She was also able to enlist Enrique “Cha-Cho” Estrada, a fellow St. Paul Police Department community engagement specialist, to help in training the young team. “He worked with our mentors over six weeks,” she said. “Then they were on their own.”
Today, the Asian Youth Outreach team has one-on-one meetings every week with their mentees, where they encourage them to stay focused on their family, work and studies and stay away from drugs and crime. “They also host group sessions every other week for our youth.” Josiah said.
For nearly a decade, M Health Fairview has sponsored a culturally specific Karen Recovery Program for adult men, said Alexis Walstad, co-executive director at the Karen Organization of Minnesota. “We hired a staff person who is Karen and had nine years of experience doing chemical health prevention and recovery in the refugee camps but no credentials in the United States. HealthEast received a grant and we were able to hire that person as a subcontractor.”
While this culturally specific program has been successful with its target audience, it has been clear that it is not the right program for Karen youth, Walstad said.
“Pretty early on we started getting questions about what can be done for Karen youth, for the kids who were under 18. It wasn’t appropriate for them to be joining in the adult activities, even for those 18-25-year-olds. The truth is, they didn’t want to be in a treatment group with men in their 40s and 50s.”
In 2019, the Karen Organization of Minnesota launched a program aimed at young people struggling with addiction called the Youth Chemical Health Program. Ner Mu, the organization’s youth health educator and program manager for community health, was the first person hired to work on the program.
“Ner Mu is focused on education and prevention,” Walstad said. “He has developed workshops on substance-use prevention. He partners with St. Paul Police Department to provide education for youth and their parents.”
Ner Mu explained that he also works with Mar Htay on the Youth Chemical Health program. “I am doing referrals with youth who are using substances and go to treatment centers,” he said. “I follow up with them and also support their parents that don’t know how to speak English and don’t know how to connect with the treatment centers and schools and law enforcement and juvenile detentions.”
Because mental illness and addiction was rarely talked about in Burma or Thailand, Karen people of all ages often feel some shame about seeking help. Another important part of Ner Mu’s role is focused on breaking down some of that old way of thinking. To do that, he’s been making connections with faith leaders in the local Karen community. Because of this work, many Karen churches are now connecting with young people as they come out of addiction treatment, offering support aimed at normalizing their experience.
“The idea has been to help them feel really welcome in community spaces,” Walstad said, “so hopefully they feel less stigmatized and they can return to the community at large.”
Josiah believes that efforts like these, ones grounded in a specific understanding of the unique cultural mores that contribute to the spread of addiction in the Karen community, are the best way to tackle the problem.
“It is a new concept for sure, but I think a lot more people in our community are more open to themselves or their children receiving mental health and addiction services, especially when they hear about them from someone who looks like them,” she said. “Usually a lot of the Karen community don’t know about mental health. It is very new to them.”
Trying open minds, to demonstrate that this kind of help can and should be accessible to all, is important, Josiah said. And Karen people of all ages are stepping forward to make that a reality for everyone in the community.