Dr. Nadia Damani-Khoja is the Associate Director-Equity in Mental Health at the University of California, Santa Cruz’s Counseling and Psychological Services (CAPS). She works to address the challenges that students of color, immigrants, first generation, international, LGBTQ+, Muslim-identified and other underserved students, encounter in accessing mental health services within the college environment. Identifying as a South-Asian American Muslim female herself, she passionately advocates for the well-being of students with diverse, intersecting identities.

Her work as a clinician and her research, infused with her own experiences and perspective, is significant in understanding barriers in mental health research and services. During the completion of her Masters in Family Therapy and Ph.D. in Counseling Psychology, she researched the role of cultural beliefs, attitudes, and knowledge in three South Asian Muslim groups. She discussed clinical implications and complexities with mental health help-seeking in South Asian American Muslim communities–peaking her interest in working with other under-resourced communities. By focusing on the perspectives of marginalized students, psychologists like Dr. Damani-Khoja can work towards dismantling systemic inequalities in order to promote destigmatization of help-seeking in research and clinical practice. Working at CAPS, her efforts are essential for promoting social justice, cultural sensitivity, and fostering a more inclusive and equitable campus environment.

Diya Verma: “To start off, what inspired you to pursue a career in psychology?”

Nadia Damani-Khoja: “My career trajectory has been very interesting. Just like many South Asian American immigrants, I was encouraged to either pursue medicine or get a MBA! I feel that families, especially those who have migrated from the sub-continent of Asia often encourage their children to pursue careers that would afford them with stability of income. After completing my BA in Psychology and MBA in Management, I worked in banking for a while. However, I realized that Psychology was my true passion and I therefore decided to pursue a Masters in Family Therapy. Coming from a large family and experiencing multiple moves across the globe, I’ve always been interested in exploring family dynamics, acculturation, and stigma towards mental health help-seeking. After working as a Licensed in Marriage and Family Therapy for a decade, I realized the larger systemic issues of inequities in mental health access. I also noticed a lack of culturally relevant assessment tools and services available for minority populations... I have explored the provision of mental health services at diverse places such as University Counseling Centers, Community Mental Health, VA hospital, school districts, and private practice. Each of these wonderful institutions has provided me with rich clinical, outreach, and supervisory, and leadership experiences. Through this journey, I have realized my passion towards working with college students. I have been fortunate enough to work at various college counseling centers such as the University of Houston, Clear Lake, UC Berkeley, and MIT. Currently I work at the UC Santa Cruz CAPS as the Associate Director-Equity in Mental Health. At each of these counseling centers, I have focused on destigmatizing mental health, prioritizing access to CAPS services, and working towards a vision of overall student success.”

Verma: “Are there any research topics you are particularly passionate about, such as your work about the psychological issues couples and families of South Asian origins face?”

Damani-Khoja: “I have always been quite passionate about understanding barriers and stigma towards mental health help-seeking, especially for those who hold marginalized identities or those who come from cultures that encourage informal help-seeking, such as South Asian Americans, among many other minority groups. Both my Master’s thesis and Ph.D. dissertation included aspects of those issues within the South Asian American Muslims. My dissertation, “Mental health help-seeking patterns in South Asian American Muslims” explored beliefs, attitudes, and knowledge about mental health services. It also explored demographic variables and preferences toward seeking help. I’m also very interested in the experiences of [Black, Indigenous and other people of color] BIPOC, LGBTQ+, international students, first gen, and other underserved student populations and their access points to seeking CAPS services. Most of my work at UC Santa Cruz CAPS revolves around assessing access and finding unique solutions to provide easy access to mental health services.”

Verma: “As a professional with a multicultural background, how do you approach cultural diversity and sensitivity in your work?”

Damani-Khoja: “I tend to prioritize cultural considerations, building trust, actively listening, and respecting all cultural differences. As a clinician, I utilize a multicultural lens, emphasizing assets and empowerment, and practicing with compassion and cultural humility. As a leader, I focus on addressing the systemic dynamics of privilege, oppression, and intersectionality and try to promote a culture emphasizing fair, equitable, collaborative, and respectful relationships for both staff and students.”

Verma: “How has your varied clinical experience with diverse clients affected your development of a relational, multicultural and systemic approach to therapy?”

Damani-Khoja: “I feel very fortunate that my varied experiences in diverse environments have afforded me a great systemic lens. I pay close attention to aspects of diversity, equity, inclusion, justice, and belongingness. As a Psychologist, I am very attuned to the larger systemic pressures on students and their families that may often become a barrier in seeking help. My approach to providing access is very much infused with my own experiences as a student who once identified as a first t gen, immigrant, international, with financial barriers in seeking higher education, and from a culture that heavily stigmatized seeking mental health help. I believe that it gives me a unique perspective in relating to my students and colleagues. I also strongly believe that coordinating student care with the larger campus partners is essential in ensuring a safe campus for all. Therefore, my relational and systemic side also lends quite well in collaborating with our wonderful campus partners.”

Verma: “What do you think are the biggest challenges facing the field of psychology today, and how do you think they can be addressed?”

Damani-Khoja: “I believe that the biggest challenge that our field struggles with is the stigma towards mental health and the hesitation around help-seeking. Often, this delay in seeking timely treatment could result in exacerbation of the mental health struggles. I also think that the post-COVID era has resulted in elevated stress, anxiety, and sense of isolation for many. Recent geo-political unrest in the U.S. and around the globe has also resulted in increased stress for our students.

As we saw in the recent email from our VC for Student Affairs & Success, Akirah Bradley-Armstrong, Ed.D., UC Santa Cruz students indicated the highest likelihood of anxiety or depression as compared to students at every other UC campus. 44% of UC Santa Cruz undergraduates reported a likely anxiety disorder and 35% reported a likely depressive disorder in the 2022 UCUES survey. Furthermore, 40% of our graduate students reported a likely anxiety disorder and 28% indicated they had a likely depressive disorder in the 2023 UCGSES survey. At UCSC CAPS, we work really hard on promoting overall wellness and prevention by destigmatizing help-seeking, reducing barriers to contacting us, and providing education around mental health struggles. Addressing mental health struggles in a timely manner so that our students have a fair chance in focusing on their academics, graduate on time, and prioritize their life cycle development.”

Verma: “What are some barriers that students of color and minorities might encounter when seeking mental health support at UCSC, and how can these barriers be addressed?”

Damani-Khoja: “I believe that BIPOC students and other marginalized student communities face many barriers to seeking help. Some of the obvious ones are language barriers, financial constraints, academic difficulties, lack of insurance, availability of culturally responsive clinicians, and anxieties around one’s identity not fully understood by the system. Some of the less talked about barriers might be the cultural beliefs about causes and treatment of mental health struggles, attitudes and preferences towards seeking help, knowledge about available resources, and other demographic variables such as age, generational status, education level, etc. that might come in the way of seeking help. CAPS at UCSC is quite committed to ensuring a healthy and safe campus life for all. We have a vision towards providing students with opportunities to reach educational and career successes by improving their emotional, psychological, and cognitive health. We work hard at destigmatizing and reducing barriers to seeking mental health help. For example, we recently re-strategized on same-day crisis access points, making it easier for students to not only see a crisis counselor but also to be able to briefly consult with clinicians on non-urgent matters. We continue to develop and add more Let’s Talk consultations that are free and easily accessible to students both in person around campus and via Zoom. Let’s Talk’s primary goal is to destigmatize mental health services and to offer spaces to our students with marginalized or diverse intersecting identities. We are constantly thinking about our students who might not want traditional one-on-one visits and providing unique ways for them to still have access to our providers. Teaming up with our campus partners also helps immensely in providing various relevant psychoeducational and outreach services to our students.”

Verma: “I'm interested in learning about the common stories or experiences you've observed among children of immigrants, students of color, and international students here at UCSC. Can you share any recurring themes or challenges that you've noticed within these populations in your work?”

Damani-Khoja: “Over the years of practicing in college counseling, I have noticed some common themes of struggles in students with marginalized identities. Lack of support, financial, familial, or social, to name a few can cause students to feel isolated and alone in their struggles. Housing, food, and financial insecurity could also create immense academic distress. Unfamiliarity towards accessing mental health resources or stigma towards seeking help from formal sources is another struggle that I have consistently noticed on college campuses. Imposter syndrome (persistent inability to believe success is deserved due to one’s own efforts and skills) and feeling not prepared for higher education can also create stressors. For our international students, experiencing acculturative stress, feeling homesick, navigating language and cultural differences, and the lack of a supportive community, in the beginning, may create some challenges in taking care of their mental health. Finally, institutional and established structures that may create systems of biases and discrimination may result in a lack of belongingness for many of our students with marginalized identities.”

Verma: “In your professional opinion, how do cultural and religious factors influence the perception and treatment of mental health issues among Muslims? How does Islam intersect with mental health, and are there specific teachings or practices within Islam that can support mental well-being?”

Damani-Khoja: “I believe that Islam and mental health treatment is not mutually exclusive. Islam values emotional well-being and encourages a holistic balanced life. The Holy Quran can also be a guide for those experiencing mental health distress. However, mental health help-seeking and treatment options will depend largely on how mental illness is conceptualized in a cultural context. There is a dearth of scholarly activity and culturally relevant interventions toward understanding the mental health needs, utilization, and the stigma of help-seeking in Muslim communities in the U.S. There is some documentation that often traditional Muslim communities might understand ailments as God’s test, punishment, or even possession, and seeking help outside the family/religious leaders might be considered as a weakness. Many Muslims might also reject formal help due to the practices that lack spiritual content. With 1.8 billion followers of Islam worldwide and the third largest religion in the U.S., it’s imperative that mental health profession understands the unique religious and cultural perspectives on mental health, of this community and others, which might influence how mental illness is understood and treated. At UCSC CAPS, we strive to provide culturally sensitive understanding and support to all our student populations. It is important to combat the stereotypes, overgeneralizations, and misconceptions that may discourage many of our student communities to reach out for help. It is important to outreach to all student communities in providing psychoeducation around clinical options as well as to find ways of providing services that are congruent to their religious and cultural beliefs.”

Verma: “So far we’ve been dissecting the barriers preventing students from accessing help. Are there any cultural strengths or resilience factors within communities of color that can be leveraged to promote mental well-being?”

Damani-Khoja: “There are many protective factors that could play a significant role in promoting mental health for our students. Connections - familial, social, cultural, religious, and spiritual play a major role in how students manage any academic, relational, or mental health struggles. Adaptive coping skills is also one of the major leverages that could foster overall mental health. Establishing strong networks that one could lean on during times of stress, formal or informal, can be an effective safety net for many. Many students may find practicing their arts and music talents helpful while many may find meaning in advocacy and caregiving acts. Lastly, in my opinion, the biggest source of strength and resilience lies in reaching out for help when needed.”

Verma: “What advice would you give to students who are navigating mental health challenges at UCSC? What advice would you give to students who want to advocate and help others?” 

Damani-Khoja: “I would like for our students to remember that the whole UCSC campus structure is built around them to ensure their success not only while they are at UCSC but beyond. Each of us are committed to prioritizing your overall wellbeing and would hope that you will consider prioritizing your mental health and reach out to us, when needed. Many of us come from cultures where mental health is not talked about and even stigmatized. However, I hope that students feel encouraged and also support other students in normalizing mental health struggles and seeking appropriate and timely treatment. We all are here for you. With the month of May being the Mental Health Awareness month, I would hope everyone takes care of their overall well-being. Students can reach our main office during our business hours 8am-5pm at 831-459-2628. That number is valid for after-hours, weekends, and holidays and students could call for any urgent matters and speak to a clinician. For any urgent mental health concerns, students on campus can also call our Campus Mobile Crisis Team at 831-502-9988 for support.”