Accelerating Solutions:Whoever saves a life
For American Muslims, suicide represents a taboo within a taboo. Rania Awaad— a psychiatrist, faith leader, and Stanford Impact Labs Design Fellow—set out to change that.
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Rania Awaad. Photo: Jess Alvarenga
The call came from a mosque in Pleasanton, California, where Rania Awaad, MD, led a weekly gathering for women.
A local high school student had taken his life, she was informed. The boy was a popular athlete who frequently cracked jokes, did volunteer work, and was active in youth programs at the mosque. The shocking loss had left the community reeling. “You’re a psychiatrist,” a leader at the mosque said. “Can you help?”
Awaad felt helpless. She had spent the past three years running the Muslim Mental Health & Islamic Psychology Lab at Stanford Medicine, established the country’s first community advisory board focused on Muslim mental health, and been a faith leader for more than two decades—yet her experience with suicide was limited to counseling at-risk patients. She had no idea how to guide her community through the aftermath.
“I thought, ‘If I’m struggling, what about others?’” she recalls.
That was 2017. Awaad has devoted the intervening years to addressing that question. Changing the narrative on suicide in Muslim communities meant first understanding that narrative. American Muslims are twice as likely to have attempted suicide compared to the national average, Awaad learned. She attributes this partly to the community’s sense of exclusion, fueled by anti-Islamic rhetoric and policies. Many Muslims are also uncomfortable with Western psychiatry, and the Quran’s explicit prohibition of suicide makes it “the taboo within the taboo of mental health,” Awaad explains.
She began creating the very resources she had been missing previously: targeted research, a thorough manual, and a curriculum for training religious and community leaders. It’s all aimed at preventing and addressing suicide among American Muslims with an approach that’s both evidence-based and informed by Islamic perspectives.
“If you’re going to touch something as taboo as a mortal sin in someone’s belief system, you have to come at it from within the faith itself,” Awaad says. “When you start there, you can build trust to bring in cutting-edge research.”
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Rania Awaad. Photo: Jess Alvarenga
Since 2022, Awaad and the nonprofit she’s founded, Maristan, have offered suicide response training to some 600 imams and other leaders serving hundreds of thousands of constituents across the United States. It’s impossible to fully measure the impact of her work, but preliminary survey data suggests that the training has markedly decreased stigma surrounding suicide among religious leaders.
One community that benefited was in Columbus, Ohio, where a young Muslim man had died by suicide. His family was active in a local mosque, and the imam reached out to Awaad. She counseled 70 community leaders and volunteers in a conference call, after which they hosted a mental health awareness event that attracted around 500 people. At least two attendees approached mental health professionals onsite to say they were suicidal.
“She probably saved lives that evening,” said Asma Mobin-Uddin, a physician and board member at a local mosque who helped organize the event.
This year, Awaad returned to offer formal training to more than 40 imams and other leaders from across Ohio—part of her ongoing effort to reach more and more communities.
“Rania’s work is shaking things up at the foundation in terms of how the Muslim community approaches suicide and taking away the stigma,” Mobin-Uddin said. “I know there’s a ripple effect from people taking this knowledge back to their communities.”
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“If you’re going to touch something as tabooas mortal sin in someone’s belief system, you have to come at it from within the faith itself. When you start there, you can build trust to bring in cutting-edge research.”Rania Awaad
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Photo: Jess Alvarenga
Helping communities heal
Awaad, who was born in Egypt and grew up in New Jersey and Michigan, started studying Islamic scripture at 14. Learning about her faith from women scholars imbued Awaad’s life with a sense of meaning and connection at a time when classmates were putting superglue in her shoes while she prayed and fighting to get her disqualified from track meets because she wore long sleeves and a hijab. By the time she was in college, she was leading religious study groups and eventually lecturing to crowds.
It was during medical school that another formative moment happened. Awaad and her husband heard a knock at the door one night and found a young Muslim woman in a state of agitation. She burst in and crouched by the couch, terrified of sounds and sights that weren’t there. Neither Awaad nor her husband knew what to do, despite both being faith leaders. Community members cited supernatural possession and prescribed prayer. Finally they got in touch with an elder from the community, who made it clear the woman was having a psychiatric emergency.
Awaad had grown up thinking of therapy as “airing dirty laundry,” but she now saw how ill-prepared she and other leaders were to help fellow Muslims struggling with mental illness. Just before residency applications were due, she abandoned plans to become an ob-gyn and instead pursued psychiatry.
Years later, after completing her residency and fellowship at Stanford and joining the faculty, Awaad established a lab. Its goal: to research and address mental distress among Muslim communities at a time of deepening xenophobia.
Then came the young boy’s suicide in Pleasanton, and Awaad’s work to train community and religious leaders began. At this point, she says, “the floodgates opened.” Muslim leaders across the country started calling when a suicide occurred, and Awaad would offer advice virtually or show up to lead emergency “postventions.” She and her lab published a suicide prevention manual to serve as a culturally relevant, evidence-based guide for community leaders.
A few years later, fearing a contagion effect after a prominent Muslim murder-suicide in Texas, she had another realization about her work: She needed to offer more than suicide response after the fact—she needed a robust, digestible resource to prepare all imams to help prevent and address suicide.
“It made it so clear to me how much they were struggling and needed support, and I thought, ‘OK, we’re turning the manual into an actual community training.’”
Video: Jess Alvarenga
Scaling the model
The eight-hour curriculum Awaad jointly developed with her lab includes modules on preventing, intervening in, and healing from suicide. It combines tools from mainstream psychiatry with Islamic context, such as scriptural mandates to protect life and refrain from judging actions taken by someone who isn’t fully rational. The training urges religious leaders to avoid sharing specifics about a suicide, speculating on its spiritual implications, or assigning blame. Instead of saying, “they are in a better place” or “I’m not sure if they will go to heaven,” the curriculum suggests sentiments like, “I am here for you,” and “I know there are no words that can fully heal your pain, but I want you to know that you are in my thoughts.” It encourages imams to combine religious counseling with referrals to mental health support when appropriate.
Awaad aimed her training at imams because they shape congregants’ views and are often the first people Muslim Americans approach with mental health struggles.
“Without this training, imams might just assume this is a faith issue—they have to pray more, or it’s happening to them because they’re not a good Muslim,” Awaad said. “Unless the information is accurate and delivered in a manner that can reach people who need to hear it most, we’re at risk of losing more people.”
In 2022, Awaad received a 10-month Stanford Impact Labs Design Fellowship, which provides funding, workshops, and mentoring to help faculty advance a project that tackles a social problem. Awaad focused on how to scale her work. “I got to pause and ask, ‘Can this be sustained without me if I have to shift gears?’” she said. “Because it needs to keep happening.”
Feedback from mentors and other fellows helped Awaad conceive of an academy that will prepare Muslim faith leaders and mental health practitioners to offer her training to others. Her hope is that this strategy, which she aims to launch this year, will get the material to 80 percent of America’s 3,000 mosques within five years. In November, Maristan won the People’s Choice Award at the Continuum Spark Awards, which supports Muslim founders, earning $100,000 worth of consulting services to launch the academy. Awaad is currently raising funds to get it off the ground.
The SIL fellowship also connected Awaad with funding opportunities to support her work, including officers at the National Institutes of Health and the humanitarian charity Islamic Relief.
Besides continuing to offer trainings around the country, Awaad and her team are now updating the suicide prevention manual and training modules to incorporate the latest science based on feedback from experts. They’re also conducting research, including investigating potential reasons for high suicide rates among American Muslims and whether trainings lead to behavioral changes among imams. Awaad has also worked with federal health agencies, helping to co-produce a public service announcement with the US Department on Health and Human Services on suicide prevention aimed at Muslim communities, and authored a playbook for the Substance Abuse and Mental Health Services Administration about engaging religious leaders in suicide prevention.
Eventually, Awaad hopes to expand her work to Muslim populations across the globe and to build modern versions of maristans, ancient healing centers that took a holistic approach to mental health. “To me, this is a passion project,” she said. “It’s heavy and intense, but it goes back to the Quranic verse: ‘Whoever saves a life, it is as though they have saved all humanity.’”
If you’re struggling with thoughts of suicide or know someone who is, please contact the 988 Suicide & Crisis Lifeline or the Naseeha Helpline at 1-866-627-3342, both of which are available 24/7.
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Photo: Jess Alvarenga
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