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Therapist Ahmed Karie gazed up at the shell of the Lake Street building where he spent years counseling his fellow Somali Americans.

"This is my office," he said ruefully, gesturing toward the hollow windows at the northeast corner of the second floor. "Nothing survived."

Blue tarp hung off the roof next to the remains of his clinical director's office. The Somali restaurant where he and his therapist colleagues used to lunch downstairs, Mama Safia, was destroyed. Through the alley, glass scowled in jagged shapes from broken windows. Wreckage from the demolished Gandhi Mahal, another lunch spot, glared to the south.

He wondered how Metro Behavioral Health, one of a small number of local Black-owned therapy practices, could rebuild here following the May riots that spurred traumatic flashbacks among patients who escaped war in Somalia.

"Anyone with symptoms of PTSD doesn't want to go to that area," said Karie, who opened Metro Behavioral Health a decade ago. "So even if we rebuild again ... we can't go back there, because for us that place has become a tragedy place."

Black-owned mental health counseling offices harmed during the unrest following the police killing of George Floyd are grappling with how to continue their work at a time of heightened need among their mostly Black clients.

East African refugees report that the burning buildings and violence gave them nightmares and traumatic memories of their homeland. African American clients have sought help distilling their grief and rage over seeing cops kill yet another unarmed Black man.

Yet they have fewer choices when seeking out therapists who share their racial background: just 2.4% of the state's mental health professionals are African American, and an additional half percentage point are African, according to the Minnesota Department of Health. That includes psychologists, clinical social workers and marriage and family therapists. The vast majority — 88% — are white.

Trying to conduct therapy sessions remotely has challenged Karie's practice near the corner of Lake Street and Minnehaha Avenue, where vandals destroyed Metro Behavioral Health's telemedicine equipment, along with reference materials, computers and files. Clients often lack the technology and a private place to talk. They have many family members at home, and COVID-19 has limited the hours of public areas.

"Our office is a safe place for them to come and now it's no longer there," said Karie.

Two miles west on Lake Street, Healing Path Wellness Services has also struggled to connect remotely with its mostly Somali American clientele. Rioters destroyed the Somali-owned clinic just as mental health counselor Kim Dillon said she believed they had gotten patients to understand that going to therapy did not mean that something was wrong with them.

"Therapy is a taboo for a lot of Somalis," said Dillon, who's also a licensed drug and alcohol counselor. "They think if you are talking to a therapist you must be crazy."

She had worked hard to get clients to open up in group and individual sessions, sharing dates — a favored fruit among Somali Americans — and encouraging them to talk about Allah and other matters of importance in their lives.

Many of the older women faced depression and anxiety related to the trauma they faced in Somalia. Some sought advice in raising a younger generation that was turning to alcohol and drugs, and Dillon also worked with those young people directly. The center became a hub for general wellness, offering sessions on healthy eating and stretching.

Most counselors at the clinic are people of color but not all are of Somali heritage, and Dillon, who is Black, relied on Somali interpreters. She and her colleagues found that after the riots, many clients could not use the technology for remote sessions, and when they tried conducting three-way calls with interpreters, clients lacked the privacy at home to speak openly.

"All you would get is very short answers: 'I'm fine, I'm not worried, I'm OK,' but nothing past that," said Dillon.

That's why the clinic is trying to reopen in a temporary location by September.

"What's been hard is we're trying to rebuild fast enough so we can be on the front lines to provide therapy and care during these traumatic events that are happening," said Sulekha Ibrahim, a Somali American nurse who owns the clinic. Clients, she added, "really want to come back. They ... want to talk to somebody."

Days after police killed Floyd on May 25, crowds surged through Lake Street in the first night of rioting. South Side residents gathered tentatively the following morning, on Thursday, to see the scope of the destruction.

Among them was therapist Felicia Washington Sy, who held back tears as she came upon the burned buildings and looted stores in her neighborhood. She said it broke her heart, but that the issues were painful and complex.

"The needs and trauma of Black and brown people continue to go unaddressed," she told the Star Tribune at the time.

Fire and water damaged the Ivy Building for the Arts, where she had a therapy practice that served mostly people of color, rendering the office temporarily uninhabitable. Over the past 2 ½ months, however, Sy has seen an increase in patients seeking remote counseling as they try to cope with the pandemic, unstable unemployment and racial unrest.

Longtime clients have also included activists with Black Lives Matter and racial-justice movements who face stress and fatigue in carrying out their mission. People are trying to address their individual racial traumas alongside collective ones, and having to always act and respond quickly to events "can erode the spirit."

"People are seeking out ways to address that so that they can stay active and also do their own self-care," said Sy, who is African American.

She works on the connection between a patient's mind and body and sometimes goes beyond traditional therapy to help them use art, drumming, dancing, meditation rituals and other methods as part of their healing.

When Black patients meet with Black therapists, they can spend less time in cultural translation. During a group-therapy session where clients talked about race, Dillon heard Somali Americans say they would not feel comfortable speaking openly with a white person present, or opening up to a white therapist.

"It was more of a difficult time for them to even open up to me," she said.

For Karie's clients, it helps that he can speak Somali and acknowledge a shared heritage and history. He said the Somali language did not have words for depression or PTSD, and even though he saw people struggling with those conditions, he did not learn their medical names until he moved to the U.S. in 1998.

Even now, Karie can relate to patients' distress because the riots provoked flashbacks for him, too.

He served as a social worker for Ramsey County, where he worked closely with Somali refugees, before studying to be a psychotherapist. Karie and Abdulahi Mohamed, a fellow Somali American therapist, opened a clinic in 2010 and moved to the Lake Street office in 2013, building up a practice with 12 employees.

Since many Somali Americans in crisis turn to their imams first, Karie helped train mosque leaders to identify signs of depression and other conditions and then refer people to health providers that had professionals of Somali descent.

He tried to file an insurance claim after the riots, citing at least $130,000 in losses. But the insurer said his firm's policy covered him only for liability, not for the destruction of his property. Karie believes that rioters intentionally targeted Black-owned businesses and is frustrated that the government is not stepping in to help after failing to protect them from ruin.

"Important work for the community," he said, "has been lost."

Maya Rao • 612-673-4210