In 1986, two expert mental health professionals, a husband and wife team, recognized that if one wanted to get a reading on the pulse of the Orthodox Jewish community and its attitude and access to, and use of, mental health resources, one needed to study the rabbis of those communities. They designed and ran a groundbreaking study later published in the journal “Tradition,” wherein they noted some fascinating, if not downright alarming, facts:
First, 82 percent of the rabbis polled thought that the majority of their communities were underserved by mental health professionals. However, a full 50 percent of the rabbis could not identify in what way they were underserved, a fact that the researchers blamed on the rabbis’ own lack of knowledge in the area of mental health.
Second, 90 percent of the polled rabbis felt that the issue of stigma prevented their congregants from seeking the proper assistance. When breaking down the numbers, 84 percent saw a difficulty in their congregants’ sense of stigma in diagnosis (“Is s/he well? Sinful? What will happen with a potential shidduch, etc., when the person or a loved one has a psychiatric diagnosis?”) and 63 percent noted that their congregants were likely to express the fear of the stigma associated with merely seeing a mental health professional and how that therapy session might negatively impact social standing within the community.
The population studied 30 years ago was a population of rabbis, all members of the Rabbinical Council of America (RCA). And while 30 years ago the rabbis of the Orthodox Jewish community and their congregants were somewhat fearful of mental health, its issues and the professionals who research and try to treat these conditions, there is no question that there has been major progress since 1986. Whereas in 1986 Orthodoxy was fearful of the mental health professional, in 2016 it benefits from experts and leaders in various subfields of mental health who themselves are committed and proud Orthodox Jews. In 1986, many Orthodox Jews dealt with mental illness by sweeping it under the rug. By 2016, we have organizations like NEFESH, SINAI, HASC, YACHAD and OHEL that are dedicated to assisting the Orthodox Jewish community in confronting cognitive and emotional challenges and in successfully helping Orthodox Jews lead complete, productive, Jewish lives. In fact, Relief Resources, a non-profit organization whose mission is to guide individuals to the best mental health resources available, now operates out of five major cities in the United States and in Canada, Israel and London. Today, they make over 8,000 referrals to mental health experts for the Orthodox Jewish community each year. May I add, as both a rabbi who has reached out to them and a mental health professional who has been interviewed by them in order to ascertain my clinical competence, their referrals are always carefully researched in order to find the ideal “goodness of fit” in order to help those reaching out to them.
In 1986, cultural sensitivities of the Orthodox Jewish community often went unaddressed in major treatment facilities for more acute emotional difficulties that required hospitalization such as eating disorders, substance abuse disorders or inpatient admissions for acute psychiatric difficulties. In 2016, many of the leading treatment facilities for these disorders not only boast kosher food and sensitivity training for their staff, they often encourage cultural awareness in treatment planning and have dedicated experts, often themselves Orthodox Jews, who can help facilitate proper patient care for the frum Jew both during and post hospitalization.
And what about the rabbis? Well, honestly, in 2016, the major organizations that train rabbis are hard at work to ensure that the rabbi (or rebbe in a school) is not only aware of the existence of the various emotional difficulties that exist within the Orthodox Jewish community, they are prepared to know their roles as rabbanim within the different treatment processes. For example, Yeshiva University’s Lev Leda’at Pastoral Psychology program at RIETS introduces rabbinical students to a wide array of issues in Jewish communal mental health and gives them the time, space and expertise to process their roles in confronting mental health issues. A wonderful resource, “The Art of Jewish Pastoral Counseling,” written by Drs. Michelle Friedman and Rachel Yehuda, two accomplished Orthodox mental health professionals, published earlier this year, provides reinforcement for many of the skills learned during the years that rabbis train for the rabbinate. And a groundbreaking course, “Confronting Mental Health Issues,” offered through YU’s Center for the Jewish Future and co-facilitated by the Center for Anxiety Relief in Union, New Jersey, is currently preparing over 50 practicing rabbis around the world to be better equipped to identify, refer, remain with and educate not only the members of their congregations who approach them with mental health issues, but to properly educate their congregations and the Jewish community at large. Not only are the rabbis learning about mental issues that we confront, they are also examining, discussing and debating these very issues through the prism of Halacha and with the background of a solid Torah hashkafa capped with access to leaders in the field and gedolei haposkim to help guide their communities as well.
In the last 30 years we definitely have made tremendous progress in building the structures necessary to address the issues our communities confront. But what about getting the people to utilize them more? How can we better get our congregants, friends and neighbors to tackle the challenges that seeking help involves?
In response to this question, the Rabbinical Council of America has called both on its membership and the Orthodox Jewish community at large to help combat the stigmatization, and its often associated negativity, that holds our community back from progress on the mental health front.
Specifically, the resolution, accessible at http://www.rabbis.org/news/article.cfm?id=105891, calls upon rabbis to discuss, in public settings, the communal prevalence, human impacts and treatable nature of common psychiatric and psychological disorders. We might expand that to include increasing our own awareness and discussion of the same in our casual conversations around the Shabbos table or in shul. Normalizing the issues, and ridding a lot of the misinformation “out there,” might empower friends and neighbors who could benefit from treatment to pursue it.
At the same time, rabbis and roshei yeshiva are being asked to take a lead in acknowledging the prevalence of psychiatric disorders and to work to end the stigma surrounding their existence and treatment. This is especially important in terms of being able to discourage our congregants’ automatic disqualification of a potential marriage partner due to a family history of certain psychiatric disorders. Being able to advise our congregants and talmidim from the perspective of knowledge will go far in building other great structures—batim ne’emanim b’Yisrael.
Finally, our community is being encouraged to support and embrace, with sensitivity and understanding, our fellow Jews who live with different psychiatric conditions, as well as their friends and families. Whether we are at our Shabbos or Yom Tov tables and invite our friends and neighbors in, or phone someone “just to check in and let them know” we care, and especially during synagogue services where bringing people in and sitting with them and making them a part is so crucial to their self-esteem and mental health, we can meet the challenges. In doing so, we fulfill the precepts of nosei be’ol im chaveiro (sharing another’s burdens as our own) and ve’ahavta le’re’acha ka’mocha (loving your neighbor as yourself).
I was recently in contact with one of the researchers of the original study in 1986. We discussed our theories as to what a 30-year follow-up might look like today. We agreed that the result would demonstrate much progress, and with continued work as a community actively combatting its own stigma issues head-on, the potentials are even more encouraging.
By Rabbi Jonathan Schwartz, PsyD
Rabbi Jonathan Schwartz, Psy.D, is the senior rav of Congregation Adath Israel in Elizabeth/Hillside, New Jersey, clinical director of the Center for Anxiety Relief in Union, New Jersey, and a known authority on mental health issues and the Orthodox Jewish community. A sought-after lecturer and teacher, Rabbi Dr. Schwartz is currently facilitating a YU/CJF course for rabbis titled “Confronting Mental Health Issues.”
