Removing the stigma
Mental health in the halachic world
Stories about the world’s growing mental health crisis seem to be in the news every day. The New York Times recently ran an exhaustive article on the alarming crisis in teen depression, selfharm and suicide.
In Israel, a massive study of more 200,000 adolescents ages 12 to 17 conducted by Maccabi Health Services found that the number of adolescent and teenage girls diagnosed with depression had nearly doubled as a result of the pandemic, with similar increases in stress, anxiety and eating disorders.
Elsewhere, another newly released study featured in The Jerusalem Post found postpartum depression to be prevalent in first-time mothers during COVID. And just last week, the Knesset approved an NIS 85 million plan to fund treatment for addiction.
To those of us in the mental health and religious leadership professions, much of this is not news. We have witnessed firsthand the emotional and psychological toll this pandemic has taken on nearly everyone. While articles focusing on the problems may raise awareness and may even be a catalyst for some to seek treatment, there is much to be done in terms of getting the proper services to all those who need it.
One initiative, which took place on Monday, is the Jerusalem Mental Health Expo, the very first event of its kind to bring together available mental health resources in a user-friendly environment.
There is no better time to bring mental health awareness to the attention of the general population, particularly as we emerge from a pandemic that wreaked havoc on people’s mental health.
Bringing the conversation out in the open creates a very positive environment in which to increase awareness, reduce the stigma of mental health and create an openness
to seeking treatment.
This positive initiative will hopefully benefit communities that may be shy about accessing these services, particularly among the religiously observant and haredi populations in Israel. Therein lies a subset of the crisis: the stigma of mental illness looms large and continues to be shrouded in secrecy and fear. We addressed this issue as part of a panel on Halacha and Mental Health at Monday’s Mental Health Expo, along with other rabbis and psychiatrists.
UNDERSTANDING HOW one’s beliefs and outlook on life determine how one experiences and ultimately overcomes mental anguish is vitally important.
Within the Torah-observant community, Halacha is the language and medium through which one relates and reacts to life’s circumstances.
Together, we – a psychiatrist and
a rabbi – have been exploring ways to deal with halachic issues across the mental health spectrum, and how to answer mental health questions within a halachic framework.
The result is Nafshi Bishe’elati, a practical guide that addresses an area of Halacha that has largely been overlooked.
Our goal is to not only guide, but to validate those who are suffering and let them know they are seen, heard and acknowledged. By giving their suffering a name, a diagnosis and halachic definition, we are attempting to create a practical framework to help them. In many cases, the halachic psak (legal decision) is a crucial part of the treatment plan.
For instance, eating disorders such as anorexia nervosa are among the most difficult and complex conditions to treat in mental health. If asked about fasting on Yom Kippur, how should a rabbi address the issue? According
to Halacha, one who is ill (a holeh) is permitted to eat in small amounts, or shiurim. A rabbi who is not familiar with the clinical presentation and treatment of this condition would miss the nuances of the person asking the question, and issue a psak halacha that could potentially undermine the entire framework of treatment.
In another example, someone suffering from depression may ask if they are obligated to attend minyan. Without knowing about the crucial role behavioral activation can play in the treatment of depression, by telling them to remain home the rabbi may inadvertently give a psak that would aggravate their situation.
Raising awareness begins with teaching community and religious leaders to become familiar with clinical presentations. This will better equip them to communicate with mental health professionals and, in doing so, provide appropriate halachic guidelines that correspond to the needs of each individual. Beyond this however, it is the dialogue between an individual’s therapist and rabbi that creates a framework of treatment and support which is ultimately crucial to their recovery and integration.
The month of May is dedicated to mental health awareness. Let’s take the time to educate ourselves about mental health issues and find ways to amplify the conversation. It is our hope that by doing so, we can reduce the stigma associated with mental health and encourage treatment, so that all members of the community can lead happy, productive and healthy lives.
Dr. Shmuel Harris is founder and director of Machon Dvir, a mental health clinic in Jerusalem, Beit Shemesh and Ra’anana. Rabbi Yoni Rosensweig leads the Netzach Menashe community in Beit Shemesh. They are coauthors of the newly published halachic responses to questions on mental health.