After struggling with depression and anxiety for years, Y. attempted to handle the situation on his own. Without support from his local community, he lacked a space to freely speak out about his mental health struggles. As a result, his work suffered and he struggled to hold down a job.
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He felt the stigma surrounding mental health acutely and paid a steep price. An image of Y. standing tall and proud today is on display at the Jerusalem College of Technology (JCT) campuses as one of the volunteers who participated in Deconstructing Stigma – a project spearheaded by McLean Hospital, the largest psychiatric affiliate of Harvard Medical School, who teamed up with JCT and its Israeli partner OGEN – Association for the Advancement of Mental Health in Israel, to bring McLean's landmark mental health awareness campaign to Israel. Additional posters are on display at Sharee Zedek Medical Center. As a member of the Haredi community, he represents an anomaly because of his willingness to speak out when society encouraged him to be quiet.
There's a certain mystique and curiosity behind mental illness, where people want to know what occurs between a therapist and their patient but are too afraid to ask. With Deconstructing Stigma, we're here to say, "Please ask us." This global effort to humanize mental illness is crucial in Israel, a country in a region where vulnerability is a sign of weakness and where being a "gibor" (hero) is paramount. According to the Ministry of Health, suicide is the second-most common cause of death for Israeli males ages 15-24 and third-most common for females in that age bracket. Further, nearly half of Israel's population suffers at some point in life from mental health issues, with anxiety and depression the most common illnesses.
Despite how common mental health challenges are, the stigma around them still exists. A Myers-JDC-Brookdale Institute study revealed that even though 18% of adults said they were experiencing psychological distress, most of them did not seek professional help to address their concerns. However, that attitude is starting to change, and this campaign couldn't have happened at a better time. If there was ever a silver lining to the COVID-19 pandemic, it's that it helped chip away at this stigma, because many suddenly found themselves isolated and struggling, creating a space where it finally felt okay to not be okay.
Yet for the Haredi community, the relationship with mental health is even more complex. Jewish religious texts are rife with encouragement and praise for healing the sick. The Rambam says that "bodily health and wellbeing are a path to God" and that it's impossible to have knowledge of the creator when one is sick. Why, then, is protecting our physical body so revered while one's mental health is not only ignored but taboo to discuss in many Haredi circles? As Psychology Today states, "The small amount of research that has occurred indicates that Haredi Jews with mental health issues often avoid using official mental health services, and sometimes tend to consult such services only in serious cases. In other words, Haredi Jews with common mental disorders such as depression or anxiety may remain untreated for these issues."
Haredim are known to treat the healing of mental health with suspicion, and the very idea of acknowledging that there's a problem is seen as taboo. But slowly, we're seeing Haredim who are willing to come forward, and change is on the horizon. Participants in our campaign – who came from all walks of Israeli life from Haredim to secular Jews to Arabs and everything in between – all agreed to have a life-sized poster telling their most intimate stories in a public setting. While they come from diverse backgrounds, the one thing they have in common is that they strive to be mental health ambassadors who hope that by telling their stories, others will come forward to tell their own.
The other aspect of this campaign was educating the healers. To that end, the campaign will also feature a research project done in collaboration with Prof. David H. Rosmarin, PhD, from McLean Hospital and Harvard Medical School, and Prof. Steven Tzvi Pirutinsky, PhD, from Touro University. Students who conducted the research are JCT's nursing students from Ofek, the Selma Jelinek School's special track for Haredi female nursing students, who participated in a comprehensive study with the volunteers so they could understand that there is nothing to fear when treating or associating with someone with mental illness. Like cancer, a broken bone, or pneumonia, mental health issues must be treated with compassion and respect. The 30 fourth-year nursing students conducted interviews with the 22 volunteers, and their perspective regarding mental illness changed dramatically. After getting to know their stories, it wasn't unusual to hear the students say, "Not only do I want to treat these people, these people are like me and in a different reality, we could have been friends."
With this campaign, we hope that more members of the Haredi community realize that it is far more damaging to ignore mental illness than to address it head-on.
Stuart Katz is the founding director of OGEN – Association for the Advancement of Mental Health in Israel.
Dr. Zvika Orr is a senior lecturer in the Selma Jelinek School of Nursing at the Jerusalem College of Technology.
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