I started working in an acute psychiatric unit fifteen years ago as an occupational therapist (OT), during which time the experiences I have had with those in the Jewish community and their petrified need for secrecy have been alarming. More on that crisis in a little bit.
First, for context, occupational therapy became prevalent in psychiatric hospitals in the early 1900s, as soldiers returning from World War I with depression and post-traumatic stress disorder were provided purposeful and meaningful activity via crafts and manual tasks. Though most OTs have moved away from this setting and toward more physical disabilities, a small population of OTs still work in psychiatric settings.
OTs evaluate patients in the following main performance areas: activities of daily living, cognition, upper-extremity strength and range of motion, and psychosocial factors, which include stress, coping skills, frustration tolerance, assertiveness and impulse control. Some problem areas OTs can address include depression, anxiety, and cognitive impairments. They run daily group therapy to include topics such as anxiety and depression management, coping skills, assertiveness, anger management, how to speak about mental illness, and positive thinking.
The Deafening Silence in the Religious Community
During the five years I worked in an acute psychiatric unit, I saw three religious Jews, and I still think about them.
I evaluated a 20-year-old religious male for occupational therapy. He was diagnosed with major depression. When I asked him who his support system was, he answered, “No one.” I then inquired further about his family or friends, but the reply was in the negative. After asking him if he could speak with his rabbi, as many rabbis are trained in psychology, he said, “I can’t speak to anyone because if I do, then I will never get a shidduch (suggested person to date).”
The second encounter I had in the acute psychiatric unit with a religious Jew was also with a young male in his twenties. At that time, the estimated length of stay in an acute psychiatric unit was one to three days. This male was admitted at some point over the weekend. I never treated him. However, when I walked into the unit on Monday and he recognized me as a religious Jew, he came over to me and sternly said, “If you ever see me in the community, pretend you never saw me.”
The last religious Jewish patient I treated in the psychiatric unit was a young mother with many children, including a baby. She was diagnosed with postpartum depression, which consisted of symptoms such as extreme melancholy, anhedonia (the loss of pleasure in once enjoyable activities) and feelings of guilt over not being able to care for her children.
All too frequently, I learn of Jewish men and women in both my community of Baltimore as well as other Jewish communities who have ended their lives by suicide. Some leave messages on their Facebook pages, including cries for help and near-misses. Some of their deaths are associated with addiction. Some are due to undertreated mental illness such as depression, bipolar disorder, or even anxiety (thoughts of death and suicide are also common symptoms of anxiety). And some are covered up to protect the family from the scrutiny and stigma the community would show them. After suicides, there is no public word about the underlying mental illness. And history repeats itself.
Silence cannot change the facts – mental illness can affect anyone of any race, culture, ethnicity, or age – including the Jewish community.
Speak Up Now
For a long time, my community had only addressed the concepts of grief and loss, as well as addiction. But this was a Band-Aid, a temporary fix or comfort. The real issues of “why” had not been talked about at all until recently (in part, due to initiatives I spearheaded). Fortunately, my community has begun to have that conversation about mental health topics in a general way. However, we still have room for critical growth in our understanding – such as discussing the underlying triggers of depression or suicide.
Changing our approach to mental health can only come once every community recognizes and speaks openly about mental health issues, supports one another, and encourages others to seek help. The truth needs to be known that once a mental illness is managed, people can live productive lives in their life roles. When mental illness is not treated or when people—especially young people like those I previously described encountering—are stigmatized and made to feel shame, their lives become bleak and unstable.
Mental Illness Fact Check
For someone who has never suffered from a mental illness, it is hard to relate to someone who has. One may even fear it is contagious or believe that all people with mental illness are violent or, at the very least, unstable. According to NAMI, the National Alliance of Mental Illness, one in every five people will experience mental illness at some time in their lives, whether it be mild or severe.
Just like with a physical illness that needs to be managed, such as diabetes or high cholesterol, people with mental illness can live the same productive lives as people without mental illness. Treatments can take the form of regular visits to a therapist, psychiatrist or psychiatric nurse practitioner, medications, and through the implementation of coping skills – such as exercise, prayer, having a support system, and keeping occupied via meaningful activity.
It is about time we get this message out to our community. End the secrecy. Start the healing. Speak up before it’s too late.
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- Our Community Leaders Must Speak Up Before It’s Too Late - January 5, 2020