Aug 17, 2010 — The mental health needs of the Orthodox Jewish community, particularly as they relate to substance abuse and family and marital problems, are perceived by the community’s mental health professionals as insufficiently addressed, according to a new study by Dr. Eliezer Schnall, professor of psychology at Yeshiva College. Despite some improvement, there is an apparent paucity of service that is especially pronounced in the Ultra-Orthodox and Chassidic segments of the community.
Dr. Schnall led a team of researchers in assessing the change in perception of Orthodox mental health professionals over the past 25 years regarding the needs of the U.S. Orthodox community. The team also analyzed whether stigma and other barriers remain that would prevent members of this group from accessing the help they require.
Dr. Schnall presented his findings of the study – “Psychological Disorder and Stigma: A 25-Year Follow-up Study in the Orthodox Jewish Community” – at the 118th Annual Convention of the American Psychological Association in San Diego, CA on August 13.
Co-authors of the study, which surveyed the approximately 450 members of NEFESH, the International Network of Orthodox Mental Health Professionals, and which received responses from nearly 100 of these professionals in the United States, were Dr. Solomon Kalkstein of the University of Pennsylvania and the Philadelphia VA Medical Center, Dr. Shalom Feinberg, clinical associate professor of psychiatry at Albert Einstein College of Medicine, and Dr. Karyn Feinberg, school psychologist at Yeshiva Har Torah in Little Neck, NY.
The study is a follow-up to similarly ground-breaking research involving the metropolitan New York Orthodox Jewish community conducted in 1984 by the Feinbergs, published in the Journal of Jewish Communal Service. Their analysis, done in collaboration with Dr. Herman M. van Praag, then chairman of the psychiatry department at Einstein, and Dr. T. Byram Karasu, the department’s current chairman, found that the mental health needs of the Orthodox Jewish community were underserved and more poorly addressed than those of the general population. It also identified barriers that prevent community members from accessing necessary mental health care, most prominently the existence of personal and family stigmas associated with psychiatric problems and mental health treatment.
“While some progress has been made, significant problems remain,” said Dr. Schnall. “The stigma of seeing a mental health professional and the relative lack of affordable mental health services are especially pronounced, just as they were then. Similarly, most clinicians in the Orthodox community are again telling us that their patients’ mental health needs are still being met more poorly than those in the general community.”
Dr. Schnall declared that these latest findings must serve as a “wake-up call. Although in many ways we have taken steps forward, we must continue to be proactive in recognizing the issues and in ensuring that they are properly addressed in the most timely and effective manner.”
Other key findings of Dr. Schnall’s study include:
• The most common problem for which Orthodox patients seek help is marital difficulties.
• Mental health needs among the Ultra-Orthodox and Chassidic are most poorly met, although the situation has significantly improved for the former group compared with a quarter-century ago.
• Almost half of those surveyed said that there are insufficient services for substance abuse, just as in 1984. Thus, more effort is needed.
• There needs to be more services for children and adolescents.
• Most respondents reported that few, if any, of their patients were referred by their rabbis.
Because of the pivotal role they serve in the Orthodox communities, “it is essential for rabbis to continue to be better trained to recognize mental illness and to understand that referral to professionals is often critically important,” Dr. Schnall said.
He pointed out that there was some good news from the study, citing as one example the fact that there are fewer clinicians today than 25 years ago who believe that services for psychotic and mood disorders are insufficient. Also, the stigma of suffering psychiatric problems, as well as mistrust in the community toward members of the mental health field, while still substantial issues, seem to be diminishing.
Dr. David Pelcovitz, Strauss Professor of Psychology and Education at Azrieli Graduate School of Jewish Education and Administration and a well-know authority on issues of psychology in the Orthodox community, said that “this is an important and carefully conducted study that draws the mental health community’s attention to its responsibility to design and implement programs that more effectively reach out to this underserved population. Research has consistently shown that early identification and treatment of mental health problems improve long term outcomes and overall prognosis. Thanks to this group of researchers, clinicians serving the Orthodox Jewish community can be more aware of the challenges they face.”