Treatment for Ultra -Orthodox

Sanity and Sanctity:

Mental Health work with ultra-orthodox Jews in Jerusalem

David Greenberg, MD and Eliezer Witztum, MD

Published by Yale Press

Ultra-orthodox Jews in Jerusalem are isolated from the secular community that surrounds them not only physically but by their dress, behaviors, and beliefs. Their relationship with secular society is characterized by social, religious, and political tensions and hostilities. The differences between the ultra-orthodox and secular often pose special difficulties for psychiatrists who attempt to deal with their needs. In this book, two Western-trained psychiatrists discuss their mental health work with this community over the past two decades. With humor and affection they elaborate on some of the factors that make it difficult to treat or even to diagnose the ultra-orthodox, such as their distrust of the secular, their belief that all suffering is G-d-sent, and the problem of distinguishing what appear to be mental disturbances from manifestations of religious fervor.

Drs. David Greenberg and Eliezer Witztum explain how they cope with their ultra-orthodox patients’ negative feelings toward Western medicine and gradually establish a relationship of trust, by listening carefully to patients’ narratives, learning about the ultra-orthodox way of life, working closely with the patient’s religious advisers, and coming to terms with their own feelings. They present fascinating case studies, ranging from some young men who became psychotic while studying Kabbalah to another man who intended blowing up a mosque to atone for a friend’s death. And they relate their observations of this religious community to the management of mental health services for other fundamentalist, anti-secular groups.

“An important and fascinating contribution to the fields of cross-cultural psychiatry, mental health services, and Jewish studies that reflects the authors’ deep understanding of and immersion in their patients’ world and beliefs.” – Robert King, MD, Yale Child Study Center

David Greenberg, MD, Director of the Community Mental Health Center, Herzog Hospital, Jerusalem, is editor of the Israel Journal of Psychiatry and senior lecturer at Hadassah School of Medicine, Hebrew University.

Eliezer Witztum, MD, Professor in the Division of Psychiatry, Faculty of Health Sciences, Ben-Gurion University of the Negev and Director of Psychotherapy Supervision, Mental Health Center, Beer Sheva and Editor of the Israel Journal Psychotherapy.

Proposal for the Establishment of the Center for the Treatment of

Ultra-Orthodox Adolescents with Behavioral Problems

It is becoming clear and widely recognized within the Orthodox and

Ultra-Orthodox communities in North America and Israel that adolescents suffer from the same wide variety of psychiatric problems that are within the non-orthodox community. These problems range from common eating disorders such as anorexia and bulemia, to schizophrenia and obsessive-compulsive disorders. Until recently, these problems have essentially been literally hidden away by the community, combined with denial that the problem even exists. Due to the dramatic increase in the number of children from religious homes, suffering from these disorders a pressing need has developed to establish clinical environments to treat these children within an Orthodox, religious setting.

The Herzog Hospital has been approached by the Ministry of Health and Ezer Mitzion, the Ultra Orthodox, self-help, health organization in Israel, to build a 36-bed unit for Orthodox and Ultra Orthodox teenagers suffering from the above mentioned psychiatric and psychological disorders. This plan requires the construction of an entirely new building on the hospital grounds. This will be a two-story building, encompassing both patient rooms and classrooms in a structure that will keep boys and girls completely separate at all times. The estimated time of treatment will be between 6 to 12 months. Therefore, it is also important that these children be provided with the proper education while they are pulled out of their school system.

In addition to the Ministry of Health, both the Israel Ministry of Education and the Ministry of Religious Affairs are involved in the complete planning of this project. Today, in Israel, there is no organized set-up or institution to deal on a professional medical basis with the psychiatric and psychological treatment of Ultra Orthodox teenagers. The fact that Ezer Mitzion is involved in this project indicates that the rabbinical authorities fully supports it.

While based in Jerusalem, the facility will serve children throughout the country with the possibility of even having children from overseas attend on a space available basis. There are several unique aspects of this project beyond the apparent ones.

The children will be provided with a full educational and yeshiva curriculum, tailored to their individual capabilities.

They will also be given vocational training in carpentry, diamond polishing, sewing and other assorted type of work, as these clearly will not be young men and women who can be expected to succeed in a long term yeshiva or kollel environment. The objective will be to treat them for the health problem that brought them to the hospital and release them as more productive citizens than they were when they entered. The age range will be 14-20.

There will be a process supported by clear criteria to determine which children are admitted to this program. Since this will be a pilot program, it could be replicated throughout Israel, as well as for that matter, within North America.