These are among the major findings of a study conducted by a team of researchers led by Dr. Eliezer Schnall of Yeshiva University to assess the change in perception of Orthodox mental health professionals over the past 25 years regarding the needs of the US Orthodox community and whether stigma and other barriers remain that would prevent members of this group from accessing the help they require.
Dr. Schnall, a professor of psychology at YU’s Yeshiva College, will be presenting 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 America Psychological Association in San Diego 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 some 100 of these professionals in the United States, were Dr. Solomon Kalkstein of University of Pennsylvania and the Philadelphia VA Medical Center, Dr. Shalom Feinberg, clinical associate professor of psychiatry at YU’s Albert Einstein College of Medicine, and Dr. Karyn Feinberg, school psychologist at Yeshiva Har Torah in Queens, NY.
Common problem: Marital difficulties
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 mental health needs are still being met more poorly than those in the general community.”
He 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 Hasidic 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, a well-know authority on issues of psychology in the Orthodox community and a professor at YU’s Azrieli Graduate School of Jewish Education, 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.”
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