Rabbi Weinreb at White House Mental Health Conference
HERE ARE HIS IMPRESSIONS
By Rabbi Dr. Tzvi Hersh Weinreb
Executive Vice President, Emeritus
President Obama and Secretary of Health and Human Services Kathleen Sibelius address issues of mental health in the United States. (Official White House Photo by Pete Souza)
Several weeks ago I received an invitation from the White House to attend a Mental Health Conference. The official language about the event emphasized that millions of Americans struggle with mental health problems, and that there is a stigma attached to mental illness so that individuals often are afraid to seek help. The conference brought together mental health advocates, educators, health care providers, faith leaders and the like. I fit into two of those categories.
The government now has a website devoted to the issue: www.MentalHealth.gov. President Obama opened the conference with general remarks describing the problem and launching a national conversation on the issue. This audience was particularly appreciative of the President and welcomed him warmly and enthusiastically, applauding many of his remarks and offering him several standing ovations. The President spoke of the millions "who suffer in shame and silence…We are not starting a conversation,” he said. “We are elevating a conversation." "Do not think that you (the patient) are alone or that you should be careful not to burden others."
"We whisper about mental health," the President declared, adding that there should be no “embarrassment and stigma." He spoke of veterans returning from Iraq and Afghanistan with "invisible wounds of war," and provided the astonishing information that there are 22 suicides a day among veterans and troops. Traumatic brain injuries and post-traumatic stress disorder are the primary diagnoses in these military suicides; he urged all of us to make people aware that treatment is available and effective, and insisted that we reduce “wait time” for veterans to receive care. Switching to another age group, Mr. Obama spoke feelingly about mental illness among children.
The President discussed the Affordable Health Care Act and how it will cover mental health and substance abuse while not permitting exclusions of pre-existing disorders. Spread the message, he said. “You are not alone; we're here for you; recovery is possible; there is hope."
Secretary of Health and Human Services Kathleen Sebelius emphasized the need for overcoming negative attitudes. She reported that 60 percent of the mentally ill do not get care, and 90 percent of those with substance abuse problems do not receive treatment. "The mentally ill continue to be outcasts,” she said. “People are unwilling to be friends, co-workers, or marry into families where there is mental illness."
Several notable guests with experiences of mental illness were present, including former Senator Gordon Smith, now head of the National Association of Broadcasters, who has spoken publicly about his own son's suicide, and who is leading NAB in a public information campaign regarding mental illness. Ted Kennedy’s son Patrick, suffering from bi-polar disorder, shared his issues publicly during his political campaigns for Congress. The actress Glenn Close and the actor Bradley Cooper added some Hollywood glitter to the event. Glenn Close, who had a near-suicidal and mentally ill family member, spoke very movingly of her personal experiences. "The stigma has hardly budged," she said. Cooper played a mental health patient in the highly rated film, Silver Linings Playbook. He was at the conference because he was ignorant of these matters until he played the role and now is an active advocate for mentally ill.
Audience discussion raised issues such as mental health and trauma; co-morbidity of mental illness and substance abuse; substance abuse as manifestation of deeper problems; the non-partisan nature of mental illness so that both Republicans and Democrats work together (at this point the members of Congress present were asked to stand); substance abuse as a way to escape depression; the need to integrate a mental health assessment ("check up from the neck up") into the standard physical exam; and that the mental health professional needs to be part of primary care.
Many topics were discussed and suggestions made in a panel discussion chaired by Secretary Sibelius. These proceedings can be found on the White House website. At this point, I prefer to reflect a bit on my own thoughts and experiences at the conference.
I was taken aback by the pervasive notion that mental illness is a disease that affects individuals and that needs to be treated. Much of what we call mental illness is related to the family, social, and cultural contexts in which we live. Questions need to be asked about what is wrong with society, not just what is wrong with an individual’s brain. The phrase "community mental health" was never mentioned. Yet in my experience, especially in the Jewish community, it is all about "community mental health." Look at the problems we have of alcohol abuse, domestic violence, divorce rate, adolescent deviance – “off the derech” – and so on.
These are not problems in someone's brain that require individual treatment. These are problems of a social nature; if we are to "treat" them, we must "treat" the community as whole. The notion of mental illness as occurring within a social system was absent from the entire conference. It is precisely because of the social context nature of many of the problems of mental illness that faith communities become vitally important.
The Jewish community must deal with these problems not just by helping the mentally ill get treatment, but by community-wide introspection into the root causes of these problems. What is wrong with us as a community?
I was gratified by how many people came over to me to discuss the role of religion and spirituality in mental health. Yet I do not recall hearing the word "spirituality" the entire day. Surely, whatever one's religion, there is a spiritual dimension to mental health!
Over the years I have seen a vast change in the attitudes of the Orthodox community to mental illness, from the time it was viewed as a shanda (perhaps because of shidduch issues), to now when Orthodox practitioners as psychiatrists, psychologists and psychiatric social workers are readily available, and in which the newspapers serving the Orthodox community feature mental health columns, sometimes several in an issue. Likewise, rabbinical seminaries are putting increasing emphasis on psychological counseling as a major aspect of pastoral skills. The days of bringing one’s problems or family problems to a rabbi whose only advice is “study Torah,” are coming to an end. I’m sure other religious denominations are also increasingly aware of mental illness in their communities.
Nevertheless, the research on the correlation between religious behavior and faith (prayer, church or synagogue attendance) on mental health was absent from the conference. However, it was evident in private conversations I had with a nun, an imam, a Baptist lay leader, a four-star general, and the heads or representatives of a variety of national organizations. There were very few actual mental health providers involved in the discussions. There were representatives and spokespeople, yes, but not the providers themselves.
I saw no other Jewish clergy besides myself, from any of the religious streams. The imam with whom I spoke at some length had just returned from a group visit to Auschwitz, where he was "enlightened, horrified, and moved." He invited me to accompany him on his next trip to Egypt. I told him that I interpreted the Biblical injunction against Jews returning to Egypt very literally. He said, "OK, how about Syria?" Jokingly, of course. I hope.
The conference sent a message that the Obama administration intends to make mental illness a major concern in its public policy. It succeeded in getting the message out to a wide spectrum of important "players" in academia, the mental health establishment, the military, the arts, and the like. I think we will see real change in the treatment of veterans returning from battle with "invisible wounds.” I believe that the Affordable Health Care Act will indeed enable millions of more people to seek treatment. The big question is the capacity of the current system to provide necessary treatment.
At the OU, we already endorse a policy of inclusion and acceptance of individuals with mental illness through Yachad and within other programs such as NCSY and the Seif Jewish Learning Initiative on Campus (JLIC). I recommend that we offer a conference to our own personnel and perhaps to synagogue leaders to learn some of what was advocated at the White House. I particularly urge our people to follow up on some of the websites which were mentioned there, starting with mentalhealth.gov, and including bringchange2mind.org, activeminds.org, and giveanhour.org. There is a vast amount of good material on those websites that can be used in the context of our synagogues and programs.
Mental health is an issue that touches us all. In the Jewish community, as noted, we must look at it as a community and continue to overcome any inhibitions about getting professional help. This is a priority issue for the OU and should be one for the klal as well.