August 19, 2008
Moving Mental Mountains
By Judy Siegel-Itzkovich
Shaf Yativ was a synagogue in ancient Babylonia made of stones rescued from the First Temple. According to the Talmud, the synagogue was "ruined and rebuilt but always had the Holy Spirit in it."It is an appropriate name for a small Jerusalem house of Torah study - the only one of its kind in Israel - aimed at rehabilitating haredi and a few modern Orthodox men suffering from mental illness who have regained daily stability with psychotropic medications.
Many of the students - aged 21 to 50, unmarried and living in hostels or with parents on National Insurance pensions - were previously patients at psychiatric hospitals. Fourteen being treated for schizophrenia, bipolar disorder, depression, obsessive- compulsive disorder and other problems are currently enrolled - but the free 18-month program can accommodate up to 35.
With the availability of effective stabilizing medications and the trend to rehabilitate the mentally ill in the community, the students of Shaf Yativ still need to learn how to follow a daily schedule, minimize social isolation, develop work habits and earn the self respect that will prepare them to find and keep jobs or pursue studies. The Beit Midrash was launched in March on the model of a yeshiva modified to provide a safe, structured environment, says Rabbi Guy Avihod, the 33-year-old Israeli rabbi who is its coordinator. "Some are much older than me, but I feel as if they were my children, not my students," says the rabbi in fluent Hebrew and English.
OVER THE past decade, the Health Ministry has invested much energy and resources in rehabilitation for the mentally disabled, but existing programs were unsuited to haredim and other observant Jews due to their religious lifestyles. Looking for a solution, the ministry's mental health rehabilitation coordinator Pamela Pearlman and her deputy Michal Cohen approached Udi Marili, an expert in rehabilitation, and asked Avihod ([email protected]) to help such men through a special Torah learning program. Although for some years there has been a yeshiva attended by former mental patients, Shaf Yativ is the only one with mental health professionals on staff.
It was set up at Yad Harav Nissim, the restored British Mandate- era learning center established in memory of the late Sephardi chief rabbi Yitzhak Nissim and situated opposite the president's residence. The Nissim family provided space on the ground floor at nominal cost four mornings a week between 9:30 a.m. and 2 p.m. As mental illness generally bears such a stigma in the haredi community (it interferes with finding marriage partners) and victims are often sent by parents to distant yeshivot, Avihod preferred a Jerusalem location far from ultra- Orthodox neighborhoods.
Avihod was born in Jerusalem to a secular family. His father is an Iraqi-born businessman holding patents for wheelchair designs, while his Russian-born mother has been a teacher. When he was a boy, Guy and his two siblings were taken to Los Angeles for a planned two or three years, but "we stayed for 12," says the rabbi. "I attended public school and Jewish school as we became closer to religion."
Without a matriculation certificate, he was unable to enroll in an Israeli university, so he went to California State University for a BA in political science and returned to Israel to serve in the Israel Defense Forces, followed by a bout of teaching high- school dropouts. Although he and his family returned to LA for nearly four years and Guy earned his master's degree in comparative politics, they all returned for good in 2003, even though profits from the highly successful wheelchair business suffered.
He met his Israeli-born wife Eris , also the child of an Iraqi- born father who lived in LA. Their parents knew each other in California but first met in Israel. Now they are the parents of four children aged nine to two. "I always wanted to teach, to be a professor - and also the prime minister (but it's fortunate I didn't go into that) - as a child," Avihod recalls in an interview at Shaf Yativ. As he became observant, his educational bent led him to teaching Torah and Talmud, and he earned his ordination from former Sephardi chief rabbi Mordechai Eliyahu at his Jerusalem rabbinical college. Today, wearing a crocheted black kippa, Avihod says he doesn't know how to label himself.
HE WANTED to do something with his ordination, so he began to teach Talmud in the Arnona neighborhood, and even had students in a bagel shop, without charging for it. After meeting Marili, he learned of the ministry social workers and their search for an effective means of rehabilitation for religious men. Shaf Yativ (www.shafyativ.com) was established, and for Avihod it was a perfect match, even though wages are low.
Two social workers are on the steering committee, along with Prof. David Greenberg, the modern-Orthodox director of Herzog Hospital's community mental health center of north Jerusalem, and an associate clinical professor of psychiatry at the Hebrew University.
"I have a patient who is attending, who is delighted and enjoys the activities, and another who is hoping to start. There are challenges facing the project - enabling participants to actually progress, study more hours and with increased satisfaction, and seeing if they can then move on to more mainstream activities, whether regular yeshivot or work.
"The concept," says Greenberg, "definitely deals with a serious issue: What is rehabilitation for a very religious patient? The secular concepts of work and leisure are likely to be much less meaningful in this community."
Each student participates in the structured learning the program offers, with an emphasis placed on his special needs, adds Avihod. The program aims to help the students acquire basic learning and social skills and relieve their isolation. Participants are trained in how to summarize and take notes in preparation for tests that Avihod calls "exercises" so they don't get intimidated.
"The exams have proven to be excellent motivation builders," the rabbi says, "and when they lack confidence, we show them they actually did well."
AMONG THE 14 students, after only five months, success stories are already apparent. Up until four years ago, "Yehezkel" attended a top-rated Jerusalem yeshiva. He suffered a mental breakdown; he became unable to sleep properly and became disconnected from his surroundings. He was asked to leave the yeshiva, and without a routine, his condition deteriorated. He left home for four years, but since joining Shaf Yativ, with the constant support and supervision of the Beit Midrash staff, he has made great strides both in learning and connecting socially. This is visible in his handwriting, which initially was almost illegible. Now, says Avihod, he is much more able to communicate. His mother was so excited that she broke into tears.
About 17 years ago, during his military service, "Rami" suffered from shell shock. After many years of being unable to hold his own in a rehabilitation program, he joined the Beit Midrash.
"He arrives early by bus and is extremely comfortable socially and academically. In the Beit Midrash, Rami acquired basic learning skills of summation and test taking. After the first test he took in the Beit Midrash, he happily exclaimed that this was the first time he had written a whole page in more than 18 years," says his rabbi.
"Alex," who settled in Israel from the former Soviet Union as a child, attended a school for new immigrants with a high level of sciences and Torah basics. His mental disorder was diagnosed a few years ago, and he was hospitalized twice. Now he lives at home. Although he is not observant, the program committee decided to accept him because of his high motivation. Overcoming his limited familiarity with the learning material, he quickly integrated. Asked how he felt about the Beit Midrash, "Alex" says: "I used to sleep until noon and then wander around; now I have a reason to get up."
"I speak to parents a lot," says Avihod. "They see changes, and some of the students's social skills are returning to the point where they were before the disease. As psychiatric patients, they were always told they don't have the ability to do things. I insist that they can, and they must write and take tests. It's a very long process, and we can't solve all their problems. They won't stop taking their medications when they leave here, but I want to give them a means to go forward. The most important thing is to help them believe they have a future. So many of them have been treated like helpless children."
After an organized Talmud class, students study in hevruta [pairs] and discuss their problems with social workers. "It was hard for them to wake up on time and get to the bus stop. We pay their fare, and if they arrive on time every day, we give them NIS 100 a month as incentive. They have to learn to live within a framework," says Avihod. "I raise the issue of coping and interpersonal relations, many of which come out of the Talmud."
The program also offers extracurricular activities such as monthly day trips around the country, enrichment programs and participation in community volunteer projects, which give them a chance to give of themselves instead of being just beneficiaries. The Defense Ministry will soon help subsidize the project and bring in modern Orthodox IDF veterans who suffer from post-traumatic stress disorder. "If all goes well, we hope to open another branch of Shaf Yativ for men in Jerusalem and then Bnei Brak and Ashdod."
Social worker Cohen says that even though the program was launched less than half a year ago, "we see progress. We want it to become a model for others. Rabbi Avihod does an excellent job in rehabilitation, even though he never studied it academically."
"It is a very exciting project," concludes Pearlman, her superior. "We want these religious men to regain a functional and satisfying life. This gets them out of the house and makes them feel useful and normal. Not everyone coping with mental illness is capable of working, but some are. Those who can't now have a way to fill their day and get encouragement, while those who can are being prepared for it."
Originally published by Judy Siegel-Itzkovich.
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