On Sunday evening, September 4, Let’s Get Real with Coach Menachem featured Rabbi Jacob L. Freedman, MD, Mishpacha Magazine columnist and psychiatrist in Israel, who shared an enlightening talk and discussion on how to support families who are dealing with a mental health crisis. Rabbi Freedman stated that the most important thing to know is that a lot of people are struggling. Every single family will deal with some sort of a mental health issue.

He pointed out that “suicide is the number one preventable cause of death in young adults, and if we don’t talk about it, we can’t come up with solutions as a community to acquire help for our loved ones and neighbors.” The goal is that we need to do a good job talking about this to prevent the next crisis from happening.

He quoted the Chofetz Chaim that everyone is fighting a battle that you know nothing about. One in three people will have a mental health issue at some point in his/her life. Everyone will have challenges at some point in his/her family. He stated that in the same way the community pulls together and offers practical and emotional support when a family is dealing with a physical illness, we need to do this for a family dealing with a mental health issue. Sadly, there is a stigma with mental health issues, and people are too embarrassed to talk about what is going on. So, people end up being alone during this crisis. It is very hard with no community support.

Rabbi Freedman suggested that practical support is the best way to help, just as you would help someone with another type of crisis. Validate the situation and then let him know that you are not judging, and you don’t need to know any information, but that you are there for him to help. Ask how you can help. Practical help, like assisting with carpool or dropping off Shabbos meals or driving their children where they need to go are all possible ways to help and support the family. Even sticking an envelope with money under the door can be a big help if the father is unable to work due to the crisis. He spoke about a few organizations that a family can turn to for guidance and help. These include Amudim, MASK, Ohel, and Relief. Kanfei Faiga is available for Lakewood residents with mental health issues.

He pointed out that it’s important for a rav of a community to have a relationship with mental health professionals. He added, “I am grateful for the relationships I have developed over the years with community leaders.”

He taught that a good frum clinician understands the difference between what is culturally appropriate and what is a symptom of something wrong.

Someone asked what support is available to someone who has a spouse with bipolar disorder. Rabbi Freedman mentioned an organization called Chazkeinu, which offers a support group for ladies with a loved one with mental health challenges.

Someone asked about issues in school and how to know when a child needs to see a mental health professional. Rabbi Freedman answered that the role of the school psychologist is to help kids and parents and to identify when parents or kids need extra resources. He encourages schools to have mental health professionals on staff.

Another caller asked about how much to inform children about when the family is having a mental health crisis. He responded that they should be part of the grieving process and the healing process. ”I encourage age-appropriate discussions with children,” he said.

Another caller wanted to know when it is correct to seek out medication. Rabbi Freedman cautioned that every case is different. Be an active consumer and look up information on the Mayo Clinic and the Massachusetts General Hospital websites. Being educated will help you to ask the right questions. He added that a good doctor will help the patient weigh the pros and cons for medication. Medication may be called for, generally, when someone is at risk of losing his or her job or if a child is about to be thrown out of yeshivah or if someone can’t take care of his children. Also, if there are issues like hallucinations, then it’s important to start medication right away.

He shared that You need to understand that one of the greatest side effects is letting oneself suffer further. The longer you descend, the longer time it will take to go back up. He stated that 50 percent of people who come to see a psychiatrist receive a recommendation to take medication. It is a good idea for the patient to come to see the doctor with a loved one and to be an educated consumer, as this will make it easier for the psychiatrist to help him.

He related that it’s important to be honest with your feelings. This helps us act in a mature and professional way. He also advised that a person who is dealing with a spouse with a mental health issue should be open to go to his own individual therapy. The spouse who is healthy needs a safe place to talk about his or her feelings in the situation. “Acceptance is so important in these challenges.”

He related how the 12-Step Program is a beautiful program filled with wisdom. He quoted the serenity prayer, which is part of the 12 Steps: “G-d, please grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.”

He noted that Rabbi Abraham J. Twerski, MD, zt”l, saw a great benefit for people with addictions to follow the 12-Step Program.

Rabbi Freedman shared that when a family member suffers with a mental illness, it is normal for other family members to feel angry. It is not okay to deny your anger. Then it gets bottled up and you explode. This is why therapy and support groups are vital. They provide a safe place to express your feelings.

A caller asked how you can convince a loved one who needs mental health help to reach out for help. He suggested calling Amudim, Relief, MASK, or Ohel for hands-on practical help in this situation. They will provide a confidential case manager to help you and to advise you. You can try an open discussion with the person and ask her what she thinks she should do. However, if that is not working, the question is for you to think of who she would listen to. There is no lashon ha’ra in speaking to a rav or professional. You are doing it to save a marriage, to save lives, and to protect your children. “By getting help, you are saving your family.”

Someone was concerned about being reported to the Child Protective Services and having their children taken away. Rabbi Freedman said these agencies are so backed up and they anyway don’t want to do that. Their main goal is to facilitate for the family to receive the help they need. In Israel, a comparable government agency provides free therapy and extra financial resources.

Rabbi Freedman emphasized the importance of dialogue with family members at early stages of a mental health crisis to help family members discuss their feelings. This is important to avoid an unhealthy build-up of negative feelings. He again stressed that the more help and support a community gives in a proactive way, the less crisis management will occur down the road.

He spoke about the organization Kanfei Faiga, which offers support to families when one person in the family is suffering from mental illness. It provides an advocate who helps and guides the family. There is basic support like homework helpers and big sister programs. This organization is for community members in Lakewood, New Jersey.

 By Susie Garber