We Are Facing a Mental Health Crisis This Pesach

As we get closer to the impending three-day Yom Tov, I’m getting more afraid. I’m becoming increasingly terrified of coming back from Yom Yov to find that there has been a rash of suicides in the community committed by people who could not handle the isolation of a three-day Yom Tov alone. While this pandemic has been jarring for all of us and we’re all still caught up in the whiplash of a world changing ever more rapidly for the worse, I’m afraid that we’re forgetting about some of our most vulnerable community members.

A three-day Yom Tov is dangerous for people who live alone or are otherwise suffering with the isolation of social distancing and quarantine. It presents an actual, life-threatening risk to many singles, seniors, people living in abusive situations, and people who struggle with mental health. While there have been some efforts to figure out ways to account for those risks and mitigate them through various halachic accommodations, not enough is being done at the moment by our rabbis and community leaders.

On March 22 the RCA sent an email to its members with a brief directive from Rav Hershel Schachter regarding the use of electronic communication for vulnerable people on Yom Tov. The directive was very broad in its application, and was intended to give rabbis very wide latitude to issue heterim to members of their community who might be in danger due to isolation over a three-day Yom Tov. Because the directive was shared with me in confidence and was never meant for public dissemination I won’t quote its contents, but suffice it to say this directive was broad enough to address virtually every situation a rabbi might encounter dealing with this issue.

The basis of this directive was, of course, the idea that we have to take pikuach nefesh very seriously, that in such cases we must err on the side of saving lives, and that issues relating to mental health must be taken as seriously with regards to pikuach nefesh as physical dangers to human life.

When I found out about this directive, I immediately started contacting RCA member rabbis urging them to make some kind of public statement to their communities about the potential halachic considerations available for vulnerable people. Additionally, I wanted the RCA to make its own public statement about the issue, as well as establish a dedicated collection of rabbis who could serve as public consultants for questions related to the use of electronics on Yom Tov.

I wanted this for three reasons:

  1. People might feel embarrassed to ask their rabbis questions about their mental health. In many communities there is still a stigma associated with mental health, and people may feel too embarrassed to reach out to their rabbis.
  2. Not every rabbi is suited to this purpose. Not every rabbi is understanding of mental health challenges, or knowledgeable enough to render accurate piskei halacha on this subject. Not every rabbi fosters the kinds of relationship with their community members that would lend itself to that kind of discussion. Loathe as they may be to admit it, we need to account for the possibility that some rabbis may be unsympathetic, or inclined to incorrectly err on the side of observance, so to speak.
  3. Not everybody has a rabbi. There are many otherwise observant Jews who don’t have any kind of relationship with a rabbi, whether that’s because distance prevents them from being part of a Jewish community, because they are young and haven’t yet found a rabbi of their own, or because they had a negative experience with their previous rabbi and haven’t yet found a replacement.

My efforts were met with mixed results. Some of the rabbis I spoke to did start immediately speaking about it with their community members. Some went a step further and pushed their colleagues to do the same. Some felt uncomfortable addressing the issue publicly at all, but after some coaxing did so anyway. Some haven’t responded.

Meantime, the issue picked up steam. On March 24 Five Sepharadi rabbis in Israel made international headlines within the Jewish press for issuing a ruling allowing members of their community to use Zoom for the sedarim under certain circumstances. Much of the coverage took the psak out of context, and immediately resulted in backlash by many prominent rabbis.

The next day, Rav Hershel Schachter issued the following public psak on the use of electronic communication on Yom Tov:

While the fact that he made such a psak publicly is certainly commendable, and the psak does acknowledge that mental health is just as important when discussing pikuach nefesh as physical health, this psak was made in the shadow of the controversy over the Sepharadi rabbi’s psak, and it shows. While it’s also understandable that a private guidance issued only to rabbis intended to give them the tools they need to then issue their own piskei halacha would be far broader than a psak intended for the general public to apply at their own discretion, the degree to which this psak is guarded and qualifies seems to be a result of the controversy.

The RCA included this psak on its website in a list of general halachos for Pesach during COVID-19.

And while that is significant and commendable, it’s still not enough. We are not doing enough. Our rabbis aren’t doing enough. Our communities are not doing enough.

Some rabbis have been proactive about sending emails or other communications to their community members directly addressing the concerns of vulnerable people in their communities. Some of these messages explicitly state that mental health dangers are considered pikuach nefesh equal to physical health dangers and encourage community members to reach out before Pesach to discuss options for coping with isolation over a three day Yom Tov. Some even went as far as to encourage community members to call them on Pesach itself if they feel they’re in distress and need someone to reach out to.

Other rabbis have opted instead to hold shiurim on the topic and address it during those, no doubt assuming that whatever gets discussed during the shiur will filter out to those who may have missed it. Recordings will likely be made available.

Still others have opted to address the issue very obliquely, asking community members to reach out to them if they have any concerns about their mental health during isolation over the three day Yom Tov, but giving no background or accompanying information.

Many other rabbis have said nothing to their communities about the issue, opting instead to wait until contacted by a community member concerned for their safety over Yom Tov, or are proactively but privately contacting community members they believe to be in potential danger over Yom Tov.

Overall there doesn’t seem to be much of a coherent response by the community at large to address this issue. There’s a psak here, a psak there, some are comprehensive, some are minimal, and some are clearly operating with a complete lack of understanding of the realities of the challenges faced by members of their community.

For example, in his psak Rav Schachter opened by saying that if an “individual has a psychological condition where physicians who know this patient have determined that there is a possibility that this person being alone over the course of Yom Tov would be in a situation of pikuach nefesh (possible suicide) if the individual was not able to com-municate or speak with family members, then the family members must reach out to this person over Yom Tov to speak on the phone or use the internet by leaving a connection open from before Yom Tov.”

The qualification requiring that the person have a diagnosed condition in order to avail themselves of electronic communication on Yom Tov is flatly ignorant of reality. Many people who struggle with suicidal ideation have never been diagnosed. Many have never even seen a therapist. Whether that’s due to stigma, internalized shame, lack of resources, lack of access, or any other reason, the reality of the danger is no less pressing. Furthermore, waiting until someone is experiencing active suicidal ideation before allowing them to avail themselves of electronic communication on Yom Tov is irresponsible.

Additionally, addressing suicide as the baseline for leniency is itself irresponsible. There are many other mental health concerns for which allowances may be issued. For example, exacerbation or relapse of eating disorders, self harm, exacerbation of severe anxiety disorders, severe depression, potential triggering of manic episodes or cycling in a person with Bipolar Disorder, potential triggering of psychosis, and so on. These are complicated issues that can’t be lumped into the category of diagnosed potential risk of suicide.

The issue of course when approaching this kind of public psak is how to balance the need to be inclusive of everyone who may need to avail themselves of the psak against a desire to not give an overly broad public psak which will either be misapplied or dismissed as too lenient. Rabbi Aryeh Klapper wrote a very detailed article laying out the various considerations that go into this process and how they might best be balanced against each other.

There are a number of problems I’m seeing as I examine more and more of the communications sent to different communities.

  1. There is no coherent response to this problem. There is no organizational effort to centralize the response. It’s happening piecemeal and haphazardly.
  2. The politics and meta-halacha of the issue is getting in the way of addressing the actual problem.
  3. There is a fundamental lack of understanding about the realities of the mental health issues faced by many of the vulnerable people these piskei halacha are meant to address, and an apparent lack of will or desire to either become more educated or contact trusted experts on the subject.
  4. There is a lack of self-awareness on the part of many rabbis of how their communities interact with them. This is especially true of many larger congregations and communities.
  5. There is a fundamental lack of trust that laypeople, if actually given the details of the halacha, might apply it reasonably.
  6. There is very little consideration being given to the infrastructure necessary to actually put these piskei halacha into effect.

To that end, I suggest the following:

  1. There needs to be a group of rabbis and mental health professionals put together to address these concerns. These professionals should be available not only to consult on and put forth halachic policy, but also be available for consultation by those who may not have a rabbi or mental health professional of their own.
  2. There should be a guidance issued to community rabbis to proactively discuss the issue with their community members. This guidance should be issued by the group mentioned above. This way there is uniformity in the message, and community rabbis who might feel unequipped to address this issue with their congregation have some materials to help them.
  3. Community rabbis must have access to mental health professionals in the group to consult about the shailos they receive. Not every rabbi can be expected to understand the nuanced realities of mental health issues, and may need help issuing these piskei halacha.
  4. If piskei halacha are going to be issued to people that they may use electronic communication on Yom Tov, there must be someone available to pick up on the other end when they reach out. A psak allowing electronic communication is meaningless if there isn’t anyone for them to communicate with. Community rabbis should either designate themselves as contact people or designate someone else as a contact person (ideally a mental health professional), and should make sure that members who receive an allowance for electronic communication have someone that they’re comfortable talking to when they’re vulnerable, whether that’s the appointed central contact person, a friend, or relative.
  5. Because a rabbi, no matter how well connected to their congregants and no matter how large or small their community, can’t be certain what their congregants may be going through with regard to their mental health, they should make sure to include resources in their communications for crisis intervention services like the National Suicide Prevention Lifeline, and encourage their community members to call those resources if they feel their lives are in danger.

We are living through a crisis the likes of which most people haven’t experienced in their lifetime, and that calls for for extraordinary measures. I urge laypeople reading this to contact their rabbis and impress upon them how seriously this must be taken, and urge them to discuss this openly with their communities.


2 thoughts on “We Are Facing a Mental Health Crisis This Pesach

  1. Since you mention, “The RCA included this psak on its website in a list of general halachos for Pesach during COVID-19,” I’m wondering if you could share a link. I’ve been unable to find this on their site.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.