Mental health has long been a taboo topic in many communities, and the ultra-Orthodox world is no exception. While discussions around physical health – whether it be cancer, asthma, or broken bones – are met with openness and support, mental health challenges remain cloaked in silence and are often swept under the rug.
Our recently published study, Socio-cultural Adaptation of Mental Health First Aid to Insular Religious Communities: The Case of Ultra-Orthodox Society in Israel, explored how introducing this program to haredi communities can help chip away at the stigma.
The study, written by researchers from the Jerusalem College of Technology’s Selma Jelinek School of Nursing (including Beth Zalcman) and Mental Health First Aid Israel, includes four focus groups totaling interviews with 45 people within the haredi community, and revealing a striking and heartening realization: The stigma surrounding mental illness, while still significant, is beginning to erode. People are seeking treatment, hospitals catering to the haredi community are seeing an increase in patients, and individuals are slowly but surely acknowledging that mental health issues are real and must be addressed. However, there is still much work to be done.
In the ultra-Orthodox community, where mental illness is often hidden and treated as something shameful rather than a medical condition, families may go to great lengths to conceal mental health struggles from neighbors or friends. Support structures available for physical illnesses, such as meal trains or community aid, are glaringly absent for those battling depression, anxiety, or eating disorders.
Mental health services in Haredi spaces
This silence has devastating consequences. When people feel isolated and unsupported, they are less likely to seek help. Moreover, the lack of open conversation perpetuates misinformation and stigma, making it harder for individuals and families to feel validated in their struggles.
This is where Mental Health First Aid (MHFA) could be instrumental. The program, which was first introduced in Australia, is an evidence-based, early-intervention course that teaches participants about mental health and substance use challenges. MHFA trains individuals to recognize the signs of mental health struggles, provide initial support, and connect those in need with professional help. Think of it as CPR for the brain. Just as we learn physical first aid to respond to accidents or injuries, MHFA equips people to address mental health crises and, crucially, prevent them from escalating.
For example, after a car accident, first responders might focus on physical injuries: Is your back okay? Is your shoulder okay? But, likely, no one asks, “How are you feeling emotionally?” MHFA empowers individuals to ask these questions and offers critical support for emotional trauma.
ENCOURAGINGLY, OUR research showed that people in the haredi community are ready to talk. Many participants expressed relief at being heard, and their stories revealed a deep yearning for acknowledgment and understanding. This willingness to engage, even on a traditionally taboo subject, is a testament to the community’s resilience and openness to change.
However, cultural sensitivity is essential and should involve rabbis and community leaders who can ensure initiatives like MHFA gain acceptance. By aligning MHFA with the values, norms, and needs of the haredi community, we can create a safe and supportive environment for these crucial conversations.
Implementing MHFA comes with challenges, particularly financial ones. Each course costs hundreds of shekels per participant, with an average class size of 25-30 people. While we hope to offer the program for free to maximize accessibility, this requires significant funding. Donors and partners who recognize the importance of mental health in building strong, resilient communities will be critical to making this a reality.
We’ve already begun this process and, in doing so, mark the first case of accommodating MHFA for an insular religious group. If the program can be adopted in haredi communities, then it may very well have the potential to also be implemented worldwide in other religious communities that are typically resistant to change.
Mental health is not a luxury; it is a necessity. Just as the ultra-Orthodox community has embraced professional education and employment as pathways to integration into broader society, mental health support must become a cornerstone of this progress.
Programs like MHFA offer a practical, culturally sensitive way to foster understanding, reduce stigma, and build stronger communities.
We envision a future where someone struggling with depression is met with the same empathy and support as someone with a broken leg, regardless of the community they belong to. We hope that in this reality no one feels ashamed to seek help, and mental health is seen not as a personal failing but as an integral part of overall well-being.
To make this vision a reality, we need community leaders, donors, and individuals to join the effort. Together, we can break the silence, lift the stigma, and ensure that mental health care is accessible to all.
Dr. Zvika Orr is a senior lecturer in the Department of Nursing at the Jerusalem College of Technology. Stuart Katz is the founding director of OGEN – Association for the Advancement of Mental Health.