IN-DEPTH FEATURES
Treating Mental Health in Bnei Brak: A Warm Home in a Cold World

Some might be creative and motivated, others are more average- thinking people. Some could even be geniuses, always quick at solving riddles. Many of them are thinkers and can express themselves aptly in poetry. You could even subdivide them into groups of boring or interesting characters, some full of humor or dry as bones, kindhearted or absolutely selfish. Statistically speaking, they definitely cover the entire spectrum of personality traits that characterize the typical average population. However, they all share one common denominator: they all suffer from mental disorders.

Healthy, But . . .

"I work only with healthy people," said Rabbi Shmuel Munk, head of the Bayit Cham Rehabilitation Center in Bnei Brak, at a special meeting called by the Health Ministry. All those present, professionals in the field of mental health, stared incredulously.

After each of them, in turn, elaborated on his special techniques in his practice with such patients, Rabbi Munk revealed his special point of view: "I believe that even a person who is diagnosed as suffering from schizophrenia, is a healthy and productive being, aside from his specific problem.

"What essential difference is there between a diabetic and a person with a mental disorder? They both have a specific problem, but nobody can deny their inherent capabilities and talents! Whenever I meet a new patient, I tell him: `We are both ailing: I suffer from high blood pressure and you suffer from mania.' "

Rabbi Munk points to a square on a diagram: "Look at this square; it is perfect on all sides, besides a little chip at one corner. Would it be fair to define the entire square as irregular?"

This is the one, bright side, of the story. What about the other side? It is dark, bleak, frightening, and menacing. If these cases are neglected and not treated appropriately, the negative traits are prone to engulf the entire personality and cause untold misery.

A mental disorder can torture a person more than any physical disease; it haunts him by day and by night. It is ever- present, ready to pounce, crippling and debilitating his every motion.

"When the body is sick," says Rabbeinu Yonah in Shaarei Teshuva, "the soul will nurture his sickness . . . meaning, the mind assists the body in overcoming his illness, by lending moral support and encouraging him to bear his suffering. But when the soul is sick, raged by depression, despair and anxiety, who will support and encourage it?"

A cancer-stricken patient will find comfort in his immediate family, in his occupation or learning. He might even be full of optimism. Hope will turn out to be his closest companion.

However, mental sickness is a sworn enemy of hope. It hates optimism, and in most cases, goes hand in hand with despondency and pessimism.

This is where the road to decline begins. The symptoms of the malady will take their toll, and the patient drowns in a sea of despair. The concern for his family weakens and he remains indifferent to any inspiring stimulation such as music or beautiful landscapes.

Many families are so obsessed by feelings of shame and concern for `what people will say,' that they neglect to give this individual the treatment he requires and allow him to be literally buried in his misery. Their concern for shidduchim of their other children causes them to overlook the needs of this wonderful member of the family, and they willingly renounce their rights to government support which is sorely needed for his rehabilitation.

In many cases, people choose a treatment that is not suitable for the patient. The choice of the professional to take care of their patient isn't necessarily the appropriate one and is not necessarily based on a pure consideration of the welfare of the patient. The professional is only chosen due to his distant location, and mostly because of his ability, in his words, to fight the problem in a "Blitzkrieg" manner ("After three sessions the boy will be cured"). Needless to say, his qualifications are lacking.

"Let us not delude ourselves", says Rabbi Munk. "There are no shortcuts. A mental illness will never evaporate into thin air. Only professional help (in accordance with a Torah outlook!) can be successful. I beg you, never give up hope! Those families who delude themselves into thinking that the problem will eventually fade away, as if it were a cold, must face the fact that if the problem is real, the situation will only deteriorate as time passes and, as would a snowball, it will grow into a monstrous reality. By then, unfortunately, there will be no alternative other than to hospitalize the patient."

Until recently, the trend actually was to hospitalize such cases. Patients were in and out of these hospitals, spending longer or shorter periods according to their needs. However, it soon became evident that they no longer found their place in society, the vicious circle continued and they ended up being more in hospital than at home.

Rescue From Falling Into Abyss

A more up-to-date, general approach for the treatment of mentally disturbed patients is, precisely, to incorporate them into society. The pioneer of this new method in Israel is Rabbi Shmuel Munk, Head of the Bayit Cham ("Warm Home") Rehabilitation Center in Bnei Brak. Yoram Mordechai, his close associate, is the coordinator of this enterprise.

Wherein lies the effectiveness of this new approach?

First, a mentally sick person who is hospitalized, spends most of his time in the company of other mentally disturbed patients, which will only worsen his condition. Conversely, when in the company of healthy individuals, he will naturally strive to imitate their behavior, which will prod him into seeking and using the healthy aspects of his personality.

This is just one aspect of the new system. Another vital point is the search for an occupation for these patients. "Work" is the saving rope for these drowning souls. When they get a job, "I am worth something, I am able to provide for my family" is the message the individual internalizes, especially when he receives his first salary. "My work is appreciated, I have a place in this world."

However, occupation per se is not usually sufficient for such people. Frustrating or boring jobs, devoid of satisfaction, will not hold the interest of this kind of people. The code word is to find them the appropriate job and not just occupational therapy. This stimulus will eventually, hopefully, be the catalyst for a complete recovery.

What made Rabbi Munk come to this conclusion? He recalls that years ago he witnessed several autistic children brought to a factory in Tel Aviv, where they were instructed how to complete a production line by fixing a simple screw at the end of an almost complete item. Some of the children would not cooperate.

However, when they were shown a far more complicated task, they readily agreed to participate and actually completed their work perfectly. This proved to Rabbi Munk that they were in fact extremely intelligent and highly motivated children and they wished to utilize their potential to the utmost.

"My father is a master at finding the most suitable occupation for each applicant," says Rabbi Aryeh Munk (son of Rabbi Shmuel Munk).

When a new patient arrives at Bayit Cham with his Bituach Leumi allocation, he is first welcomed by Rabbi Munk, who converses with him and treats him as an equal. During this encounter, and an ensuing leisurely walk, Rabbi Munk tries to discover his potential and inherent capabilities.

At Bayit Cham there is a large hall with various facilities for occupation. The sole purpose of this hall is to establish which work is suitable for each person. Rabbi Munk observes the applicant as he tries his hand at various jobs. Is he more technically or more intellectually oriented? How does his coordination function? Is he capable of working with other people?

Take David, for example. He was hospitalized for six draining years in a closed ward due to serious mental disorders. His home was on the verge of collapse, and he almost lost hold of the last thin thread that joined him to sanity. At this point the great miracle of his life took place -- he met Rabbi Shmuel Munk.

During their conversation, he mentioned he had learned to be a silversmith earlier in his life. "Wonderful," said Rabbi Munk with great enthusiasm, "I am looking for someone to craft me a silver cup which I wish to present to one of the supporters of Bayit Cham."

After some persuasion, they traveled to Tel Aviv where they purchased the necessary equipment and material, and David set to work. The final product was a masterpiece. "I arrived at the home of this benefactor, handed him the gift and told him: This silver cup was crafted by a person who literally crawled with his nails out of the grave."

Rabbi Munk shows us a selection of stunning silver objects. He had invested exorbitant sums in order to acquire the intricate equipment and even had to increase the electricity wiring to enable David to carry out his work. But the investment proved worthwhile: Slowly but surely the occupation drew David out of his depression. No price was too high to achieve this priceless result.

Today he is a self-supporting, productive person. The medication he takes is but a small detail in his daily life. His wife and children have found again a loving husband and father. Rabbi Munk: "It might be impossible to cure these people completely, but my goal is to avoid the sharp ups and downs that pose a threat to their life and that of their families."

The misery that engulfs those closely related to a mentally sick person is indeed indescribable. Rabbi Munk shows us letters of family members who literally collapse due to the hardships they endure, and when the patient actually begins to rise from his sickness, the relief is felt no less by those who surround him.

The fields in which these patients are employed are very varied. Some are gifted and excel in preparing flower arrangements or exquisite bars at wedding halls, others work at supermarkets, do menial office work or are employed as bank clerks. One rehabilitated patient even became a lawyer. Another one is a learned ben-Torah, who gives very popular Torah-lectures at mental health clinics!

The Remedy: Occupation

It may well be that you have been served at some store by one of the rehabilitated patients of Bayit Cham. Take Shimon for example: At his first encounter with Rabbi Munk he was a pitiful sight to behold. During their casual stroll, he suddenly stopped at an optician's store. Rabbi Munk immediately deduced that this would be a suitable occupation for him. He turned out to excel in this field. Today the customers at the store where he works demand to be served exclusively by him. However, this metamorphosis did not occur overnight. Much effort, tears, perseverance, professional help and above all, much tefilloh were needed to reach this wonderful result.

In order to enable Bayit Cham to accept a patient, he must be provided with a Rehabilitation Form from the government, which authorizes any initiator to work with the individual. This wonderful project is classified as a private enterprise and the Ministry of Health "buys" its services. There are fourteen instructors spread out around the country, whose task it is to provide guidance to these rehabilitated individuals. They are in constant contact with the patient, serving as a "shoulder" to lean on.

At first the contact is daily, as the instructor accompanies the person to his work place and helps him complete his chores. Slowly, he attempts to make the employee less dependent, as gradually his visits become more infrequent, while all the time he monitors his progress. If any problems arise, the instructor is always available for moral support and guidance.

All these rehabilitated patients are the "official" successes of Bayit Cham, those who decided to face the reality and not to sweep their problem under the carpet. There are, however, hundreds of cases that are neglected and deprived of treatment due to feelings of shame. "They approach me in shul, on the staircase, or elsewhere. `I cannot approach Bituach Leumi; it will become common knowledge and my children will suffer.' The applications are endless and their urgency is pathetic.

"I wish I could help all of them, but I have insufficient financial means," says Rabbi Munk. Even those who are officially recognized by the authorities do not receive the entire amount necessary to finance their rehabilitation. During the first nine months of treatment, the daily allocation is NIS 74; for the following six months, he receives 45 shekels daily; this is later on reduced to 31 shekels daily. According to American statistics, rehabilitation patients arrive at work 17 days a month.

"Not by us," says Rabbi Munk. "We hold a record of patients who come to work at least 22 days a month."

The work places which employ Bayit Cham people pay the wages to the organization, but many times the sum is minimal. This is due to the fact that any employer who is willing to accept these rehabilitation patients for work must take into account that they often make mistakes, work slowly or don't show up at work.

Rabbi Munk feels a need to supplement their salary. It must be clearly stressed that for these people the wage is a most important component of their mental recovery. It is literally a "piece of health," much more significant and crucial than for a mentally healthy person.

It must also be stressed that the sum allotted to each individual by the government does not include additional expenses, such as the purchase of work equipment, courses, excursions and a wide range of indispensable side-expenses. Just as it would be unthinkable that a road-accident victim be deprived of a life-saving blood transfusion due to lack of means, so too, it would be irresponsible to refuse these mental disorder-stricken individuals their life- saving requirements which can restore their sanity.

We refer to a monthly budget of hundreds of thousands of shekels. Rabbi Munk dreams of many additional projects, such as hostels, support groups and many more, but the lack of funds curtails all these wonderful plans.

Rabbi Munk and Rabbi Mordechai are shlichei tzibbur who undertook to provide for a portion of the community that no one else cared for. They deserve our utmost support to enable them to continue their wonderful undertaking.

"He who has mercy on his fellowmen, will be deserving of Heavenly Mercy together with his family."

Rabbi Michel Yehuda Lefkowitz, among many other rabbonim recommends us all to contribute to this very vital and worthy cause. Donations are tax deductible and can be made out to Friends of Bayit Cham. For information: 1 800 392 392. 13 Rechov Yishmoel, Bnei Brak, 51553, Israel.