It seems that often, in the Jewish community, mental illness is hushed up and not spoken about. Do we have an obligation to report to social services (or elsewhere) a member of our community that we feel needs professional psychiatric help?
What is the best course of action to report a member of the Jewish community that seem to be mentally unstable? Should we report this to our community Rabbi, Jewish Family Services, public social services, the police? Where is the line between hurting someone with Lashon hara and helping to prevent tragedies?
Although mental illness may have once been a dark secret within the Jewish community, I don’t agree that communities continue to hide it. Certainly Jews have a primary value of pikuah nefesh (preserving life) and if there is ever a belief that someone might harm themselves or others we have a moral (and at times legal) obligation to notify the proper authorities. We must recognize that we cannot solve all problems people face and that even our most experienced rabbinic leaders are not trained therapists or doctors.
The line between lashon hara (evil speech) and pikuah nefesh is bright and clear in my mind. If we believe someone is in danger, we have an obligation to act. Where that lines blurs is in an instance where someone is not a danger, but rather is troubled. There is no one solution for the incredible number of challenges people face. I encourage you to speak with your rabbi for guidance. Speaking in confidence to alert a spiritual leader and seek advice would not violate the principle of lashon hara if your intent is to seek help.
There are a number of levels to your question. If someone is a danger to himself or others, I believe we have an obligation to report the individual to whatever body would be of help. First, the Halachah of Pikuach Nefesh, saving a life, overrides all other commandments except idolatry, sexual immorality and murder. This means that any prohibition such as Lashon Harah (gossip and slander) or Mesirah (handing a Jew over to gentiles such as the police) may certainly be violated in the case where a mentally unstable person is a danger to himself or others. The question, however, is to whom do we make the report? If one is a teacher, clergyman, mental health professional or medical professional, one is mandated by law to report suspicions of abuse to social services. The law of Dina D’malchuta Dina, the law of the land must be followed as the overriding law, comes into play, in my opinion, even though some authorities believe that that maxim only applies to monetary laws such as fines and taxation.
What about cases where mental instability does not appear to create an imminent danger to the individual or through him to others? In that case I do believe we should at least offer our concerns to the person’s immediate relatives. We must remember, however, that what looks abnormal to one person may actually be totally normal for another. Nevertheless, I would suggest that one broaches the subject with the apparently impaired individual’s loved ones by asking them if their relative is perhaps not feeling well because you’ve noticed that he/she is slurring his words, or seems confused and disoriented or is displaying whatever other seemingly abnormal behaviors you have observed. I don’t suggest one should “diagnose” the person, but out of the ethic of Kol Yisroel Areivim Zeh L’Zeh, that every Jew is responsible for every other Jew (and I believe this maxim extends to all peoples’ interrelatedness), one should inform the persons loved ones about what one has observed. Where there are no loved ones, I do think the observer can call Jewish Family Services to provide help for the person.
There is no question that as a Jewish community we must acknowledge that mental illness a real and significant challenge that must be addressed, and not swept under the rug. Like many challenges in the general community (gambling addiction, alcoholism, domestic violence) mental illness is a part of the Jewish community as well. We cannot pretend it isn’t there but we must find ways to help those that are affected. We must consider the affects of mental illness not only on the individual but on their family and we must program and care for people who live with this challenge. This is an extremely Jewish thing to do, for as Rabbi Sari Laufer writes, in an introduction to a curriculum entitled “Caring for the Soul: A Mental health Resource and Study Guide” produced by the UAHC in 2003, “we ask not only for a refuat ha-guf, healing of the body, but also for a refuat ha-nefesh, a healing of the spirit. For the rabbis, just as for us today, the mind and the body were inextricably inked; in order to achieve wholeness, both must be healthy.”
That being said, helping someone doesn’t mean hiding it and therefore, we have a responsibility to be aware of it, to advocate for help for people, and of course, to take preventative measures if there is a clear and present danger to someone’s health and safety, which could include calling a responsible caregiver, a rabbi, Jewish Family service, and yes, even the police. I understand your concern that asking for help could turn into lashon hara, however, if one is able to use discretion and sensitivity, and speak to the appropriate people, I believe that all involved could handle it well.
It seems that often, in the Jewish community, mental illness is hushed up and not spoken about. Do we have an obligation to report to social services (or elsewhere) a member of our community that we feel needs professional psychiatric help? What is the best course of action to report a member of the Jewish community that seem to be mentally unstable? Should we report this to our community Rabbi, Jewish Family Services, public social services, the police? Where is the line between hurting someone with Lashon hara and helping to prevent tragedies?
In the wake of the shooting of Congresswoman Gabby Giffords, there was much discussion in the press about whether the tragedy could have/should have been prevented if Jared Loughner had been forced to seek mental health treatment or even been forcibly committed. The fact is, while there are legal mandatory reporting requirements for suspected child abuse, there are no such requirements for suspected mental illness. After the shooting, Jeffrey Geller, director of Public Sector Psychiatry at the University of Massachusetts Medical School, and Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute made such a proposal in an article printed in USAToday (http://www.usatoday.com/news/opinion/forum/2011-01-18-satel17_ST_N.htm). However, even in such proposals, the presumption is that the mandated reporters would be health care workers, not the general public.
There is nothing in Judaism that would require someone to report on suspected mental illness in another member of the community. In my opinion, unless you are reporting to the police that you were victimized by this person and suspect mental illness to be the cause, there are few other circumstances under which ‘reporting’ on this person would not be lashon ha-ra. Even among mental health professionals, there is a great reluctance to presume to diagnose mental illness in someone they have not formally examined. For a non-professional to do so would be ill-advised to say the least.
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