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January 23, 2009
Inclusion helps fight stigma
Report addresses needs of mentally ill community members.
SUSAN J. KATZ
Homelessness and mental illness, we see them linked in the media regularly these days. In order to assess the needs of people with mental illness in our community, a report was commissioned by the Jewish Federation of Greater Vancouver and the Vancouver Yaffa Housing Society, with funding from the Jewish Community Foundation.
According to the 2008 study, there are approximately 1,250 Jewish people in Greater Vancouver, or approximately four to five per cent of the population, living with serious and persistent mental illnesses. These people struggle every day to find solutions, recovery, community and a roof over their heads. They are not all strangers who stand anonymously on a street corner on the Downtown Eastside: they are our relatives, friends, colleagues and ourselves.
According to the report, another 10 per cent of us will struggle with varying levels of mental illness sometime in our lives, which may not put us on the street, but will impair our ability to work or function.
Finding help and relief has always been challenging for people with mental illness. Stigma, the discrimination to which people with mental illnesses are subjected, is the biggest impairment to getting funds for the combination of medical, social and spiritual services mentally ill people need to support themselves during recovery.
The most damaging effect of stigma is the separating out or exclusion of people with mental illness from community activities and services, which results in confusion of who people with mental illnesses are and what their needs may be. One mental health consumer interviewed said, "I always thought of myself as 'genetically' Jewish because of my family background, but I always felt out of place and different when I tried to be involved in Jewish activities. I almost felt anti-Semitic, because of how bad that made me feel."
Dr. Robin Friedlander, a Vancouver psychiatrist, said, "Mental illness is one of the great unspoken stigmas of the 20th century. People think somehow it's your fault if you have a mental illness, but having a developmental disability is not your fault. It's a shame, they think you are lazy, but after having a diagnosis, family members have more understanding."
Friedlander got involved with mental health housing in the Jewish community after providing his services to clients at a Christian fellowship group home in Richmond, which had several Jewish clients. He said the families there were actively involved, and he wanted to look into housing options for the Jewish community. He is currently the psychiatric consultant for the Vancouver Yaffa Housing Society, which provides housing for Jewish adults with mental illness.
Yaffa House, a group home with a capacity for up to five residents, is currently the only housing option in the Jewish community for Jewish adults with a mental illness. This will increase by five more units when the city's project at 17th Avenue and Dunbar is completed in 2010.
Where do the 1,240 other people live? Some are fortunate enough to have relatives who help them find shelter. According to Federation's report, some members of Jewish Family Services Agency's Bagel Club live at Worthington House and Cascadia community home, which have supervised care but are not Jewish, or at non-supervised housing options, such as B'nai B'rith.
Many people live in family homes, group homes, transitional shelters and couch surf with friends and relatives while waiting for a housing placement. Of those interviewed in the report, housing was consistently ranked as the biggest need in the community for people with mental illness.
The lives of those without family or community ties is full of instability, getting bounced around from service to service, never quite getting the right fit. Another problem, for those with mental illness who are living independently, is expressed by a Vancouver businesswoman who declined to be named due to fears that the stigma would be detrimental to her business reputation: "What I worry about is where I will live when I am too disabled or elderly to work."
This statement expresses the fact that housing is not a one-size-fits-all issue. Marge Johnson has an adult son with mental illness, but his level of needs do not fit the level of care at Yaffa House, so he divides his time between a private apartment and Riverview Hospital. Johnson would like to see the community provide respectful care as the priority, regardless of the degree of religious practice in the residence.
In addition to housing, JFSA provides some relief for people in the form of financial assistance and programs, such as the successful Canes EnAble and Bagel Club programs. Their counselling department, however, does not staff a psychiatrist and does not provide counselling or treatment services for adults or youth with mental health issues. According to the Vancouver businesswoman, "JFSA has a good sliding scale, but I couldn't afford it. They helped me with funds for prescriptions and they wanted to help me move, but I was emotionally unable to do it."
According to Friedlander, "It's a crazy system because the peak need is at 19-20 years old; that's the time the child service transitions to adult and the support system is weak at this stage of greatest need." He would like to see early intervention programs in the community for teens aged 15-25 who are at risk for developing mental health crises. The unnamed businesswoman would like to have support groups and programs that are designed for adults with a higher level of ability.
Bat-Ami Segal, who has both an adult daughter and a granddaughter with mental health needs, has seen a dramatic increase in Jewish community support over the last 20 years. Segal said in an interview, "Kudos to some separate programs of the JFSA, such as the Bagel Club," but, she added, "There is still a definite need to be really inclusive of people. We're good at singling out needs in a disability group. I would like to see more inclusion of people in groups. They are part of the fabric of community. I know some [people with disabilities] are most comfortable with other people with disabilities, but there needs to be the option to be included." Segal said she gets the support she needs as a member of her synagogue, Or Shalom, and other agencies, but still, because of the social awkwardness caused by stigma, she cannot bring her daughter to the community activities she attends.
A hopeful beginning towards solutions to these wide-ranging issues is the recent creation of a new mental health outreach worker position, thanks to a donation to JFSA by the Morley Greene family. In this new part-time role, Charles Leibovitch, who is also the part-time mental health support worker for Yaffa House, has been networking and creating community among Jewish consumers and their supporters. In addition to identifying and attending to the needs of individuals, Leibovitch also runs a caregiver support group and has a community Kabbalat Shabbat and dinner program every month at Yaffa House.
In the Federation report, service providers ranked some of the unmet needs of community members with mental illness: housing, outreach and inclusion in Jewish holidays and culture, community mental health education through speakers in synagogues, parent support programs, peer counselling, cheap kosher food, paid work and accessible classes in Hebrew and Jewish studies.
Susan J. Katz is a Vancouver freelance writer.
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