Improving mental health knowledge of the Charedi Orthodox Jewish Community in North London: A partnership project.

INTRODUCTION: This article describes a successful community-based partnership project between statutory and third-sector services targeting the strictly Orthodox Jewish community (OJC). METHODS: The City and Hackney Black and Minority Ethnic (BME) Access Service (East London NHS Foundation Trust (ELFT)) collaborated with Bikur Cholim, a local third-sector organisation based in the heart of a north London Charedi OJC, to develop a brief culturally tailored psychoeducational group intervention focusing on mental health promotion and prevention. In total, 34 carers in the Charedi OJC were provided with general information on mental health, the availability of support services and self-care. RESULTS: Overall improvements in well-being, increased intentions to access services, particularly talking therapies, and qualitative feedback indicated that the group was very well received. CONCLUSION: The project endorses the value of culturally relevant psychoeducation, enabling suggestions for culturally appropriate service development.

Pastoral care of mental illness and the accommodation of African Christian beliefs and practices by UK clergy.

Faith-based organisations, especially those related to specific ethnic or migrant groups, are increasingly viewed by secular Western government agencies as potential collaborators in community health and welfare programmes. Although clergy are often called upon to provide mental health pastoral care, their response to such problems remains relatively unexamined. This paper examines how clergy working in multiethnic settings do not always have the answers that people want, or perhaps need, to problems of misfortune and suffering. In the UK these barriers can be attributed, generally, to a lack of training on mental health problems and minimal collaboration with health services. The current paper attempts to highlight the dilemmas of the established churches' involvement in mental health care in the context of diversity. We explore the inability of established churches to accommodate African and other spiritual beliefs and practices related to the etiology and treatment of mental health problems.

Locating the Social Origins of Mental Illness: The Explanatory Models of Mental Illness Among Clergy from Different Ethnic and Faith Backgrounds.

Clergy have historically provided 'healing' through various spiritual and medical modalities and even in modern, developed welfare economies they may still be an important help-seeking resource. Partnerships between religion and psychiatry are regularly advocated, but there is scant research on clergy explanatory models of illness. This paper aimed to explore their relationship with psychiatry and to examine how clergy in various faith groups conceptualised mental health problems. In this qualitative study using in-depth interviews, these issues were explored with 32 practising clergy in the UK from a range of different Christian, Muslim and Jewish faith organisations and ethnic backgrounds. This paper presents findings related to clergy explanatory models of mental illness and, in particular, how the social factors involved in causation are tinged with spiritual influences and implications, and how the meanings of mental distress assume a social and moral significance in distinctive localised matters.

The mental health benefits and costs of Sabbath observance among Orthodox Jews.

This study aimed to examine the perceived psychological costs and benefits of Sabbath (Shabbos) observance among 13 practising Jews, 9 UK residents and 4 US residents. Emerging themes were as follows: Shabbos as a special day, giving time to contemplate on profound issues, withdrawal and rest from mundane concerns, and deepening relationships. These aspects can potentially improve feelings of mental well-being, and were indeed often said to do so. Some difficulties were described: some found they were prone to worry more on Shabbos because of the freedom from distractions, and there were reports of the difficulties of explaining to non-Jewish work colleagues the religious need to be free from work commitments. These findings were related to the literature on religious ritual observance and generally accord with other work in anthropology and psychology of religion examining the psychological impact of ritual. Work on the mental health implications of ritual observance needs to be expanded. It has received only limited attention, and understanding has been constrained by a misleading confusion between ritual and obsessionality. Other impacts of religion on mental health are better documented and understood, and religious ritual and its impact needs further documentation and attention.

Mental health and mental health care for Jews in the Diaspora, with particular reference to the U.K.

BACKGROUND: Suggestions are examined with regard to psychiatric epidemiology among Jews: raised prevalence of depressive disorder in men, low prevalence of alcohol related disorders and suicide, higher prevalences of obsessive-compulsive disorder and psychosis. METHODS: Demography, psychiatric epidemiology, service provision, use and barriers to use are described in the U.K., with brief comparison with other Diaspora communities. RESULTS: Prevalence of depression may be as high among Jewish men as among women. Prevalence of anxiety, alcohol abuse and suicide may be low by world standards. No clear picture emerges regarding oCD, psychosis and other disorders. Barriers to treatment seeking include stigma and mistrust. LIMITATIONS: there are inadequate data with respect to many disorders, service uptake, and the effects of religiosity. CONCLUSIONS: there is scope for more research on a range of issues, including psychosis, eating and childhood disorders, anxiety and depression, and service use. Risk factors include anti-Semitism. Protective factors include family stability, social support and religion.

The role of religious fundamentalism in terrorist violence: a social psychological analysis.

This paper examines the social-psychological factors often implicated in discussions of terrorist violence/martyrdom, with a particular focus on the role of religion. We offer a brief description of the psychological theories underpinning terrorist research before focusing on social-psychological factors. The roles of psychopathology, irrationality and grievance/threat are examined, followed by empirical research on the beliefs which have been associated with the perpetration and support of terrorist violence, and the social factors which foster those beliefs, including social identity, socially carried interpretations, group leadership and individual differences. Although religion is not a single, simple causal factor in terrorist violence, religious elements often feature strongly in the belief systems associated with terrorist violence, and can also feature in other important fostering factors for terrorist violence, such as the use of rhetoric. Finally, the status of lay explanations of terrorist violence, focusing on the role of religious fundamentalism is examined.

Challenges to sanctuary: the clergy as a resource for mental health care in the community.

The transfer of psychiatric care from the institution to the community has presented community structures including faith-based organisations (FBOs) with an additional burden of care. In recent years there has been an increasing policy interest among government departments, public and non-statutory agencies for the inclusion of FBOs as partners in health and welfare services. However, despite their long historical involvement in healing and healthcare, clergy are seldom viewed by mental health professionals as partners in healing and restitution but with suspicion [Koenig, 1988. Handbook of Religion and Mental Health San Diego: Academic Press; Larson, Hohmann, & Kessler, 1988. The couch and the cloth: The need for linkage. Hospital and Community Psychiatry, 39, 1064-1069]. This may be compounded by ignorance about mental health care provision within FBOs in the UK and the preparedness, confidence and willingness to undertake such care. This paper is based on a study which examined clergy contact with people with mental illness. Thirty-two interviews were conducted with male clergy (Christian ministers, rabbis, and imams) most of whom were London-based. We examine barriers and dilemmas for clergy in caring for people with mental illness. We found that they play an important but often confined role the scale and impact of which is not recognised by their central organisation and training bodies. Low confidence about managing psychiatric problems, underscored by anxiety, fear and stereotyped attitudes to mental illness restrain their willingness to formalise their function. We argue that any proposed extension of clergy involvement in mental health will require further research and thorough deliberation by mental health services and religious organisations.

Culture-sensitive counselling, psychotherapy and support groups in the Orthodox-Jewish community: how they work and how they are experienced.

BACKGROUND: There is political and scientific goodwill towards the provision of culture-sensitive support, but as yet little knowledge about how such support works and what are its strengths and difficulties in practice. AIMS: To study groups offering culture-sensitive psychological and other support to the strictly orthodox Jewish community in London. METHODS: Semi-structured interviews with service providers, potential and actual users from the community, and professionals serving the community. Interviews asked about the aims, functioning and achievements of 10 support groups. RESULTS: Thematic analysis identified seven important themes: admiration for the work of the groups; appreciation of the benefits of culture-sensitive services; concerns over confidentiality and stigma; concerns over finance and fund-raising; concerns about professionalism; the importance of liaison with rabbinic authorities; need for better dissemination of information. CONCLUSIONS: The strengths and difficulties of providing culture-sensitive services in one community were identified. Areas for attention include vigilance regarding confidentiality, improvements in disseminating information, improvements in the reliability of funding and attention to systematic needs assessment, and to the examination of efficacy of these forms of service provision.

The suicide beliefs of Jews and Protestants in the UK: how do they differ?

It has been suggested that Protestant culture has become more tolerant towards suicide in the previous century, while Jewish culture has traditionally not condoned suicide. There have been reports that suicide rates are somewhat lower among Jews than among people of Protestant background. We asked whether there were differences between Jews' and Protestants' beliefs about suicide that might relate to these suggestions and reports. Beliefs about suicide were assessed from the Reasons For Living Inventory (RFL), and with questions about the acceptability of suicide in some circumstances. Self-reported suicide ideation and attempts were also assessed. Some religious-cultural differences were found in beliefs about suicide, but not with regard to ideation and behavior. We discussed the relations between differences in belief, and reported differences in suicide prevalence, and suggested that most of the belief differences were consistent with reported patterns of prevalence. Notably, Jews believed more strongly than Protestants that moral-religious objections to suicide were reasons for living, and that suicide was less acceptable in certain circumstances.

Beliefs about alcohol among UK Jews and Protestants: do they fit the alcohol-depression hypothesis?

BACKGROUND: Some research has suggested that Jews drink less alcohol than other cultural groups, and may have different beliefs about its use. Differences in beliefs about alcohol, and different patterns of use, may play a role in accounting for cultural and gender variations in depression prevalence. Alcohol may act as an escape route from depression, thus deflating depression rates in certain groups of people, in particular, men from Protestant backgrounds. METHODS: Self-reported use and beliefs about alcohol were assessed in a UK sample of 70 Jews and 91 Protestants, including non-practising people of Jewish and Protestant background. The effects of religious group and of gender on measures of alcohol behaviour and beliefs were examined. RESULTS: Some differences were found between Jews and Protestants. Jews had less favourable beliefs about alcohol and drank less than Protestants. More importantly, and in line with our hypotheses, there were gender differences in Protestants but not Jews with respect to some beliefs about alcohol and actual use of alcohol. CONCLUSIONS: The study goes some way in supporting the notion that religious-cultural and gender differences in beliefs and behaviour towards alcohol may contribute to religious-cultural and gender differences in rates of depression.

Faith conquers all? Beliefs about the role of religious factors in coping with depression among different cultural-religious groups in the UK.

How effective is religious activity believed to be in coping with depression? This study assessed the perceived effectiveness of different religious activities - previously identified as important in coping - among 282 people in the UK. The mean age was 25 years, and participants were either Christian, Hindu, Jewish, Muslim, other religion, or no religion. Relative to other kinds of help for depression, religious activity was not seen as particularly helpful for depression. Religious activity was seen as less helpful by the ever-depressed than by the never-depressed and as less helpful by women than by men. Among religious activities, faith and prayer were seen as the most helpful. Muslims believed more strongly than other groups in the efficacy of religious coping methods for depression, were most likely to say they would use religious coping behaviour, and were least likely to say they would seek social support or professional help for depression. Other differences between groups were also observed, and comparisons with qualitative material obtained in an earlier study were made. The implications of these findings for help-seeking are considered.