Why mental health is an halachic issue

There is a significant halachic discussion regarding writing on a computer on Shabbat. The discussion is two-pronged: Is the usage of electricity on Shabbat a Torah prohibition? Is writing on an electronic screen considered writing on a Torah or even rabbinic level? Both these issues are hotly debated among halachists.

Nevertheless, there are quite a few notable rabbis who believe the answer to both questions is no and would therefore put writing on a computer in the same category as writing with one’s left hand.

In order to apply this information to the case at hand, we must be in a place where we adequately understand the therapeutic reality — but this is a very complex requirement and it should be emphasised that no case is like the other, and it would be impossible to rule clearly for all cases in one fell swoop.

The complexity derives from the fact that in order to apply the above to a specific case, the case needs to be classified as one where the halachah recognises the situation of the specific individual as life-threatening (choleh sheyesh bo sakanah). And if not,  how does one tell the difference between an individual who is mildly suffering and one who is suffering more significantly, to the extent that the halachah would consider him “unwell”?

These questions have never been properly answered in the field of mental health and still lack clear definitions in our halachic literature.

To further exacerbate the issue, even a therapist cannot, at times, offer a clear diagnosis. While the end result of biological hazards and diseases can be fairly well-predicted, there is a large grey area when it comes to mental health. Indeed, many of those to whom I have given one leniency or another over the years, have felt guilty after the fact: “Did I really need the leniency? In the end I was fine! Maybe I never really needed it?”. It is always impossible to know “what if” and this compounds the issues already mentioned.

Luckily, the halachah teaches us that safek pikuach nefesh (chance of a danger to life) is as pikuach nefesh itself. In other words, we do not need to know that the individual in question is definitely in a life-threatening situation, only that he may be, that his reality is statistically relevant as far as we are concerned.

While therapists are reluctant to give any guarantees about their patients, they are certainly able to discuss probable developments in an individual patient’s wellbeing, based on their history and personality. This opens up the possibility for rabbis to give a “halachic diagnosis”, following the professional one.

I do not have room here for detailed explanation of how I reached the following conclusion, but after much deliberation (on both halachic and professional levels) I would say that the following individuals are considered high-risk, enough that they may violate Shabbat even when a Torah prohibition is involved, if it helps to alleviate what they are going through:

l Anyone who feels a strong tendency to commit a suicidal act then and there, and knows that if he does not engage in other things there is a chance he will indeed do so.

l Anyone who has a past of suicidal attempts, and now feels that an active suicidal thought (meaning: involving a specific plan of how to go about it), is beginning to plague his thoughts again.

l People with disorders whose suicide rates are higher than five per cent and active suicidal thoughts begin to plague their thoughts.

l A person who has a past of psychotic illness, or a past of psychiatric hospitalisation due to a psychotic illness, and is now experiencing symptoms that from past experience indicate deterioration in this direction again.

l A person who has a history of self-harm  and is now experiencing symptoms that from past experience indicate a deterioration in that direction again.

l Additional situations which are harder to quantify, such as harder cases of depression.

In such cases, it should be clearly and unequivocally stated, that journalling is absolutely allowed, no questions asked.

Those who are engaging in it, should not feel guilty for violating Shabbat — it is as much a necessity for them as it is to save someone from drowning on Shabbat. They must focus on their wellbeing and know that they are doing the only thing they can do.

For those who don’t fall into these categories, but suffer significant functional impairment as a result of their mental situation (for example: not being able to function around the house, go to work etc ), they may be allowed to do things that are a rabbinic prohibition on Shabbat, but not a Torah prohibition (examples of which were previously discussed).

To me the most important takeaway from this is that those who are struggling with these issues should be encouraged to turn to their Orthodox rabbi and ask the question. The answer to their specific situation is out there – we just need to make sure it reaches its destination.

Rabbi Rosensweig is the founder of the Ma’aglei Nefesh Centre for Mental Health in Israel. He is currently on a speaking tour in London arranged by the Senior Rabbi’s Office of the S & P Sephardi Community. For details, see seniorrabbi.com/rabbiyoni