In my privileged position as both a community rabbi and a clinical psychologist, I am often entrusted with the inner workings of others’ lives.
This can mean sharing in someone else’s good fortune, joy and light. Frequently, however, it means witnessing another person’s distress and darkness. One of the most painful experiences is to watch unnecessary suffering. The question that haunts these interactions is whether this pain could have been avoided; if things had been different for this person at home, at school, at shul, at their youth club, in their society — could this brokenness have been prevented?
Current social systems appear to only address problems when they present themselves or become obvious. That sort of reactive approach might be appropriate for an unexpected emergency — a car crash breaks a leg which needs repair, or a person is diagnosed with cancer that needs treatment. An otherwise healthy and safe life is attacked by a hardship that needs an appropriate response.
However, as the data accumulates in the area of mental health and wellbeing, we see that the car journey itself is perilous, that the cancer is already spreading.
A recent review of evidence from Public Health England states that mental health problems are the main cause of years lived with disability. One in four adults and one in 10 children are likely to suffer from a mental health problem in any year. People with severe mental health problems die 15-20 years prematurely. Critically, 70 per cent of children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age. In truth, before the Covid-19 pandemic came about, we were already in the throes of another – mental health – pandemic.
While the mental health pandemic has a massive economic cost — 70 million work days are lost each year because of poor mental health, costing the UK economy from £70 billion to £100 billion per annum (approximately a third of the cost of the entire UK Covid-19 response) — the human cost is even more staggering. Families ripped apart, relationships destroyed, the perfect skin of youth mutilated with the criss-cross patterns of self-harm.
Inevitably, the scars of intense distress leave a damaged imprint on a person’s psyche for years to come. We walk around in a society of broken minds and broken hearts.
The robust efforts to combat and stem the death toll from the coronavirus pandemic provide an excellent example of societal innovation and coordination. So too we must meet the challenges of our psychological darkness. Currently, we are inoculating the population to make immune systems more resilient and capable of dealing with the virus. Translating that into mental health terminology leads us to wonder: how do we vaccinate against extreme sadness, worry and strife?
Prevention and early intervention projects seek to make a change before difficulties develop or become too advanced. They may include parenting workshops to understand attachment, support groups for teens navigating the competing demands of a constantly changing world, working with employers to improve the healthfulness of workplaces, supporting carers to manage ageing with dignity – and so much more.
At their best, such projects could innovatively offer culturally sensitive interventions applicable to groups across the community spectrum (young people, parents, teachers, community leaders) and along the lifespan of individuals.
In so doing, the intervention becomes bigger than just the specific content of the therapeutic material; the process of talking about mental health, wellbeing and a more deeply wholesome existence brings the issue into social consciousness.
The topics of Shabbat morning conversations have recently ranged from Brexit to Labour Party antisemitism to coronavirus, furlough and “which vaccine did you have?”. Imagine if we were preoccupied in our small talk by discussing the steps we took during the week to learn something new, develop our wellbeing further or expand ourselves. A community within which such sharing discussions could be held would be a remarkably more resilient place.
The concept of early intervention and prevention is not a new one. Even in the Talmud, the sages of millennia past coined a phrase — “Makdim refuah l’makkah” — that God arranged the remedy in advance of the possible wound.
As a nation we have always been at the forefront of social action, visionary leadership and mutual responsibility. It is time for us to build on the excellent work that existing community organisations do to mitigate mental health problems. I would like to invite interested parties to join together with me in a conversation that will begin to chart a co-ordinated, proactive plan to help our community be as healthy as it can be.
Let’s change hearts and minds. Let’s shine a little more light. Let’s change the world.
To express interest in joining this project, email: rabbidrsamuellandau@gmail.com.
Rabbi Dr Samuel Landau is Rabbi of Barnet United Synagogue and a clinical psychologist in the NHS and private practice
