Orthodox Mental Health Needs Not Being Met: Study

As stigma against treatment lessens, population remains largely underserved.

Eliezer Schnall

More Jewish Options For End-Of-Life Care

Rabbi Charles Rudansky, director of pastoral care at Metropolitan Jewish Hospice.

Metropolitan Jewish’s acquisition of two hospices may bring palliative approach to more families.

Pumping Iron For The Payes Set

David Lowey hits the elliptical and studies the Talmud at Green Fitness. Sharon Udasin

Tuesday, May 18, 2010

Sharon Udasin, Staff Writer

Taking a mid-afternoon break from running his busy Williamsburg restaurant, David Lowey hustled over to a new Bushwick gym and hopped on an elliptical machine, pedaling vigorously in his full Satmar regalia.

Tzitzit dangling from his black pants and payes swinging over his ears, the 290-pound 26-year-old breathed heavily, as he scrolled through the day’s Daf Yomi Talmud page online, from a touch-screen computer panel in front of him.

When he began working out three months ago, Lowey was the lone Satmar member of Green Fitness Studio, an eco-friendly gym that opened in December and serves a primarily hipster clientele.

But with Lowey, who has already lost 60 pounds, leading the way, more than 100 members of his community now work out at Green Fitness, some in their three-piece formal wear, others sampling the gym’s complimentary sweats.

“I pushed them a lot because I feel there’s a need in the chasidic community for [exercise] — the obesity problem is overwhelming,” Lowey said.

Green Fitness Studio is not the only Williamsburg-area gym where chasidic Jews now exercise alongside hipsters. Soma in Williamsburg also has a chasidic clientele. And fitness-minded Satmars and hipsters also interact over a shared interest in cycling, at Baruch Herzfeld’s Treif Bike Gesheft bike shop in Williamsburg.

With hipsters and chasidim living within blocks of each other, “there’s a much greater intermingling of cultures and interests than we’ve been trained to expect,” Herzfeld said. “There are chasidim who do triathlons. There are many chasidim who have outside interests that would surprise us.”

While Green Fitness Studio’s owners Allan Lewis and Barry Borgen are both Jewish, outreach to the chasidic community was not part of the initial business plan. Instead, the focus for the new venture, which joins just a few other trendy new locales a couple blocks from the Morgan Avenue L-train

Allan Lewis, Lowey's personal trainer and co-owner of Green Fitness.

stop, was on eco-friendliness.

Aside from its regular LifeFitness treadmills — which are actually refurbished secondhand units — Lewis said that Green Fitness’ other equipment is entirely self-powered, and the spinning studio features flooring made of bamboo, which grows much faster than most wood and is considered a more renewable resource.

While chasidic Jews were initially below the owners’ radar, when Lowey rented the gym’s outdoor atrium to host a benefit and his fascinated party guests ventured into the empty gym, shedding their fedoras and testing out the bodybuilding equipment for themselves, Lewis and Borgen had an idea — why not invite these guys to join the gym?

There were a few stumbling blocks, however.

“Men and women don’t like to work out together,” Lewis told The Jewish Week last Thursday, sporting a tank top over his multitude of tattoos.  Continue reading…

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Vacation In Israel, Come Home Cured

Patients consult with a doctor in the waiting room of Assuta Medical Center in Tel Aviv, which has become one of many Israeli hu

Sharon Udasin, Staff Writer

Wednesday, May 5, 2010

Rachel and her partner had been contemplating artificial insemination for years, but they didn’t actually go ahead with the process until Rachel came to Jerusalem from New York for a one-year teaching fellowship. After some encouragement from another couple that had gone through the process, the decision was clear: they would create their child in Israel, at Hadassah Medical Center in Mount Scopus.

“I wanted a Jewish donor who lives and serves in Israel, and has his family living there, so that if my child ever wishes to search for the donor someday, my child will be led to Israel, which is religiously and ideologically important to my wife and me,” Rachel told The Jewish Week, asking that her real name be withheld for privacy. “Israel is renowned for its fertility treatment, and they don’t play around. They want and plan to get you pregnant as soon as possible, without dragging it out to make more money off of you like they do in the U.S.”

After five trials of regular intrauterine and intracervical insemination, and the assistance of the Gonal-F fertility drug, Rachel, now 14 weeks pregnant, finally conceived at one-fourth to one-fifth of the cost of a similar process in America.

Israel has seen a surge in medical tourism for various procedures in the past few years, yet thus far, experts say that the clientele remains largely concentrated among former Soviet countries and some African nations, where treatment facilities are still inadequate. But in recent years, Israel has begun to broaden its reach to couples like Rachel and her partner, slowly attracting customers from Western European countries and North America. While the medical care in Israel equals or even sometimes exceeds that of the United States and Western Europe, the cost of procedures remains significantly cheaper.

“Medical tourism in Israel has been around for about 17 years, but only in the last year or two has it become part of the Ministry of Tourism’s agenda, the Ministry of Finance’s agenda,” said Ira Nissel, CEO of International Medical Services (med-international.com), which has been guiding medical tourists through Israel for five years — reviewing pathologies and consulting multiple specialists. “We’re trying today to put Israel on the map. But in comparison to India and Costa Rica, the prices are a far cry from what you’d expect there.”

The quality of medical care in Israel, combined with an ideal vacationing environment, is drawing more patients to visit Israel for their procedures — most commonly for oncology, cardiac and in vitro fertilization procedures, according to Nurit Agiv, medical tourism executive at Assuta Medical Center in Tel Aviv. Residents of former Soviet countries, she noted, can easily visit Israel for these procedures because they no longer need a visa to travel there.

“A lot of the doctors had their fellowships here in the United States,” Nathalie Steiner, vice president of marketing at a new medical tourism initiative called Global Health Israel (globalhealthisrael.com), a subsidiary of her father Moshe Steiner’s larger medical equipment distributor, Israel Scientific Instruments, told The Jewish Week during a recent visit to New York. “And compared to India and Costa Rica, you can go out and eat at a lot of good restaurants — it’s a Western culture here.”

Steiner, who is limiting the focus of her fledgling company to IVF procedures for now, aims to target American insurance companies, self-insured private companies and uninsured Americans, who might enjoy the added benefit of a vacation in Israel. Nissel, who says his company has been bringing in patients for IVF treatment for years, estimates that between 85 and 90 percent of these tourists are from former Soviet countries, where IVF is often unavailable, as opposed to Israel, where women can undergo the procedure through age 42.

“You are not sick when you have IVF, so you can enjoy the country,” Steiner said, noting that IVF treatment in most Israeli hospitals will cost tourists approximately $4,000, about a third the cost in the U.S. And while in Israel, tourists can rely on companies like hers to arrange airport transportation and accommodations.

The lighter financial burden can be a huge attraction.

“It’s not the bargain rate of India, but it certainly has a top-notch medical system,” said Laura Carabello…   Continue reading…

Cuts Could Hit Autism Programs

Shining A Light On Older Teens With Autism

Dr. Fred Volkmar discussed the challenges in working with young adults with autism at recent conference here. Michael Fine/UJA-F

In the last 10 or so years, autism has exploded into the national consciousness. For parents with young children, the terms “autism spectrum disorder” and Asperger’s syndrome have become part of a new vocabulary to describe children who seem withdrawn, uncommunicative, anti-social or slow to pick up on social cues.

While the vast majority of the attention given to autism has focused on very young children, teenagers with the condition who have to navigate the difficult transition into adulthood seem to have received short shrift. For them, the passage can be a particularly trying time, as they struggle to achieve academically, adapt socially and excel in new careers — independent from the arms of the local school districts that oversee their care until age 21.

To shine a light on this underserved population, UJA-Federation of New York convened an autism symposium on April 22 that focused on adolescents emerging into young adulthood with a wide range of spectrum disorders, and how the community can better respond to meet their growing needs. The diagnosis rate of autism has surged in the past couple of years, rising from approximately 1 in 150 in 2007 to 1 in 110 in 2009, according to a Center for Disease Control journal publication presented at the conference by Marshalyn Yeargin-Allsopp, medical epidemiologist and chief of developmental disabilities at the CDC.

But research on the disorder has thus far focused primarily on children, leaving those who are striving to become independent young adults largely out of the picture.

“Sometimes in adolescence kids take off for the better; sometimes kids take off for the worse,” said Dr. Fred Volkmar, director of the Yale Child Study Center and a speaker at the conference. He laments the lack of resources that focus on autistic young adults. “This is unfortunate because this is often the group of people that want help the most.”

The conference stemmed from the UJA-Federation’s ongoing effort to promote research and community action for people with mental disabilities. In recent years the charity has poured about $7 million into the effort, channeling money from its Caring Commission to agencies such as the Jewish Childcare Association, the JCCs of the Greater Five Towns, Manhattan and Mid-Westchester, the Riverdale Y, the Samuel Field Y, the Sid Jacobson JCC and Westchester Jewish Community Services, among others. The money began flowing after a federation-sponsored study in 2006 analyzed the recent increase in autism cases and the impact of the disorder on the Jewish community. Agencies were then asked to develop programs to meet the growing need.

“A lot of our work has been focused on those young adults with autism who are not eligible and for whom there is no special funding,” said Anita Altman, deputy managing director of government and external affairs at UJA-Federation, who works with city and state governing bodies to bring public funds to the programs. “There’s very little money that goes into these kinds of services.”   Continue reading…

Orthodox Compulsive Disorder?

“You see a lot of compulsive behaviors with the intention of undoing something that has been done wrong,” said Dr. Jeff Szymanski, the executive director of the International OCD Foundation. “I have to repeat it until it’s done perfectly.”

by Sharon Udasin
Staff Writer

‘Mr. A” is a 43-year-old chasidic man who is so afraid to make mistakes in his daily prayers that he cannot bring himself to get out of bed until noon or 1 p.m. The reason? Obsessions he’s faced since his days in yeshiva, when he was consistently the last person to finish praying each morning.

“He thought he was just more religious than everyone in the class,” said Dr. Steven Friedman, a professor of clinical psychiatry at SUNY Downstate, who was addressing a group of fellow therapists. “Patients who have religious obsessions often don’t recognize or admit that they have symptoms.”

Friedman was speaking to a group of 30 therapists — at least 20 of them Orthodox Jews — who had gathered for a three-day conference this week at SUNY Downstate Medical Center in Brooklyn sponsored by the Behavior Therapy Training Institute of the International Obsessive Compulsive Disorder Foundation. While the Institute holds about three of these meetings annually, this was the first conference tailored specifically to the needs of Orthodox Jewish therapists, who had been unable to attend regular Saturday programming.

Sessions last weekend were largely the same as any other Behavior Therapy Training curriculum, aside from Friedman’s Sunday afternoon lecture about “Religious Scrupulosity,” which targeted obsessions and compulsions rooted in Jewish ritual. In addition to discussing these specific behaviors and treatment techniques, the doctors focused on the unwillingness of many Orthodox Jews to even seek treatment, in a community where mental health issues are somewhat taboo.

“You can speak Yiddish like I do and you’ll still find that that won’t get you access to certain populations,” Friedman said. “Since the community is so small, most of them you know and it’s one degree of separation. If you give me the name of an Orthodox person in the United States, I can find someone who knows something all about them.”

“This is problematic when you do therapy,” he added.

OCD is a genetic disorder that equally affects men, women and children of all backgrounds, typically appearing between the ages of 10 to 12 or in late adolescence or early adulthood, according to the Foundation. On average, OCD inflicts 1 in 100 adults and 1 in 200 kids and teens, amounting to about 2 to 3 million adult cases and 500,000 childhood cases in the United States alone. Because OCD runs in families, there is a 15 percent chance that a patient’s child will also exhibit OCD, though not necessarily in exactly the same form, Friedman explained. For example, he said, a parent might be an incessant hand-washer, while the child might become a compulsive checker.   Continue reading…

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This article was also reposted on the blog FailedMessiah, and has many interesting comments below it.

Also reprinted on VosIzNeias, with additional comments.

Mumps Spreads To New Communities

by Sharon Udasin

A mumps outbreak in the Orthodox community, which began last summer, has spread beyond Williamsburg and Borough Park to include scattered incidents in Crown Heights, Brooklyn, and Far Rockaway, Queens, city Health Department officials say.

Far Rockaway pediatrician Dr. Hylton Lightman told The Jewish Week that he has seen about 20 mumps patients, most of them men between 17 and 23, as well as four or five girls and two mothers. Among his patients is a staff member at the Bnot Shulamith Elementary School in Woodmere, L.I.

Of particular concern to some doctors is that the age range of patients — who remain 80 percent male — now includes an older population of young adults, many of whom misplaced their immunization records after graduating high school, according to Dr. Jane Zucker, assistant commissioner for the Department of Health and Mental Hygiene. In the affected communities, 70 percent of children under 18 have received their two immunization dosages, but for young adults statistics remain unclear.

“People who are not vaccinated have a higher rate of complications,” Zucker said. “We want people who don’t know their status to go and get vaccinated.” This week, the Department of Health will host free vaccination clinics in Borough Park and Williamsburg with Jewish organizations.

The total of New York City cases has risen to 909 as of Feb. 8. Outside the city, the state now accounts for a total of 928 cases, with 317 occurring in Rockland County and 611 in Orange County as of Feb. 10, according to State Department of Health Spokesman Tom Allocco.

The most common symptoms of the mumps are fever, muscle aches and parotitis, the signature inflammation of the salivary glands below the ear. Rarer side effects can include meningoencephalitis (inflammation of the brain) and pancreatitis, which can cause abdominal pain and vomiting.

Original version here.

Cross-training The Body

by Sharon Udasin

For Caroline Kohles, cardiovascular fitness is a vital part of both her career and her personal life. Kohles, 48, has been the Health and Wellness fitness director at the JCC in Manhattan since it opened in 2002. Both an athlete (she has participated in triathlons) and a dancer, she is known for her combined emphasis on mind and body in every workout, a trademark that specifically comes to life in her work as a Nia martial arts trainer and black belt teacher. In April, she says, the JCC will be hosting a free multi-sport triathlon symposium.

What stands out for you when training fellow Jews at the JCC?

“Jewish people tend to want their workout to make sense – there is an intellectual component to working out. They don’t want to just do it for the sake of doing it – they want to do it because it makes sense to their livelihood and their spirit and their intellect, knowing that by taking care of their bodies they’ll be able to do other things in their life.”

Does cardiovascular training at the gym translate well to outdoor settings?

“The trick with training is what are you training for? … If it’s heart health, then you want to have a component of cardiovascular fitness. The great thing about cardiovascular fitness via triathlon training is that you cross-train the body…Triathlon training appeals to such a wide variety of body types that we find people who are all ages, shapes, sizes and genders doing triathlon training.”

How do you help JCCers to prepare for the New York City Marathon?

“For the Marathon we ran a program where we showed a film, and we had a running coach, a chiropractor that specialized in sports and running injuries, a nutritionist that specialized in running and triathlons and a massage therapist that specialized in training. … When we’re talking about heart rate and cardiovascular training specifically, there’s an opportunity for education to happen. There’s an opportunity for people to understand, ‘Wow, my heart rate is different everyday — and why wouldn’t I pay attention to that and adjust my workout accordingly?’”  Continue reading…

The Health Burden Of The Survivors

by Sharon Udasin
Staff Writer

For Jews who escaped Europe during the Holocaust and settled in Israel, the Jewish state really was a kind of Promised Land. Yet from a health perspective, the young
country couldn’t immunize them from the physical and mental burdens they carried with them.

In fact, Europeans who immigrated to Israel after the Holocaust were 2.4 times more likely to develop cancer than those who arrived before the war, according to a recent study published in Journal of the National Cancer Institute.

Researchers at the University of Haifa’s School of Public Health compiled a database of 315,544 Israeli Jews of European heritage born between 1920 and 1945. Lital Keinan-Boker, one of the authors of the study, explained that the data came from the Population Registry as well as the National Cancer Registry. Of the more than 300,000 immigrants studied, 57,496 were born in Europe and immigrated to Israel before or during World War II and did not endure the Holocaust; the remaining 258,048 moved to Israel after the war and had been caught up in the Shoah.

The scientists theorize that the biggest risk factors for these post-war immigrants were prolonged periods of both famine and severe mental stress at an early age. But funding is not yet available to test these hypotheses, wrote Keinan-Boker, who also works for the Israel Center of Disease Control.

“We cannot be sure that all of [the immigrants] were in the camps; some may have been hiding away, some in the resistance movements and some — in the USSR — running away from Poland eastwards,” she said in an e-mail interview with The Jewish Week. “The point is that our information is based on existing databases, not on individual data, and this is why we refrained from using the term ‘Holocaust survivors’; we could not be positive that all of the ‘exposed’ were indeed Holocaust survivors.”  Continue reading…