Israel’s immigrants and the struggle for mental healthcare
With one-third of Israel’s suicides being new immigrants, what does the country do to help?
Since the Israeli Declaration of Independence in 1948, more than 3 million Jews have made aliyah to Israel - immigrated through the Law of Return.
They arrived for many different reasons: to fulfill a Zionistic dream, be closer to family, or create a new life.
Many of these olim (Jewish immigrants) return to their home countries, LiAmi Lawrence, the founder and director of Keep Olim, told i24NEWS.
“More than half of the Americans go back, more than half of the Canadians go back. Forty percent of the French go back, and one-third of the Russians and Ukrainians go back,” he explained.
Keep Olim hopes to help the country retain some of its immigrants with post-aliyah services. From legal aid to advocacy in the Knesset (Israel’s parliament) to placing immigrants with families to feed them during the holidays, Keep Olim aims to make the new lives of immigrants easier while dealing with the difficulties of transitioning to a new country.
We lost too many people
The organization also runs a mental health division, known as Tikva, providing low-cost or free mental health counseling in 15 different languages to those who need it.
Lawrence himself made aliyah in 2014 and explained to i24NEWS that he watched his friends leave Israel, struggle to find work and housing, and generally have a hard time building a life in their new country.
The formation of Tikva, directed by Susan Cohen, came from more tragic circumstances.
“We lost too many people,” Lawrence explained.
A third of all suicides in Israel between 2000 and 2013 were committed by olim, according to a 2015 report by the Knesset Research and Information Center. Lawrence believes that statistic is closer to 40 percent.
Immigrants make up just 20 percent of Israel’s population.
Israel's Health Ministry made a distinction while speaking to i24NEWS, however, saying that only 2 percent of suicides in Israel were new immigrants, and that one third of suicides in the State of Israel are people born abroad in general. This includes immigrants who have been in the country for 10 years, or, in the case of immigrants from Ethiopia, more than 15 years since immigration.
“One of the key ingredients that play a role in suicide ideation is really feeling alone and isolated, and not having a strong social network,” Tanya Prochko of Get Help Israel told i24NEWS.
Get Help Israel provides a database of English-speaking mental health professionals, created “because there was a significant gap in what accessibility English speakers had in mental health.”
Lawrence, Prochko and Cohen, while speaking to i24NEWS, all emphasized the importance of having a therapist or psychiatrist that speaks the same language as the person seeking the treatment.
Despite the high number of immigrants in Israel, that might not always be possible.
“People go to the kupah (healthcare plan) website, looking for an English-speaking therapist. They start working with someone who says that they speak English, but their English is broken, or even if there's a decent English, there is a cultural mismatch,” Prochko explained to i24NEWS.
Finding a therapist who speaks a language such as Russian or Amharic covered by a healthcare plan is even more difficult. Twenty-one percent of suicides were immigrants from the former Soviet Union, and six percent were Ethiopian immigrants, according to the 2015 data.
Therapists who speak English, but not Hebrew, have difficulty getting hired by healthcare services in Israel, Ayala Laub of the Shira Pransky Project explained to i24NEWS.
The Shira Pransky Project focuses on educating and assisting immigrants with access to their health care rights and benefits, helping them understand how to get the best medical care.
A cultural barrier also exists, Laub noted. “The system here looks different than where we came from.”
“In general, the culture, attitude, bedside manner is totally different than many people are used to.”
Laub also said that many people don’t know what their rights are or what types of care they have access to, not knowing where to start in terms of searching for mental healthcare, which makes organizations such as Shira Pranksy necessary.
Waiting too long
Long waiting times for therapists under the country’s four health plans also lead to gaps in accessibility. It takes a minimum of six months to access a therapist, according to both Prochko and Lawrence.
In the case of emergencies, they both noted that Israel’s suicide hotline lacks a comprehensive English option, let alone languages such as Russian, Amharic, French or Spanish.
“I've heard time and time again that there wasn't an English-speaking representative on the other line. You would just be waiting and waiting and waiting, and there wasn't anyone in English,” Prochko said.
Shoshi Eizenberg Hertz, director of the Suicide Prevention Unit at the Health Ministry, told The Times of Israel in 2018 that the state had not allocated appropriate resources to handle immigrant issues.
In late 2020, Israel's Health Ministry cut the budget that provides money to mental health NGOs in half, according to a Knesset article.
"Committee Chairman MK David Bitan (Likud) said the Finance Ministry had allocated NIS 17 million ($5 million) to the Health Ministry for this issue, but the Health Ministry has not used the money for this purpose," the article stated.
“According to MK Alex Kushnir (Yisrael Beitenu), NGOs that can provide mental health assistance to new immigrants lack the budget to do so because the Health Ministry refuses to transfer the necessary funds."
Israel’s Health Ministry told i24NEWS that the information provided in the Knesset article was inaccurate.
They said that NIS 17 million was being provided for various services, with NIS 6 million going towards the Education Ministry, NIS 2 million towards the Welfare Ministry, and approximately NIS 3 million given to suicide hotline organizations.
Roughly NIS 5 million was intended to go to organizations that provide services such as training.
However, according to Lawrence and Cohen, Tikva was supposed to receive part of an NIS 2 million ($600,000) fund for mental health organizations, yet, they haven’t received any money from the State of Israel.
“We don't receive any government funding, even though we're entitled to government funding,” Cohen noted. Lawrence is not hopeful that they will receive the money, especially with the fragile state of Israel’s coalition.
This lack of funding has limited the organization, including being unable to participate in May’s Mental Health Expo in Jerusalem, which brought together various organizations all in English to provide information about mental healthcare in Israel.
The Mental Health Expo saw roughly 1,500 people attend nine panels, all about mental health in Israel. Those running the expo are working on expanding to Hebrew, Shlomo Katz, one of the expo organizers and the director of Relief Israel, said to i24NEWS.
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“I think that the expo showed that there is a tremendous amount of availability of good professional, licensed clinicians who can provide those care,” Katz noted. “It doesn't have to cost hundreds of thousands of dollars, it's affordable. And there are organizations that can help you get to that care or organizations that provide that care and support.”
A step in the right direction, but there’s still a long way to go before comprehensive mental healthcare is offered for immigrants.
“I would like to see mental health centers in each of the big cities,” Cohen said. “That are open 24 hours a day, where people can walk in off the street and see somebody like a psychiatrist and a therapist, and sit down and have a conversation with somebody and get immediate care.”
With the rise of Covid and many experiencing new or resurging mental health issues, Israel’s Aliyah Ministry launched a mental health phone line, available in only five languages.
However, many people believe that it is too little, too late, and organizations like Keep Olim, Get Help Israel and the Shira Pranksy Project are working to fill the gaps.