Highlighting the urgent need for mental health education
By: Ilan Preskovsky
“Had I been educated, I am almost 100% convinced I could have saved her life.”
Between the COVID-19 pandemic, an economic near-recession and, of course, the horrific events in Israel on 7 October last year and the ensuing fallout, the mental health crisis in our community and in communities across the world (though most especially, obviously, in Israel) has reached something of a breaking point. This year, in particular, our community has been racked by a shocking number of suicides and even more attempted suicides.
As Rabbi Shalom Hammer – who lost his own beloved daughter to suicide at the tender age of 18 and has been working ever since to promote suicide and mental health awareness worldwide – told a relatively small but utterly rapt audience at the Chev’s David Lopatie Centre a couple of months ago, this crisis is even worse than most of us might think. But, with the right education, it is also far more manageable, even preventable, than we might assume too.
Rabbi Hammer was born and raised in the United States, before making aliyah 34 years ago. With a background in both education and psychology, he has worked as an educator in Israel for many years, and is, I can attest, a wonderfully engaging speaker. It was the death of his daughter, Gila, in 2019, though, that spurred him specifically towards mental health education and suicide prevention and founding the non-profit organisation called Gila’s Way (Mental Health Awareness – Gila’s Way) that offers numerous programmes on the subject. Indeed, as he admits, he gave his first lecture on the subject just three days after the end of sitting shiva for Gila and has since travelled to communities across the world to tell his story and to raise awareness and break certain stigmas around mental health and suicide.
As Rabbi Hammer admits, with heartbreaking frankness, “my wife and I say consistently that Gila should be alive today and one of the reasons why she isn’t is because we were not educated – had I been educated I am almost 100% convinced I could have saved her life.”
Horrifying Numbers
Before getting into the specifics of his own story, though, Rabbi Hammer introduced a number of statistics that were, to say the least, terrifying. In Israel alone, he notes, some 650 people die by suicide a year, with a further 6 000 attempting it. And these are just those that are recorded. In the US, there are 1,4 million attempted to suicides a year and worldwide there are 720 000 deaths by suicides worldwide per year and is the third leading cause of death in those ages 15 to 29.
I say “die by suicide” rather than “committed suicide”, incidentally, because Rabbi Hammer notes, quite reasonably, that “commit” connotes a crime and people who die by suicide are, pretty much by definition, killed by a disease. It’s the same reason why the rather harsh halachot regarding suicide, such as being buried outside of the cemetery and family not being allowed to formally mourn for the deceased, have (all but?) entirely fallen by the wayside as halachic authorities have deferred to mental health professionals in understanding what suicide actually is.
“The most precipitous rise of death by suicide over the past couple of decades is in the generation of young people known as ‘Gen-Z’.”
And what they have also found is that the highest rates of death by suicide may be among men between the ages of 40 and 55 (in Israel, though, it’s actually men of pensioner’s age), but the most precipitous rise of death by suicide over the past couple of decades is in the generation of young people known as “Gen-Z”. In particular, highly respected social psychologist Jonathan Haidt notes that it was the arrival of the first smartphone and social media that changed everything for adolescents and young adults – especially, it should be noted, for girls and young women.
Rabbi Hammer certainly agrees with this as he echoes the fundamental objections to social media in how they hurt actual, interpersonal relationships and how something like Instagram creates an impossible fantasy against which young people judge themselves and others, but more simply, he stresses that adolescents and young adults up to 25 have a fatal mix of a still developing prefrontal cortex (the “decision-making centre”) and not enough life experience to be able to put certain things in perspective. Plus, at that age, most people really do think themselves immortal and have a fairly immature understanding of their own mortality.
This may sound condescending, but it’s actually developmentally appropriate. Us old folks may scoff when we hear a teenager say their “life is over” after breaking up with their first boyfriend/girlfriend, but Rabbi Hammer stresses that for them that may well be exactly how it feels. It’s also not for nothing, I suppose, that death-obsessed “goth” culture is overwhelmingly a young person’s game. However much we shouldn’t simply write off even typical “teenage hysteria”, though, we should obviously be especially sensitive to genuine cries for help.
Gila’s Story
Gila, Rabbi Hammer told us, was a happy, vivacious, outgoing young girl until an incident at summer camp at the end of grade 9 changed everything. One of the other kids got hold of her phone and texted “I want to have sex with you” and sent it to the whole camp. Along with the embarrassment of the text itself, her camp counsellors asked no questions and immediately kicked her out of camp, with the boy who used her phone facing no reprisals whatsoever. She was sent home on a train all by herself and, quite understandably, burst out crying when her father picked her up at the station.
Rabbi Hammer explains that Gila “saw the world in a wholesome way. She was a very trusting, very non-judgemental girl who was very sensitive to the world around her”. Such an incident was, of course, traumatic enough for such a person, but the next year at a Purim party, her trusting nature led to tragedy when a boy lured her into a room, quickly locked the door and sexually assaulted her for an hour. The fallout from this…encounter, was profound and catastrophic.
Gila was, in short, clinically traumatised – another scary statistic from Rabbi Hammer: 80% of cases of PTSD come from sexual assault – but as is so often the case with sexual assault she felt too embarrassed to talk about it, even with, or perhaps especially with, those closest to her. When it comes to trauma, Rabbi Hammer continued, it’s extremely important that it is confronted as soon as possible after the incident, which is why IDF soldiers have a psychological debriefing pretty much the minute they leave the field and it is why Gila’s deteriorating mental health snowballed as badly as it did.
One of the key ways that those who suffer through a trauma deal with their feelings is through substance abuse and for Gila that substance was marijuana. It’s already dangerous for 15 or 16-year-olds to smoke substantial qualities of weed, but the most alarming part was that she wasn’t smoking socially, but on her own. Her mood started to become noticeably worse and the old Gila had all but vanished by the time she had entered grade 11 and a teacher told her parents that they believed that Gila had been sexually abused.
Her parents had obviously noted the changes in their daughter but were shocked by the news and started immediately seeking professional help. They started, naturally, with therapy, but at this point Gila just wasn’t receptive to it and would see a therapist for three or four sessions before bailing. She was, to say the least, not getting better. By the end of the school year, in fact, Gila had started to turn against her parents, both verbally and violently, which lead to her being hospitalised for two weeks and then being sent to a “therapeutic school” for two more. Sadly, things only got worse from there. She started to practice self-harm soon after and ultimately ended up attempting suicide by overdosing on pills. She was rushed to hospital where her life was saved, but she was quickly discharged after talking to a doctor for all of twenty minutes. Her parents were, by this point, obviously despondent, and again had her hospitalised for a further three weeks at a facility that specifically dealt with mental health.
This time, though, Gila clearly benefited from her stay there, not least because she got to interact with others facing similar challenges. Unfortunately, this too proved to be fairly short-lived because she left the hospital without a framework for how to cope in her everyday life, which was exacerbated by the fact that her mental health challenges had left her alienated from her friends, especially as they graduated and moved on to the next chapter in their lives, while she remained adrift and purposeless.
On Sukkot, she again attempted suicide by swallowing pills, but immediately afterwards she walked up to her mother and said, “I’ve made a terrible mistake, please take me to the hospital, I don’t want to die.” She was again saved, but not long after that she succeeded in taking her own life.
Learning from Gila’s Story
Gila’s story – which I tried to capture as well as I could in the space provided, but I highly recommend listening to Rabbi Hammer tell it if you get a chance – is at once uniquely hers and representative of far too many others. There are, in particular, so many aspects to her story that resonate with and powerfully illustrate essential psychological concepts. We see in it, the power of meaning, the hideous effects of sexual violence, the complexities of post-traumatic disorder, and the importance of social interaction.
“People who die by suicide generally don’t want to die; their despondent, depressed mental state leaves them feeling as if it’s their only option.”
There are two messages, though, that Rabbi Hammer drove home time and time again in his talk and again in a brief conversation I had with him via WhatsApp. First, that people who die by suicide don’t actually want to die, but their poisonous, despondent, depressed mental state see it as the only option left to them. They fundamentally want to live, but they don’t see how. Second, as should be crystal clear from her story, Gila’s parents were anything but neglectful as they tried to do everything possible to save her, but the problem often isn’t a question of commitment, care and love, but of knowledge and effectiveness.
It’s about knowing exactly what signs to look out for (and a list of these can be found on the Gila’s Way website). It’s about using the right kind of psychological and psychiatric care to most effectively target the problem. It’s about setting up a framework in their everyday life that maximises not just emotional support and love, but one that provides as much meaning to their life as possible. And, most fundamentally, it’s about creating an environment where mental health and suicide can be talked about with as much frankness and understanding as possible.
And if this article only touches the surface of this vitally important but obviously massively complex and nuanced subject, I hope that it can at least serve as a starting point for awareness and an openness to discuss it.
