Sandy Eller
It was exactly one year after the onset of COVID that SIMHA, the Sephardic Initiative for Mental Health Awareness, first opened its doors to address the ongoing need for assistance in the Sephardic community, with a wide range of services and programming. Having been contacted by local rabbanim, kallah teachers, community leaders, and others about a variety of complex and sensitive issues, Rabbi David Sutton, SIMHA’s founder and director, realized that members of the Sephardic community needed access to high quality professional mental health care. He understood what life was like for those who were struggling with anxiety, depression, various disorders, addiction, and other issues. And in his mind’s eye, Rabbi Sutton envisioned them as being stranded in the ocean, surrounded by sharks and battered by uncontrollable tides.
“SIMHA was created to be that island of safety,” explained Rabbi Sutton. “Someone who speaks to a friend might experience some comfort, but they are still in the ocean, fighting that tide and those sharks. When they reach out to SIMHA, we become that island for them, providing them with a safe haven, and getting them on the road to recovery.”
SIMHA provides clients with free comprehensive assessments, the first step in addressing mental health issues. Evaluations are done in person and can take an hour or longer to complete, giving SIMHA’s licensed clinicians an opportunity to identify the root problem instead of just treating its symptoms. Oftentimes, clients may reach out to SIMHA to discuss a particular issue, when in reality, the actual matter is something completely different. Such was the case with one man who contacted SIMHA to discuss what he described as a marital problem.
“After doing the assessment, it turned out that the husband was struggling with a severe anxiety disorder that was negatively affecting their marriage,” said Dr. Eli Mandelbaum, SIMHA’s director of clinical coordination. “Sending him for shalom bayit classes or to a marriage therapist wouldn’t have helped.”
SIMHA’s licensed clinicians draw on their training and considerable experience as mental health professionals to develop an accurate understanding of their clients, as well as their unique situations. In addition to clarifying the actual problem at hand, they provide support and psychoeducation from the start. And clients often find the intake process to be therapeutic, even though SIMHA’s clinicians do not provide actual therapy services.
Referrals are the next step in the continuum of care. Clinicians search SIMHA’s extensive database of approximately 800 therapists, psychiatrists, and facilities to find the one that is best suited to the client. While the process is both thorough and time consuming, referrals are typically made within 24 hours of an assessment. Most of those practitioners are located in the New York – New Jersey area and, if need be, are insurance-based. SIMHA also has access to well-known experts in the field who don’t necessarily work with insurance.
“Over 50 percent of our clients see clinicians that take insurance, and we try to work within their budget,” noted Rabbi Sutton. “We do our best to make it work for them, and have met hundreds of clinicians, and gone down to dozens of clinics so that we could locate affordable care.”
Other factors are also at play in the referral process, according to Dr. Mandelbaum. Clinicians consider whether a particular therapist and the client are a good match, in addition to considering availability, personal preferences, such as gender, and whether the client wants to do in-person or telehealth sessions.
“All of this happens collaboratively,” explained Dr. Mandelbaum. “We connect with the clinician first and get the green light from them, and then we tell the client who we came up with for them.”
SIMHA’s involvement doesn’t end with sharing a therapist’s contact information with the client. Clinicians are more than ready to help schedule appointments for their clients, and they also make follow-up phone calls to hear how the initial conversation went. In cases where clients who had initially agreed to schedule their own appointments decide not to follow through, SIMHA’s clinicians switch into case management mode, pinpointing the reason for the hesitation, and shifting gears, if necessary.
“If that clinician doesn’t work for them, we’ll find them another one,” said Dr. Mandelbaum. If they didn’t call for a particular reason, we can discuss those unstated reasons so that the process can continue.”
SIMHA’s ongoing support also includes reviewing clients’ progress, making sure that they are receiving the care they need to remedy the problem at hand. The fact that SIMHA’s clinicians stay in touch with their clients means that if something goes wrong, they are there to jump in right away and make the necessary corrections.
“We’ve had countless examples of people falling off the train,” said Rabbi Sutton. “It takes handholding to get them back on.”
Education is an important and ongoing component of the clinical coordination process, shedding light on topics that can be sensitive and unfamiliar. At times it might be something as simple as explaining what anxiety or depression are, or validating their feelings. In other instances, it might include simply understanding the therapy process and how to get the most out of treatment.
“I’ve had clients tell me that they need a new therapist because they don’t like what their therapist has said about a certain thing,” said Dr. Mandelbaum. “I tell them to talk to their therapist and let them know, just like you would tell a restaurant that they burned your steak. It is important for clients to know that they are the customer, and that being open and forthcoming with their therapist helps the treatment process.”
In addition to opening over 500 new cases a year, and providing mental health services to community members in Brooklyn, Deal, and Lakewood, SIMHA is also tackling contemporary mental health challenges from the educational side, offering training courses to provide local mentors with life-saving tools to address mental health issues, since few are trained in the field.
“Much like a Hatzalah member’s job isn’t to do heart surgery, but rather to stabilize patients and get them the help they need, our goal at SIMHA is to give our first responders the tools they need to react, whether they are community rabbis, rebbetzins, kallah teachers, shadchanim, nutritionists, or anyone else who might pick up on the first telltale signs of a mental health challenge,” explained Rabbi Sutton. “These courses teach how to navigate sensitive situations and guide people to professional help when needed.”
Dr. Shloimie Zimmerman, Director of SIMHA’s rabbinical training program, developed and led the men’s 24-week program, while Dr. Sarah Miller ran the women’s cohort. Both programs were designed to provide participants with tools to provide care and guidance with compassion and dignity, and included an emphasis on validation, empathy, and numerous other skills.
“The role of the rabbi has changed over the years,” observed Rabbi Joseph Dana of the West Deal Synagogue. “Rabbis don’t just give speeches from the pulpit – they are expected to advise on an array of matters that aren’t taught in kollel.”
“I used to try and actively solve people’s problems,” added Rabbi David Nakash, who runs the Bnei Aliyah minyan at Shaarei Zion. “I’ve since learned that listening empathetically and offering guidance is far more effective.”
The classes were an introduction to SIMHA for some participants, including Rebbetzin Sandra Mansour of the Safra Synagogue, who was gratified to realize the many services being offered to community members who struggle with mental health issues. Mrs. Renelle Maslaton, Principal of Bet Yaakov Yesodot HaTorah, felt that the art of active listening was one of the key takeaways of the program.
“Dr. Miller’s practical teaching style gave us the ability to take ideas that we already knew, as well as lots of new information, and put them into practice,” said Mrs. Maslaton. “Taking the time to really hear what someone is saying, including being conscious of what goes unspoken, is incredibly important.”
Those thoughts were echoed by Rebbetzin Aviva Ben Haim of Bnei Shaarei Zion, who gained skills that helped her through an issue with a particular student that had been plaguing her for years.
“The course was excellent,” said Rebbetzin Ben Haim. “Dr. Miller was very practical and I think that all of us who took these classes can honestly say that we are grateful to SIMHA for empowering us and giving us the tools we need to better serve our communities.”
Even as it continues to evolve to meet communal needs on multiple fronts, SIMHA remains steadfastly committed to its founding mission – helping those who are struggling with dignity, skill, and compassion.
“Baruch Hashem, mental health issues are no longer being swept under the proverbial rug,” noted Rabbi Sutton. “SIMHA is grateful to be able to play a part in shattering stigmas, so that no one has to suffer in silence. Help is literally right around the corner.”
If you or someone you know need guidance, advice or assistance, SIMHA is ready to offer help. Call or text 718-675-3000 or email office@simhahealth.org.