Investigation of Delay of Treatment for Severe Mental Illness among Brooklyn Hasidic Communities

Principal Investigators: Ellen Lukens, Ph.D. (CUSSW); Gretchen Borges, M.S., C.S.W. (CUSSW); Rachelle Kammer, M.S., C.S.W. (CUSSW)

Funding: Center for the Study of Social Work Practice

The Brooklyn Hasidic Communities in Williamsburg have rapidly expanding populations whose members maintain a distinct culture, purposefully limiting contact with the outside world. The Hasidimís tolerance for mental illness and fear of ostracism have contributed to their postponing treatment for family members who suffer from psychosis or other symptoms of severe mental illness. Decreasing this delay from the onset of symptoms to the seeking of treatment is of critical importance both to mitigate the suffering of persons with illness and their families, and to increase the likelihood of a better prognosis, particularly in diagnoses sensitive to timely interventions, such as schizophrenia. A clear determination of deterrents is the critical first step in improving service delivery to the Hasidic community, tailoring interventions that are culturally appropriate and acceptable, and developing community education programs focusing on severe mental illness and the value of treatment compliance.

This pilot study will undertake a preliminary investigation of the issues faced by Hasidic Jews who seek treatment for a severe mental illnessótheir own or a family memberís and will be conducted at Pesach Tikvah, a mental health clinic in Williamsburg. The goals are: To determine if there is a delay amongst the Hasidic community in Brooklyn in seeking mental health services for family members with schizophrenia; to clarify the specific deterrents and precipitants to seeking treatment amongst the Hasidic community in Brooklyn; and to obtain preliminary data to be used as a basis for planning a more extensive protocol that employs a control group.

 

Six focus groups will be held with clinicians, community members, and religious leaders of the Hasidic community. The information drawn from these focus groups will be used as the basis for structuring qualitative interviews to be conducted with a group of individuals whose immediate family includes an individual with severe mental illness and also with a small group of community religious leaders and clinicians, who would add additional insights about barriers to treatment. Qualitative interviews will then be held with individual community leaders and clinicians and with approximately 15 family members. Quantitative data (demographic, prodromal symptoms, onset of illness, date of first seeking treatment, and patterns of help-seeking behavior) will also be collected from the participants. A chart and record review will also be done for the15 individuals with illness as a means of generating additional information regarding diagnosis, onset of illness, course of illness, and additional clinical information relevant to developing a cogent picture of the issues involved for this particular community in seeking, receiving, and maintaining treatment contact with service providers.

The pilot data from this study will be used as the basis for developing a more extensive protocol for submission to an outside funding source in which comparison data from both a non-Hasidic sample and a non-religious community sample would be collected. Such research could then serve as the basis for designing efficacious and appropriate social work interventions and educational programs regarding schizophrenia in the Hasidic community.