JACS Vancouver

COVID’s impacts on mental health

(image from bastamanography)

Purim 2020, which took place in early March, brought with it added significance. For some, it represented the last time they gathered in a Jewish setting in person, outside the home. For others, it was the first “live” service to be canceled as a result of SARS-CoV-2. In the days that ensued, lives changed as the perils of the coronavirus became apparent. School, work and religious services all moved online; personal contact with friends and family became exceedingly limited; travel, for most people, ceased.

Among the societal issues compounded by the pandemic have been increased isolation, drug dependence, and food and job insecurity. Underlying these problems has been COVID-19’s effect on mental health, including within the local Jewish community. As a result, numerous groups have stepped up their efforts to help the most vulnerable, and all those who have been impacted by the pandemic. During the past weeks, as the first anniversary of COVID-19 came and went, the Jewish Independent spoke with several people at the forefront of handling the Greater Vancouver Jewish community’s response.

At Jewish Family Services (jfsvancouver.ca), efforts to tackle mental health issues have widened, as more people have been seeking the agency’s support. Early on, JFS opened a crisis line that runs seven days a week, from 9 a.m. to 9 p.m. (604-588-5719 or [email protected], with the promise to respond within 24 hours).

“People are struggling, without a concrete end to the restrictions, and so demand for emotional support and learning different coping skills has surged. Our crisis line is always there for people who need immediate help and, for many community members, this is the easy way to connect with a counselor. If someone wants to remain anonymous, that is absolutely an option, we do not require a caller to identify themselves,” JFS chief executive officer Tanja Demajo told the Independent.

From its launch at the start of the pandemic to August 2020, the JFS Community Crisis Line received 955 calls, serving 494 individuals. Case workers spent 2,052 hours on the line. Additionally, 166 individuals accessed free programs offered by the JFS mental health and wellness team via telehealth and video conference – a 40% increase compared to pre-COVID times.

“Many are struggling with the added role of being a caregiver in the pandemic context, as well as dealing with their own emotions, so our workshops and support groups provide a community where people are able to vent, talk and support one another. We also connect people with friendly callers. These services have been a lifeline for many of our clients,” Demajo said.

A report released by the JFS client advisory committee last summer highlighted many ongoing concerns. One alarming quote from a client cited in the report reads, “COVID-19 has been depressing and frightening for me. My anxiety has been through the roof and I’ve had an increased number of panic attacks and migraines. My chronic health conditions have increased in severity and I have new ones. My nightmares and terrors have also increased.”

Prior to the pandemic, some JFS clients were already battling with mental health issues, often severe, which have been aggravated by the need to now cope with unaccustomed fears and anxieties. Some people, according to JFS, have refused to go outside, whether it be to the grocery store or outside for a walk. This problem is often felt by seniors, who, like everyone, need exercise and who confront serious health conditions such as heart disease, diabetes and high blood pressure.

Many housebound JFS clients depended on family and friends visiting for social and emotional connection before COVID hit and have been feeling deeply alone since the pandemic began. Irritability and anger are rising. Senior clients who were used to spending significant time with their grandchildren are missing them desperately. “I miss hugging my grandchildren,” is a common refrain.

Since mid-May of last year, there have been weekly depression and anxiety support group meetings with JFS’s mental health outreach therapist, Kevin Campbell. Run on Zoom, the 90-minute sessions teach coping skills and allow a safe place to talk and share. The group focuses on cognitive behavioural therapy and mindfulness techniques. JFS also has an active seniors caregivers support group led by Lily Shalev.

Not all COVID-19 developments in connection to mental health are grim, JFS notes. Due to technological developments, some of those experiencing isolation are able to access telehealth, work from home, get home deliveries and view a variety of educational and cultural offerings online, including many synagogue activities.

Jewish Addiction Community Services Vancouver (jacsvancouver.com), an organization that helps community members navigate the troubles of various substance abuse issues, has held one-on-one meetings on Zoom ever since COVID started.

“Clients seem to like this kind of individual counseling better, as it allows for greater intimacy, even though it is on Zoom,” said Shelley Karrel, manager of counseling and community education at JACS. “What people liked most about the group meeting was the getting together physically.”

To help those who would prefer to meet in person, Karrel has arranged for one-on-one socially distant coffee meetings. “What JACS has done is to make ourselves more available to someone when they want to talk, and to be able to schedule a meeting fairly quickly. As a registered clinical counselor, I am able to offer clients tools and exercises for managing their symptoms and for exploring the root causes when the issues of anxiety and depression are evident. Some of my clients are finding AA meetings helpful online. And, like with our clients, some are not using that medium for the same reason – it’s not personal enough.”

For ongoing support, JACS has a monthly email that lists many resources for people, if they want to reach out for specific help. JACS is also beginning a new program, Sustaining Recovery, that offers additional support in the form of a structured plan to help someone develop goals and be able to keep track of their progress. This plan, JACS finds, is very useful in creating accountability and support.

Inclusion services at the Jewish Community Centre of Greater Vancouver (jccgv.com/inclusion) continues to provide a number of targeted social and recreational programs intended to engage, educate and provide meaningful lifelong learning opportunities, as well as engage individuals with diverse needs. The programs are rooted in Jewish values and the principles of social connection, community building and belonging.

“Social isolation is a prevalent issue for individuals with diverse abilities [and] this reality was exacerbated by the COVID-19 shutdown,” explained Leamore Cohen, coordinator of inclusion services. “These communities have been particularly impacted by the loneliness, uncertainty and economic hardships caused by the global pandemic, leaving these individuals at higher risk for numerous health challenges. The work we do in the inclusion services department creates the needed awareness of the individuals we support. But, now more than ever, community members are looking to us for routine and engagement at a time when they are most vulnerable.”

As people have settled into life with COVID-19, “these individuals continue to be shut in and vulnerable to mental health challenges,” she added. “In response, we offer a hybrid of virtual and in-person programming throughout the week that is both accessible and safe. In-person programs adhere to best COVID practices, and our virtual offerings allow for those who are unable to attend in person to access programming and community virtually.”

The Bagel Social Club, for example, met weekly in pre-COVID times as a means to increase avenues for integration, self-reliance and wellness. The program has shifted to weekly social clubs over Zoom and a weekly Relax and Just Breathe class, which includes gentle stretching, breathing exercises and visualizations.

As the lockdown took effect last year, Jewish Federation of Greater Vancouver (jewishvancouver.com) began convening multiple stakeholder groups to determine the pandemic’s impact on many aspects of Jewish communal life. A common thread during these discussions involved concerns about the impacts of increased social isolation on seniors, families and youth. Federation also hosted several webinars on mental health for community members, related to the impacts of COVID-19.

“Through this work, we were able to identify a number of key initiatives that we could support both financially and organizationally,” said Shelley Rivkin, vice-president of global and local engagement at Federation. “These include over $170,000 in emergency funds to Jewish Family Services, part of which was used to support the emergency care line; funds for Jewish Seniors Alliance to expand their peer support program; and the organization of several webinars with community psychologists directed toward young adults, families and teens.

“The Jewish Community Foundation, Federation’s endowment program, has also supported a number of projects to enable community agencies to undertake mental health initiatives,” she added. “Support for mental health issues for both agency employees and leaders was also identified as a priority for the community recovery task force when they launched their first grant round. It will continue to be highlighted as we move into the next grant round.”

Last December, youth workers voiced concern about the mental well-being of youth and young adults. Consequently, Federation hosted a roundtable with key leaders to ascertain how community members in this age range are faring, especially when faced with so many disappointments and cancellations over the past year. Based on these conversations and others, Federation will be collaborating with these agencies to develop a community mental health strategy for children and youth.

Sam Margolis has written for the Globe and Mail, the National Post, UPI and MSNBC.

Making safe, inclusive space

Clockwise from the top left: Tanja Demajo, Shelley Karrel, Amanda Haymond Malul and Rabbi Yechiel Baitelman participate in a JACS Vancouver panel discussion Oct. 15.

“When someone comes through the door and says, ‘I’m an addict. I’m a recovering addict,’ do they feel judged or do they feel accepted? Do they feel that we are putting them in a box, giving them a label?” asked Rabbi Yechiel Baitelman in a recent community discussion. “We have to identify the illness, there’s no question about that. But, is that the only way to view a human being? I think to respect every human being for their humanity, that’s what people are really craving – respect and love.”

Baitelman, director of Chabad Richmond, was one of three panelists on the topic Building Safe and Inclusive Spaces for Those Affected by Addiction and Mental Illness. He was joined by Tanja Demajo, chief executive officer of Jewish Family Services (JFS), and Amanda Haymond Malul, a community member in recovery, in the Oct. 15 event presented by Jewish Addiction Community Services (JACS) Vancouver. JACS Vancouver’s Shelley Karrel moderated the conversation.

Haymond Malul would like to see more community discussions on addiction and people being taught acceptance. She spoke of the need to “have support from the religious leaders of the community, from every single agency in the community, to start talking about it – make it acceptable, educate.” (See jewishindependent.ca/help-repair-the-world.)

And we need to ensure that what we are teaching is in line with our actions, said Demajo. “If we talk to children about acceptance, but we don’t actually practise that, that’s creating double standards where we talk about certain things, but that’s not what people experience,” she said. This could be damaging, she said, to people who “really need that support and want to trust.”

We must see each member of the community as a human being, said Baitelman. Love is important, but, he said, “Love is on my terms, respect is on your terms. If I love you, it’s more a reflection of who I am. But, if I respect you, it’s more of a reflection of how I see you, what you are about – and I think that’s really important. Respect the humanity. If you can love them, that’s even greater. But respect is more fundamental.”

When Karrel asked panelists for tangible ways in which people could be more accepting and inclusive, with love and respect, Demajo said agencies are overwhelmed with the number of people needing support. She said it is up to each of us to connect on a personal level with others, accepting that it will take time for them to trust us enough to share.

“You have to build a relationship, and a relationship is not built overnight,” said Demajo. “I had a client who I often think of, a person who spent a number of years [in the] Downtown Eastside being homeless, not having pretty much anything in his life…. He would come to see me … and we would speak about books, because he was a huge reader and I love reading. It took him six months until he really started talking about things that were going on in his life and what he actually needed, and we started working from there. Now, he has a regular life. He has a home. He brought his family back. He is working. So, things are in a place that he wanted … a number of years ago. Recovery is a process of being vulnerable and, so, if social services don’t have the time to invest in people, I think we are setting ourselves up for a really huge failure.”

All panelists agreed that having a drop-in centre with people who understand is absolutely essential and that, while professional support would be ideal, it is not essential. To be kind, respectful and loving, you do not need to be a professional, they said.

While there are recovery clubs in the general community, Haymond Malul said it would be great if there were also one in the Jewish community – “having a safe place for people to come and be able to drop in, and know that this is the Hillel House of Recovery,” she said.

However, having a community place might inhibit some people from coming out, due to fear of being exposed, warned Demajo. “The other piece is that I do feel that what Amanda has done tonight, speaking of her own experience and being in the community, and [talking about] some of the things that were helpful for her, is important to start with; having those opportunities to open up the conversation – not just for me, in a professional role, but from a personal place – because that is where the relationship happens. I do believe that is the core of whatever we come up with – the core is the relationship.”

Each of us is deserving of respect, regardless of our achievements, successes, failures or addictions, stressed Baitelman. “The fact that you were created by G-d makes you worthy of the highest form of respect and no judgment,” he said.

“Why would I not be involved with somebody who’s in recovery?” asked the rabbi. “After all, these people are accountable. They’re working on character development and are improving certain areas of their lives that they have the courage to acknowledge need to be corrected. They’re actively making amends with people around them. They are working on a conscious relationship with G-d rather than on other forms of success that society often judges success by. This is really an achievement.

“How many of us would like to change even one iota of our character, and people in recovery have changed more than one iota. They have made an incredible change, which is so admirable and should command respect. I think that’s part of the attitude that should be helpful in the broader community, and how we act with people, and the stigma.”

Karrel closed the discussion by giving a brief synopsis of JACS and its services. “We are working to diminish the stigma of addiction,” she told the Independent after the event. “Let’s keep this conversation going so we all feel we belong in our community.”

Rebeca Kuropatwa is a Winnipeg freelance writer.

Talking helps reduce stigma

Left to right: Peggy Allen, Shelley Karrel, Shelley Rivkin, Jordan Bowman and Howard Harowitz. (photo from JACS Vancouver)

The capacity for transformation and healing was front and centre at the event Optimism and Hope: Erasing Stigma of Mental Illness, Addiction and Homelessness.

Co-sponsored by Jewish Family Services (JFS), Tikva Housing and Jewish Addiction Community Services (JACS) Vancouver, the panel discussion on Feb. 26 was held at Temple Sholom. It featured Shelley Rivkin of the Jewish Federation of Greater Vancouver, Abbotsford entrepreneur and volunteer Peggy Allen, and Jordan Bowman of Last Door treatment and recovery centre in New Westminster.

Temple Sholom’s Rabbi Dan Moskovitz welcomed those gathered by talking about the Aleinu prayer, which, he said, asks us “to go out into the world and do what we’re praying for. And so, if I can make a request of all of us, myself included, it’s to go out from this room and to do and to share what we’ve learned and what we’ve heard tonight with our families and with our broader circle. That’s our shlichut, that’s our sacred mission, beyond just coming here today to get what we need for ourselves.”

JACS Vancouver board chair Howard Harowitz briefly described the missions of each of the event sponsors before introducing the night’s speakers, beginning with Rivkin, who shared the stories of a few community members who have been impacted by the risk of homelessness. She prefaced her remarks by saying homelessness is not limited to people living on the street or who live in shelters. Rather, the growing concern in our community is “relative homelessness, the lack of suitable, consistent and predictable housing,” she said.

She also noted that “it is not a natural equation that addiction, mental health and homelessness are faced by all people” in need. “Each person has to be approached individually and uniquely,” she said, then listed six sources of support in our community: JFS, Tikva Housing, Yaffa Housing, JACS, the Kehila Society of Richmond and the community’s synagogues.

Originally from Regina, Sask., Allen has lived in Abbotsford for a long time. She lives in an area where homeless people have gathered since the Salvation Army moved into the neighbourhood in 2004. A wife and the mother of two children, the situation was very difficult initially. She shared stories of her young granddaughter witnessing people having sex and shooting up, and of being chased out of her home by a crack addict.

“I was quite a happy person and then the homeless moved in and I changed forever,” she said. “I got angrier and angrier and angrier and I ended up making, in 15 years, I made 463 calls to the police. And they came every time and did nothing, because what are they going to do?”

Allen said she became very depressed. Then, she was invited to a meeting at city hall about the homeless. She challenged attendees to come and see the extent of the problem for themselves, and two women from Fraser Health took her up on it. Over coffee, Allen shared with them her concerns and, despite her self-described antagonism to them, they invited her to speak at a meeting of the Drug War Survivors, a peer-based user group that participates in the development of harm-reduction policies, among other things.

Reluctantly, she agreed. Expecting an audience of maybe 10 drug addicts, “there were 110 of them,” she said. “I look around and I open my mouth and I just let it all out. I don’t know what happened, it was a miracle, really. I talked about my father and I talked about him beating my mother so desperately,” waking Allen’s sister, who was told to return to bed by their mother, and did. “That’s what we were raised with,” said Allen. “I had never spoken about it, and I just let it all out,” including how she was kicked out of a school in her teens for selling drugs.

After her remarks, audience members lined up, but she didn’t know why, so she started to leave. “As I’m walking out, the first guy comes up and hugs me. They were all standing there to hug me,” she said, holding back tears.

One of the men recognized Allen from secondary school. He shared with her that he was raised with such anger that he went down the path of drugs, whereas she – who his family warned him about as a teen, since she sold drugs – did not. He said to Allen, “I see now that I, too, can change my life.”

This interaction, she said, changed her life. “I went home, and I was walking up the driveway to get the mail and this crazy lady that lived on the street and was a huge drug addict and was nasty and did not like me, she came running up my driveway swearing and yelling at me with this other guy. I was so emotional, I went running at her, I don’t know what I was going to do, and I stopped. I changed my mind. I turned around and I went home. And my life changed. Everything on our street is still happening and nothing has changed much there, except me.”

Allen started giving to the homeless. She joined the city’s Business Engagement Ambassador Project, which works to build relationships between Abbotsford residents, business owners, homeless and others to strengthen the sense of community. “What I do is I speak all over the place and raise money to help them help themselves,” she said of those who are homeless.

The project is a year-and-half old and she described it as a success. One aspect in particular that is working, she said, is that the program pays homeless people to clean up area businesses and parks.

The last speaker, Bowman, now 22 years old, has been clean for just over four years. He is a youth program support worker at Last Door, the centre at which he was set on the path of recovery.

Bowman said he had a good upbringing, went to Jewish summer camp and day schools, was into sports, has lots of friends and has a great family. Having lost his mother to cancer when he was 10, he said, “That was obviously tough, but by no means do I point my finger at that and say, ‘that’s when I started using drugs.’”

He described his life as normal, living with his dad and brother. There were no indications, he said, that he would become an addict. Addiction does not discriminate, he said, and people need to know that. His family, he said, were completely surprised to find out about his drug use and were “unversed in the topic of addiction.” Luckily, he had a cousin who works as a drug and alcohol counselor and “she saved the day” when it came to him seeking help.

At age 14, Bowman started to experiment with marijuana. He couldn’t say exactly why he started using harder drugs, but perhaps he had just gotten in with the wrong crowd. He described the process as progressive. “It went from using once in awhile to using every day, to doing whatever it takes,” he said.

“I’m not going to get too much into the things I did to get to get high every day but it definitely involved a lot of stealing from the people very close to me. It didn’t matter if you would love me, if you would hate me, if you were older, if you were younger, if I had the chance, I would try and rip you off if I was with you, and that was the reality of my life.”

From age 16 to 18, he was using opiates every day, while still going to school, while still trying to cover up that he was an addict. “I wanted help, but I didn’t,” he said. “I wanted help because I knew in my mind that I could be a better person than I’m being right now but, in the other part of my mind, I was scared and I wanted to keep getting high.”

The breaking point came when he stole a significant amount of money from his brother. From that day, when his brother reacted with love rather than anger – Dec. 22, 2015 – the efforts at recovery began, with the help of his father, brother, cousin and others. There were a few false starts, a couple of detox and treatment centres, before he landed at Last Door in mid-January 2016. He has not used drugs since.

Waiting times and the cost of treatment were among the topics discussed in the question-and-answer period. Giuseppe Ganci, director of community development for Last Door Recovery Society, was in the audience. He explained some of the different levels of care, ranging from assisted living residences, for which there are minimal guidelines, to treatment centres, which will have psychiatrists and other professionals on site. The definitions of the levels differ between regions in the province, he said, making the system hard for people to understand and, therefore, access.

“The problem is,” he said, “you always hear there are not enough beds in British Columbia. That’s actually a myth. There are so many beds. Last Door runs probably at 80% capacity every day [and has] for years. We have about 100 beds and only 35 of them are funded [by government]; the rest, there’s no funding for them, so it’s a shortage of funding for treatment, it’s not a shortage of beds.” This means that people who can afford it are able to get treatment within 24 hours, rather than join the queue of six to eight weeks or longer, he said.

After a couple more questions, Harowitz wrapped up the event. Addiction is not a choice, he stressed, citing JACS speaker Steve Whiteside. “It’s not a weakness of character, it’s not anything other than any other kind of disease that people have,” he said, challenging the audience “to keep the conversation going.”

Sukkah more than symbolic

As we celebrate Sukkot this week, we’ll be thinking about many things – notably, how lucky the vast majority of us are to have a solid roof over our heads. For most of us, the sukkah is but a symbol of our wandering in the desert all those years ago, a symbol to remind us to be humble, empathetic, grateful. However, for many living in Metro Vancouver, including members of our own community, homelessness is a reality.

Last week, we ran a good news story from Tikva Housing Society – residents were moving into the recently completed Storeys complex in Richmond. The Diamond Residences at the Storeys will house six singles (five of whom are seniors) and 12 families. Tikva Housing is also working with various partners on the development of 32 townhouses in Vancouver, and they anticipate accepting residency applications by early 2018. These new projects are in addition to Tikva’s Dany Guincher House, in Vancouver – which has 11 units for people with low-income, people with disabilities who are independent and families fleeing abuse – and the Esther Dayson Rent Subsidy Program.

There is a lot of which to be proud. However, there is much more to do. Last year, Tikva Housing reported a decrease in donations to its rent subsidy program of more than $15,000. As a result, the organization had to decrease the monthly subsidy it provided to singles, couples and families.

According to Tikva, more than 16% of Jewish Vancouver residents – more than 4,200 people – are low-income and at least 450 Jewish children under the age of 15 in Vancouver are “living in households that depend on income assistance.” Its 2015 report on housing in Metro Vancouver concluded a need for 1,827 affordable housing units in the Jewish community, including for “those under 65, low-income singles, couples and families.” Calling this “an unreachable goal,” the report nonetheless suggests some solutions, most of which the Jewish community is already pursuing, such as rent subsidies and partnering with other agencies to develop new projects.

Yet, the problem remains. And, of course, it is not a problem unique to the Jewish community. On Sept. 26, the final report on Metro Vancouver’s 2017 Homeless Count was released. On the night of March 7, more than 1,200 volunteers conducted surveys throughout the region, on the streets and at shelters, “to obtain a 24-hour snapshot” of the situation. The final report confirmed the preliminary results – 3,605 were homeless in the metro area.

While there were four percent fewer homeless youth in 2017 as compared to 2014, there were five percent more homeless 55 and older. Overall, there was a 30% increase in homeless since 2014, “and the highest number since 2002, when the first metro-wide count occurred.”

According to the report, “The three most cited barriers to finding housing were the high cost of rent (50%), a lack of income (49%) and the lack of availability of housing that suits their needs (30%).” More than 80% of respondents reported having “at least one health condition, including addiction, mental illness, physical disability or a medical condition/illness. More than half of the respondents (52%) have two or more health conditions.” More than 40% of respondents received income assistance, 28% a disability benefit; 22% were employed.

Following the local Walk for Reconciliation on Sept. 24, where some 50,000 people – including an organized Jewish contingent – gathered downtown to join in a “call to action,” it is sobering to learn that 34% of the respondents of the Homeless Count self-identified as indigenous/aboriginal. “Indigenous people continue to represent about one-third of the homeless population in the region,” states the report, noting that it’s the highest proportion found to date in a regional count and “constitutes a strong over-representation compared to the total population, where two percent identify as aboriginal as per the 2011 Census.”

In a statement of the obvious, Mike Clay, chair of the Metro Vancouver Housing Committee, said, “In order to stem growing homelessness, it is clear we need more affordable housing options.”

But additional solutions are also needed, given the systematic discrimination that still exists for First Nations people and the health conditions many of the homeless are facing – and not only the homeless. Just last week, the Independent ran an article on the impact of addiction in our community. Jewish Addiction Community Service (JACS) Vancouver estimates that as many as 5,000 Jews in our community need support, “whether grappling with their own addiction issues or the addiction of a loved one.”

The Homeless Count’s findings most likely underestimate the problem. The report references the “hidden” homeless, which includes people “who do not have a regular address of their own where they have security of tenure, and who may be staying temporarily in another household – often called ‘couch surfing.’” The Tikva Housing press release about the new tenants at Storeys noted, “One 83-year-old woman cried when she was told she would be moving into a studio unit, as she has not had a place to live for years and was sleeping on someone’s couch.”

Then there are the tens of thousands of people at risk of becoming homeless. Apparently, housing shouldn’t account for more than 30% of a person’s or family’s gross income, yet the Homeless Count report notes there were 56,000 Metro Vancouver households in 2006 that spent more than 50% of their income on shelter, and the number had increased to 62,355 by 2011. (More recent data weren’t available but, based on skyrocketing housing costs, we can guess that the number of households spending 50% or more of their income on shelter has also increased.)

There is much to contemplate as we gather in our sukkot this week. And, once the holidays are over, once we celebrate Simchat Torah, thankful for the Jewish texts and traditions that have shaped the moral compass of even the most secular of us in some way, there is a lot of work to be done.