Shelley Karrel

Pushing for more oversight

Members of the Jewish community, as well as members of various professional organizations, are calling on the government of British Columbia to do more to regulate practising therapists and counselors in the province.

According to the Federation of Associations of Counseling Therapists in British Columbia (FACTBC), which is at the forefront of the campaign for this change, there is currently no regulatory body for counseling therapists in the province and, therefore, there are no regulatory standards for the work that counseling therapists do.

As it stands, they claim, someone can call themselves a mental health professional in British Columbia without having the checks that exist elsewhere in Canada. This, FACTBC points out, differs significantly from Ontario, Quebec and Alberta, which have all established regulatory bodies to oversee who can become a mental health professional. And, they add, the remaining provinces have done more than British Columbia when it comes to the consideration of implementing regulation.

A member of the Jewish community recently came to the Independent with her story. In her attempts to remove a social worker from her mother’s life, she encountered what she believes were numerous inadequacies within the present system regarding the protection of the public’s interest and confidence.

“When we seek the help of doctors and nurses, there is a protected title that tells us the person is qualified and safe and that there is a professional regulator to back up this promise,” she said. “Regulation protects people from harm. I cannot change the events of the past, but I can take from that experience and do what I can to ensure that all our citizens are protected, moving forward.

“I knew,” she added, “and had confirmed by other counselors and social workers that what this registrant was doing was in violation of their professional code. I saw my mother become further isolated from friends and family, while her health continued to decline both mentally and physically, while in this registrant’s care.”

The community member filed a complaint with the B.C. College of Social Workers (BCCSW). “Through this experience, I saw firsthand the lack of transparency in the complaint and discipline process that gives social workers the ability to enter negotiated complaint resolution agreements (CRAs) in exchange for keeping matters confidential. How can the public have confidence in regulators if the public is not aware of actions taken by regulators to protect them?” she wondered.

The community member then did what many who lack the financial means could not: she filed a civil claim against the social worker. She was not looking for money, she told the Independent; rather, she was looking for accountability and safety.

In the end, the woman and her family received an apology from the registrant and a promise to not repeat the following conduct: failing to differentiate between professional and personal boundaries; creating a situation of dependence with clients; and failing to limit their practice within the parameters of their competence.

“The college, in their inquiry decision, acknowledged that the time the registrant spent with my mother and the amount the registrant billed were not reasonable. I am not sure I will ever be able to fully reconcile with the events that occurred over a three-year span at the hands of a social worker, who was a friend at the time, and [that] I helped facilitate the introduction to my vulnerable, senior mother,” the woman said.

“To help with my own personal healing,” she added, “I elected to join FACTBC’s stakeholder table. I hope to lend my voice to ensure social workers, counseling therapists and emergency medical assistants who deal with our most vulnerable citizens are recognized as health professionals and regulated under the Health Professions Act.”

For Shelley Karrel of Jewish Addiction Community Services (JACS) Vancouver, the importance of regulation for counselors in British Columbia cannot be overstated. “For counselors working in the area of addiction and recovery, it is critical to know the importance of assessment, understanding the various stages of addiction, being able to identify the options available for treatment and recovery,” she said.

Karrel explained that understanding co-morbidity – i.e., the presence of one or more additional conditions – of mental health issues with addiction requires psychotherapists and counselors to have the proper training and education to know how to help clients deal with their various challenges.

“Having counseling fall under a regulated body will give clients the assurance they are dealing with qualified professionals who have to meet professional standards of practice, ongoing continuing education and clinical supervision,” she stated.

According to Glen Grigg, a Vancouver clinical counselor and the chair of FACTBC, “proper regulation will prevent consumers from harm. A consumer should not have to guess whether the therapist is equipped to deliver the services they promise. Moreover, when harm is done, it is important to know that a registrant’s college has the power to bring restoration and remediation when harm has occurred.”

FACTBC, which is comprised of 14 professional organizations that represent 6,000 mental health professionals in the province, is asking for safety and accountability. On professional title, it recommends one legislative authority and one coherent and fair process that prevents harm and has the power to act accordingly when harm has been done.

The B.C. government has said that it will first implement modernization of the health professions regulatory system – a step that FACTBC enthusiastically supports – and then give attention to the mental health system.

To Grigg, “this response comes down to saying, in effect, ‘despite the opioid crisis and mental health fallout from the pandemic, we can defer this issue.’ When pressed for what is intended after a new regulatory process is put into place, timeline unknown, the response is that government will ‘recommend’ that professions, such as counseling therapy and social work, become a ‘priority.’ A recommendation to a yet-to-be created bureaucracy falls far short of commitment and action.”

Grigg added, “FACTBC has been advocating for public protection where counseling therapy is concerned for more than 20 years and have heard, over and over, variations on the theme, ‘Yes, of course, we are going to protect the public, but later, at a time we’re not prepared to specify.’”

FACTBC does give the province credit for creating a Ministry of Mental Health and Addictions – a huge step forward, in their view, as was the $5 million the province put towards increasing mental health services. What the government needs to do to follow up on this momentum is to regulate counseling therapy, they assert.

At present there is no way of accurately ascertaining how many practising counselors there are in British Columbia. However, Grigg cites what Ontario discovered. In that province, in the time since they implemented statutory regulation on counseling therapists, they found that half the people providing services did not have any form of registration or certification.

“That’s dangerous,” said Grigg. “And we suspect that the situation in B.C. is similar but, because there is no central authority, even the scale of the problem is guesswork.”

He stressed, “It’s easy to see why this is so crucial. Suppose you were sick or injured and went to your local clinic or emergency department and discovered that it was up to you to figure out whether the people working there really were nurses and doctors, and whether they were qualified to provide care? That’s what people looking for counseling services are up against every day in B.C. There is no single title, like doctor or nurse or dentist or pharmacist, that identifies qualified and accountable counseling therapists.”

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

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.

A shidduch like none other

Brad Chenkis shows off a couple Sonovia masks. (photo from Tikva Housing)

It all began when Boris Chenkis, owner of After Five Fashions, was watching Israel Daily TV (ILTV) and saw an interview with Liat Goldhammer, the chief technology officer of an Israeli startup called Sonovia. She was talking about a new fabric-finishing technology for textile manufacturing developed at Bar-Ilan University, explaining that the technology could repel and kill bacteria located on clothing. Because it was in early January, a few weeks before COVID-19 became a worldwide pandemic, Chenkis just listened with interest.

On ILTV March 18, Dr. Jason Migdal, a microbiology researcher in Israel, discussed how the Sonovia technology mechanically impregnates metal nanoparticles into masks that destroy microorganisms in fabric. This was verified by two independent labs. It was also durable and washable. Now Chenkis was very interested.

With COVID becoming widespread, Sonovia had positively impacted Israeli doctors and health professionals by providing them with the technologically advanced masks. On May 12, Chenkis saw another interview about the Sonovia mask technology on ILTV – and an opportunity to get involved.

During his teenage years, Chenkis lived in Israel, studying and working at Kibbutz Rosh Hanikra. With this connection to Israel that never left his heart, he wanted to support an Israeli startup and so he purchased some masks to keep his family, friends and community safe. Soon after, he received an email from Sonovia, offering him an opportunity to help distribute the masks in Canada. Chenkis said yes. The masks were shipped from Ramat Gan to Vancouver and, within days, he was delivering hundreds to friends and family.

One of those who received the Sonovia mask was Yosef Wosk. Being both pleased and impressed with the technology, Wosk, like Chenkis, saw an opportunity to help not only the community here but also Israel. Wosk wondered how the masks could be made available locally to community members who might not be able to afford them, as they cost $65 each.

Wosk spoke with Shelley Karrel, chair of Tikva Housing, who contacted Tanja Demajo, chief executive officer of Jewish Family Services Vancouver. The need for the masks was confirmed and the shidduch almost complete.

Working with Chenkis’s son, Brad Chenkis, and with Wosk’s help, Tikva has acquired and will distribute 500 masks to residents of Tikva Housing, as well as clients of Jewish Family Services. It’s a win, win and win – tikkun olam, tzedakah and chesed.

For more information about the Sonovia masks, contact Brad Chenkis directly at [email protected].