Aliyah and Mental Illness
Israel is the homeland of The Jewish People pure and simple. This means that irrespective of an individual's medical or mental illness, Israel will always be their national home. Israeli law prevents discrimination against individuals with mental illness and requires that adequate treatment be provided for all of its citizens.
This is very relevant for many people considering Aliyah as the prevalence of mental illness is significant. With up to 1-in-3 individuals experiencing mental illness over the course of their lifetime, a sizable percentage of people moving to Israel will have a history of being in psychiatric treatment themselves or will have a loved one with mental illness.
For the individual with a history of mental illness, the process of Aliyah can present additional and unique challenges. More specifically, many people with mental illness will find that a significant life change can be somewhat destabilizing. This is further compounded by issues related to establishing a new treatment team, learning about and navigating new resources, and having left behind one's established support network. Nefesh B'Nefesh is dedicated to supporting Jews from diverse backgrounds in their Aliyah journey and has a wealth of information related to understanding the national health system on their website. Beyond this, it is important to highlight potential hurdles for individuals with mental illness during the Aliyah experience in order to help each Jew to be as successful as possible in their move to Israel. So while this is not meant to serve as specific treatment guidelines, the following can be viewed as general considerations for individuals with mental illness as they prepare for Aliyah.
In the Months Prior to Aliyah
Because Aliyah can be a challenging and stressful period in a person's life, it is important to be in a stable place with one's psychiatric treatment in the months before making Aliyah. Individuals involved in longterm treatment should discuss the termination of therapeutic relationships with their treatment providers. Individuals treated with psychiatric medications should aim to be on a stable medication regimen prior to making Aliyah. Any laboratory tests associated with one's medications or treatment should be completed and discussed with one's physicians prior to making Aliyah to ensure that an individual is in good health before their journey. The months prior to Aliyah should also be dedicated to reaching out to individuals in Israel that can be a part of one's support network upon arriving. This can include notifying loved ones of the specifics regarding one's history, current psychiatric care, and safety plan.
Finding a New Treatment Team
It is also important to try and establish new treatment providers in Israel as soon as possible. Due to recent legislation, the four major health insurance providers are required to provide mental health treatment for their subscribers. It is noteworthy that access to mental health treatment continues to improve and that significant strides have been made to address this on a national level. Therefore many individuals will choose to utilize their health insurance benefits for psychiatric care and psychotherapy. Choosing a health insurance provider with mental health resources in close proximity to one's Aliyah destination is a must in addition to ensuring that the insurer's formulary provides coverage for one's medications.
Other individuals will choose to seek private psychiatric treatment outside of the national healthcare system for a variety of reasons. For many, having personalized treatment with a provider that speaks their native language fluently is a necessity that should be explored prior to making Aliyah. Individuals desiring private psychiatric treatment are advised to preemptively contact treatment providers in order to select an individual who might be most helpful to them upon arriving in Israel.
The Flight to Israel
Because the flight to Israel is across time zones, individuals should be aware of the fact that their sleep will be disrupted. Changes in sleep can pose a problem for individuals with certain mental illnesses (specifically bipolar disorder) and this should be discussed with one's treatment providers prior to embarking on the Aliyah journey. As with other medical conditions, Nefesh B'Nefesh recommends that individuals making Aliyah consider bringing a supply of their prescribed medications in order to avoid a complicated situation in which a person may run out of their medications upon landing in Israel.
After Landing in Israel
As the immediate days and weeks after making Aliyah may pose unique stresses, it is advisable to reach out to one's loved ones upon making Aliyah: both back in one's previous place of residence and in Israel. That way a person can ensure that they will have the support they need to be successful.
Additionally, an individual should aim to connect with their new treatment providers shortly after arriving in Israel to schedule an initial appointment and establish a therapeutic relationship. Furthermore, as individuals with mental illness are at increased risk of medical illness, it is advisable to establish a relationship with one's new primary care provider in order to remain as healthy as possible.
In short, making Aliyah is a great and beautiful journey. For individuals with mental illness, addressing potential challenges before they arise can be critical to ensure a successful Aliyah experience.