Advice for making Aliyah with mental illness

Because immigration 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 moving.

Teen depression (photo credit: INGIMAGE)
Teen depression
(photo credit: INGIMAGE)
The past six months has seen a massive increase in people considering immigration to Israel. In the wake of the global coronavirus pandemic, rising antisemitism, and both financial and political instability in many Western countries, moving home to Israel is becoming a reality for many individuals and their families.
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 psychiatric treatment be provided for all of its citizens.
This is very relevant for many people considering aliyah – immigrating to Israel – as the prevalence of mental illness is significant among all populations. With up to one in three 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 someone 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 its 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 immigrating.
In the months prior to making aliyah
Because immigration 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 moving. Individuals involved in long-term treatment should discuss the termination of therapeutic relationships with their treatment providers. Anyone 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 one is in good health before their journey. The months prior to moving should also be dedicated to reaching out to individuals in Israel who can be a part of the new support network upon arriving. This can include notifying Israeli friends and family 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. Israeli law requires the four major health insurance providers to provide mental health treatment for their clients. 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. 
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 destination in Israel is a must, in addition to ensuring that the insurer’s pharmaceutical 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 who speaks their native language fluently is a necessity that should be explored prior to making aliyah. Individuals desiring private psychiatric care 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 crosses multiple time zones, individuals should be aware of the fact that their sleep will be disrupted. Changes in one’s circadian rhythm can pose a problem for individuals with certain mental illnesses (specifically mood disorders), and this should be discussed with 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 or shortly after landing in Israel.
After arriving 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 arriving, 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 to establish a therapeutic relationship. Furthermore, as individuals with mental illness are at increased risk of medical illnesses, 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.
The writer is a board-certified psychiatrist and a business consultant based in Jerusalem. After completing his training as an award-winning chief resident at Harvard Medical School, he and his wife made aliyah with their family. His new book, Off the Couch, is now available from Menucha Publishers.