A Conversation with Relief Director Rabbi Binyomin Babad

Zahava Emanuel

Until about 20 years ago, Rabbi Binyomin Babad’s résumé looked fairly typical: yeshivah, kollel, a stint at Agudah. So what convinced a Lakewood yungerman to get into the mental health field two decades ago, before therapy was a buzzword? And what caused him to open a mental health referral organization which today spans four countries, has 11 locations, and responds to 3,000 calls a month?

Making matches

Rabbi Babad breaks into a smile at the question. “My involvement began quite by accident. I worked at Agudah’s PCS from 1995 to 2001 doing job placement. I’d match unemployed, talented people who wanted to work with businesses who were looking to hire. At the time, Rabbi Sendy Ornstein worked as an accountant, and he would regularly tell me about his clients who were looking to hire. The two of us must have made a dozen employer-employee shidduchim together.”

Apart from his daytime accounting job, Rabbi Ornstein moonlighted in setting up Rabbi Shuki Berman’s medical referral agency. That experience got Rabbi Orenstein thinking: if a referral system was necessary for medical doctors, all the more so for mental health professionals.

Rabbi Babad explains, “If a guy needs a cardiologist and then gets heart surgery, the biggest proof of whether the surgeon is good is if the patient is walking around smiling. Also, nobody is shy to say they had heart surgery. But people don’t talk about their mental health help as much. All this leads to a situation where someone can need mental health help and not have a clue where to turn for help. That’s how the idea was born.”

Shortly after his brainstorm, Rabbi Ornstein met an askan by the name of R’ Shea Ostreicher. R’ Shea had been involved in setting up other organizations, and he helped Rabbi Ornstein get started in founding Relief.

In its first year, Relief received 200 phone calls. The volume, without any advertising, led Rabbi Ornstein to believe he was onto something.

To reach more people who needed help, he knew he’d need staff. So he called up his old friend from PCS Rabbi Binyamin Babad and recruited him to the cause. And the rest, as they say, is history.

Creating a map

“Twenty years ago, there was no map to follow in opening this organization,” Rabbi Babad says. “We weren’t professionals, and there wasn’t vast knowledge available online in those days. So we started reading books and trying our best to network. We’d get the name of a professional and cold-call him. If we could forge a relationship with him, that was a success. We’d ask him how we could learn more about different topics. He might refer us to a certain lecture at NYU, and we’d go there, learn, and meet other professionals. We trained and trained and trained until we both became very knowledgeable.”

There was no textbook to follow, and there was also no Halachah sefer to follow. “The mashgiach Rav Matisyahu zt”l was our go-to address in the beginning,” says Rabbi Babad.

The pair spoke to him all the time, and he answered many fundamental questions. At a time when there was no map, the Mashgiach was there.

As the first of its kind of organization, Relief also had to chart the map in terms of standards and procedures. As Rabbis Babad and Orenstein made connections, they recruited top-of-their-field professionals to the fledgling organization’s medical advisory board. With this professional oversight, the pair created procedures and instituted standards.

The process

When a client calls Relief, they are often nervous and uncomfortable.

“There is no such thing as a simple or complex case that first call,” explains Rabbi Babad.

That’s because the caller often doesn’t understand themselves exactly what kind of issue they are facing.

The 28 Relief staff members who provide referrals undergo months of intensive training before getting on the phone lines. They ask detailed questions to clarify the nature of the challenges that prompted the client to call in. And Rabbi Babad stresses that the client can choose to remain completely anonymous.

In that first call, Relief staff categorize the caller into one of three categories: adult referral, child referral, and eating disorders. That’s because each of these categories requires unique knowledge, and different members of the Relief staff are trained in each category.

Relief staff then interview the caller deeply but gently to understand the presenting symptoms and the client’s history. Then, when the situation is clear to the staff, they provide a professional referral and contact information to the client.

But their job isn’t over yet. Once the client reaches out to the professional, Relief acts as a sounding board for the client, feeling out if the therapy is going well, providing further referrals if necessary, and answering any questions that may crop up along the way.

“On average, the client will call back eight times in the first three months of their therapy,” says Rabbi Babad.

Vetting the professionals

How does Relief stay on top of its ever-growing network of 8,000-plus professionals?

“It takes a lot of research,” says Rabbi Babad with a chuckle.

Relief vets each professional with phone calls and by reading up about their work and approach. Then comes an interview, in which Relief asks pointed questions to figure out which client type this professional would be a good match for.

Once a professional is in the system, Relief uses information from the clients to create a further profile of information.

“When dealing with the numbers we deal with—over 3,000 calls a month—we begin to see patterns.”

Those patterns can be fascinating. There was the therapist who specialized in OCD who did extremely well with some clients and poorly with others. Eventually, Relief cracked the code: the professional did well with self-motivated clients and clashed with more resistant clients. That knowledge helped Relief refer in a more fine-tuned manner.

Are there any issues that place a therapist on a black list?

“Certainly. Inappropriate behavior, falling asleep during sessions—if we heard it once, maybe there was a misunderstanding, but the second we see a pattern, we take that very seriously.”

Refined referrals

Those patterns are constantly evolving. “Just because we gave a referral for someone a year ago, doesn’t mean we’d still give that referral today. So much damage can be done when some well-intentioned person who doesn’t know what they’re doing gives their neighbor, friend, or sister a referral.

“I’ll tell you a story. A woman called about her son’s ‘addiction’ and mental health issues. She requested a referral to an addictions facility. Our policy is that we don’t recommend a facility unless there is a qualified professional making the suggestion. We asked to speak to her son’s therapist to understand what his needs were, and she said she would get back to us.

“When we followed up with her the next day, she declined our overtures. ‘Thanks, but we got a good recommendation for a facility, and he’s actually on his way there as we speak.’

“Two days later, she called back. The facility had called to say that her son was not an addict but had a different mental health issue that they are not equipped to handle. However, they still charged her $7,000 for the first week of care.”

Therapy in the community

Our conversation morphs from Relief’s work to the kinds of issues Relief sees most often.

“Anxiety is a big one,” says Rabbi Babad.

As someone who works in schools, I pose a question I’ve been curious about. “Why do I often notice that anxious kids have anxious mothers? Could it be that anxiety is a learned behavior?”

Rabbi Babad is quick on the response. “Certainly, some anxious behaviors are learned, but anxiety happens to be genetic.”

He stops me before I can ask.

“And no—don’t even think about researching family anxiety when it comes to shidduchim. There’s not one family in Klal Yisrael that doesn’t have anxiety.”

This doesn’t have to be a problem, though. “Sometimes,” Rabbi Babad notes, “the familial factor can be a plus. We have mothers who call and say, ‘My child has anxiety, and I don’t want her to suffer the way I do.’ That’s a tremendous ma’alah and very admirable parenting.

“In general, wise parents realize that they’re the ones parenting their child the whole week. ‘Outsourcing’ their child to a therapist and saying, ‘Fix my kid’ doesn’t work. Wise parents take an active role in their child’s therapy and attempt to modify their own parenting in order to bring out favorable results in their child.”

Another issue that has become common in our community is ADHD. Why has ADHD become so rampant, and what can be done about it?

“In my opinion, ADHD has a lot more to do with the education system than anything else,” Rabbi Babad says.

Likely thanks to the rampant too-large class sizes, our educational system has become very rigid. Children may color out of the lines, both literally and figuratively.

Which is why parents with an ADHD child—a child who has a real diagnosis, not just hyperactive tendencies—have a real conundrum on their hands.

“On the one hand, their child might be really successful in life with their ADHD. Some of the klal’s most famous askanim, gvirim, and roshei yeshivah have ADHD—it’s well channeled, and they’re succeeding beautifully in life. As one rosh yeshivah once told me, ‘I jumped from sugya to sugya and I was all over the place, but I learned well and I covered ground fast.’ And I’ve heard the same things from gvirim. Their short focus and fountains of energy gave them the stamina to accomplish worlds. So that’s one side of the conundrum.

“On the other hand, kids with ADHD often don’t succeed in school. And that brings its own bundle of problems. At Relief, when we get phone calls about ADHD students, we need to look at each situation and consider its details. Is the child succeeding at all in school? How are their self-esteem and self-confidence? What are the parents’ and rebbe’im’s attitudes toward the child? All these aspects contribute to the direction we’ll go in each case.”

New-age phenomenon?

“Why are mental health issues so rampant now, but nobody needed help in the shtetl?” I wonder.

Rabbi Babad shrugs. “Well, who said so? On one end of the extreme, there was always the town meshugene. Maybe we have more sophisticated terms for those now.

“When Rabbi Orenstein started Relief, his father, a war survivor, was perturbed. ‘Why do you need all this stuff these days?’ he wondered. ‘When I was a kid, the fact that I was alive with clothes and food was enough to make me content. Who cared about self-esteem?’

“But we live a very different life. Part of the change is wealth. We’re not struggling to get by. Instead of fear that we’ll be killed in a pogrom, our minds are filled with other things. Baruch Hashem.”

The question begs to be asked, so I ask it: “On the flip side, are we overdoing it today? Does everyone who is in therapy need to be in therapy?”

Rabbi Babad sighs. “It’s a hard question to answer. Yes, to some degree, the community might be overdoing it. On the other hand, I don’t want someone who reads this to not call for help if they really feel they need it. You’re certainly better off calling if you think you might need help.

“You know, one of the questions we ask during the initial intake is for how long the issues have been presenting. One woman who called in answered, ‘Since Thursday.’ Okay, so that’s probably a bit too proactive if the issue isn’t an emergency.”

To be clear, Relief does not believe that everybody needs therapy. “Someone who has a phobia of flying doesn’t need therapy if all their family members live nearby and they never need to fly anywhere. The phobia isn’t affecting their life. But if your brother is making a wedding and you can’t get on the plane to join, your problem is impeding you from living your life.

“And that’s it in a nutshell. You can benefit from therapy if your challenge is impeding you in any way from living the life you want to live.”

The big, bad word

With therapy so common these days, is there still any stigma surrounding mental health?

Rabbi Babad’s answer surprises me. “What do we mean by mental health stigma? Is it stigma or privacy? The same way we don’t talk about certain very private medical issues, it’s often not appropriate to discuss mental health issues.

“I would only call it stigma if it prevents people from getting the help they need. Does that still exist? Somewhat. But by the sheer volume of calls we get, I’d say we are leaving the stigma behind.”

Privacy is actually the reason Relief doesn’t run any fundraising campaigns or dinners. “We would never ask anyone to get up and say, ‘Relief helped me.’ That’s a violation of privacy. So our fundraising is all private.”

Worldwide Relief

Relief has 11 local centers. Pre-covid, only people in cities with a local Relief branch called in. But with covid came a new reality: people were okay with telehealth and Zoom therapy. Suddenly, Relief started getting calls from just about everywhere.

“In the months after covid began and throughout that year, we got calls from over 350 locations—35 states and 22 countries.”

But it’s not only Zoom that has opened Relief’s doors wide to the cities or countries without a local branch. Relief’s long hand in networking has opened many previously closed doors too.

“A parent in Colorado called me recently. She needed a child psychiatrist for a complex case. We don’t have a branch in Colorado, so I called a professional in Chicago who sits on our advisory board.

“‘Who do we know in child psych in Colorado?’ I asked.

“He thought for just a moment. ‘It’s your lucky day,’ he answered.

“Turns out, we had a child psychiatry expert in NYU whom we were close with during the duration of her work at NYU. But then she transferred to Colorado, and that was the end of that. Except now it wasn’t. We got back in touch with this expert, and she was happy to help her old friends at Relief. A child in Colorado is getting the help he needs—all because of the siyata d’Shmaya we are constantly privy to, exhibited through our amazing network of wonderful professionals.”

Stories like this abound.

“We had a woman in a yehupitz town in Texas who needed a psychiatrist who specializes in the issue she was struggling with. This is not a major Jewish community, and I literally had no connections there. But these types of psychiatrists network well with each other, and a lot of them know each other. So we called one at UCLA and asked her for ideas. What do you know? Her good friend is a psychiatrist in this yehupitz town in Texas, and she specializes in that issue. Another shidduch made, more relief found.”

The future

At this point, Relief is helping people across the globe. It’s the only organization in this line of work. Where does it go from here?

Rabbi Babad is thoughtful. “We started off as a tiny organization. Then we spread out far and wide—much faster than we could have imagined. The model we have is working. It’s helping people who can’t help themselves.

“So what’s our mission? To continue to help as many Jews as possible, wherever they might be.”

A parting message

As I pack up to go, I ask Rabbi Babad if he has any parting message for Voice readers: mothers who are worried about their child, young adults who are worried about themselves, or anyone else who is toying with the idea that perhaps they need professional help.

Rabbi Babad is quick in his response: “I want the readers to know that there is good help out there. You just have to find it. And don’t try to do it on your own.”

Sidebar:

Relief in numbers

11 offices in 4 countries

40 employees

Clinicians in the database: 8,713

Average number of individual clinicians recommended per month: 1,100+

Average number of calls per month: 10,000

Average new cases per month: 1,300

Average total caseload per month (includes new cases and cases from the past that required follow-up or further care): 3,000+

Total unique cases since inception: 158,916

Budget: $5.5 million annually