“My feeling at the moment is that there’s no place in the world for me,” wrote Efrat Gil, an outstanding student at Hebrew University in January 2005. “That there’s nobody willing to help me with my post-traumatic stress. That the state, which I love so much, set up hundreds of hostels, hospitals, closed and open wards, day hospitalization, wow. But there’s no place for me.”
A few days later, she committed suicide in her dorm room.
Gil suffered severe post-traumatic stress stemming from gang rape and incest in her childhood. Her letter described time spent in a closed psychiatric ward that merely worsened her flashbacks, a doctor who refused to readmit her when she starting cutting herself because “the framework wasn’t suitable,” and problems with various other treatment programs.
“More than anything, I want to live and not to harm myself,” her letter concluded. “But I can’t do it alone. I need help.”
Gil is far from the only victim of sexual abuse to suffer serious psychiatric problems. But the stir caused by her letter moved the Social Affairs Ministry to begin taking action, which resulted a decade later in the opening of Beit Ella, an alternative to hospitalization for victims of sexual abuse who suffer from post-traumatic stress.
Beit Ella, intended for women over 18, opened in September in central Israel. (The location is not publicized.) Women can stay there for as little as a few days or up to three months; then, they’re supposed to leave.
“The hostel’s principal goal is getting [residents] back into routine” – physically, emotionally and functionally, said its director, Dr. Roni Elran-Barak. “Physical routine means food, sleep and medical care; emotional means psychiatric and psychological treatment; and functional routine means getting up in the morning, being productive, simply doing things.”
“Physical routine, for example, is very important,” she continued. “They often sleep during the day and are awake at night, and eat in a very irregular fashion.”
Beit Ella is run by the Keshet organization and funded by the Social Affairs Ministry. It can accommodate 10 to 12 patients, but currently has seven.
In many ways, it looks like a normal house. It reflects the understanding that psychiatric hospitals are often unsuitable for sexual assault victims, even if their post-traumatic stress has psychiatric manifestations like self-harm and detachment from one’s surroundings.
Reut Lechter, Beit Ella’s social worker, explained that unlike other psychiatric patients, victims of sexual abuse aren’t helped by drugs. “No medication will stop flashbacks or [detachment],” she explained.
Tzipi Nachshon Glick, head of the ministry’s department for young adults at risk, added that psychiatric patients are sometimes physically restrained, and there are often men in the wards – both factors that, for sexual assault victims, merely worsen their trauma.
At Beit Ella, no men are present.
Sexual assault victims can’t apply to Beit Ella directly. They must be referred by a therapist or treatment program to which they can return after leaving the hostel, since Beit Ella is meant to be only a first step toward recovery.
Beit Ella is the first institution of its kind in Israel, and its staff believes it’s the first of its kind worldwide. Since it isn’t based on any existing model, the initial months have to some degree been a process of trial and error. For instance, the in-house nurse was replaced by a dietitian after it became clear that many of the women suffered from eating disorders.
The hostel has already experienced some unpleasant moments. At least one woman who suffered from severe detachment from her surroundings left; she says she was kicked out due to the severity of her symptoms.
“So what did they open the place for?” demanded H., the 38-year-old who left. “You can’t limit symptoms.”
Elran-Barak wouldn’t comment on H.’s case, but said that in general, women wouldn’t be kicked out because of their symptoms, but because of refusal to cooperate. Nevertheless, she added, Beit Ella isn’t a hospital, and some women do require hospitalization.
Marva Zohar, who spent more than two years working to get Beit Ella up and running, sounds only partially satisfied with the result. “From the start, it was clear this wasn’t the full answer,” she noted, adding that she thought the admission process was too complicated.
Surprisingly, however, H. still believes in the model – if it is adjusted to handle women with more severe symptoms. “I believe that if they arrive at the right recipe, it will be excellent, and many girls could be helped by it – including me,” she said. “I need a place like this, but one that will accept me ‘as is.’”
MK Aliza Lavie (Yesh Atid), who helped shepherd the program to fruition as chairwoman of the Knesset Committee on the Status of Women, said Beit Ella still has its growing pains, but will improve as time passes. The very existence of an alternative to hospitalization is progress, she stressed. “But we still have a long way to go.”
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