A s a practicing psychiatrist in the US I would get a few phone calls every week from people who needed a “letter.” Some people want one for social security in order to be recognized for state benefits. Other people want a letter to aid with their appeal for public housing. I was once asked to write a letter to the airlines in support of a patient who likes to bring her “therapy poodle” on the flight between Miami and LaGuardia.
Sometimes the requests were straightforward and legitimate and then I had no problem supporting my patients. A young woman with treatment-resistant schizophrenia who can’t make a living and would benefit from supportive housing is certainly deserving of these services to allow her to live independently in the community. On the other hand a young man who doesn’t want to work because of “anxiety” — when he’s really spending most of his time and resources growing and smoking nonmedical marijuana — likely doesn’t meet criteria for “disability” beyond having bad judgment and a lack of personal responsibility.
Living in Israel comes with all sorts of new complexities as far as writing letters for my patients. Beyond becoming familiar with the ins and outs of Bituach Leumi the Israeli version of Social Security and Diur Mugan sheltered housing there was a whole new type of letter that I’d be asked to write for my patients: a letter to the army regarding capacity for military service.
This issue was certainly a sensitive one. There are those who say that mandatory service means mandatory service irrespective of religious practices. There are others who say that a yeshivah deferment is legitimate and should be guaranteed according to the goals and laws in the State of Israel. Then there are differences between all-chareidi units and hesder units. And what about issues related to kashrus Shabbos and mixed-gender units? Furthermore there have been a number of well-publicized stories of psychiatrists providing illegitimate exemption letters for individuals seeking to escape their mandatory military service. This had resulted in legal consequences including suspended medical licenses.
