Emily* is 27, happily engaged and with a job in healthcare, which she loves. This is a very different picture to her life several years ago, when she was dangerously ill with anorexia. A concerned friend put her in touch with Noa, an organisation offering confidential support for girls and women aged 12 to 24 from the Orthodox community.

“I was in denial,” says Emily. “The anorexia had made me very angry and stubborn, but Noa accepted me straight away. They completely saved my life.”

Her condition was exacerbated by food playing such a central role in the Jewish religion. “It’s like having Thanksgiving every Friday night, so the thought of food was in my head the whole time. I am now in recovery, but food is still a difficult issue for me.”

As well as allocating Emily a key worker, Noa supported her mum, a single parent, providing a liaison officer, who managed to get her daughter into a specialist hospital unit and access a dietician.“Noa helped me rebuild my life,” says Emily. “When I was in hospital, the key worker would come to all the meetings with the medical professionals regarding my care.”

Even after Emily left Noa, her key worker continued to check in with her. “I know if I need anything, Noa will be able to help. It’s never really the end with them.”

In her experience, the issue of mental health “is a taboo in every part of the Orthodox community, but more so in the ultra-Orthodox one. Girls are worried they won’t find someone to marry if they have mental health problems.”

“For a long time, I felt that I had to hide all my thoughts and feelings from everyone, but when I was at Noa, I could take off my armour and just be myself. It’s scary to think what the scenario would have been if I hadn’t found Noa.”

Noa was set up in 2009 by child and adolescent psychotherapist Naomi Lerer, with just seven teenagers on its books. It now works with 180 girls annually, but the pandemic has seen demand swell and there are currently 58 girls on its waiting list. “There has been huge anxiety surrounding young people with parents feeling anxious and families struggling,” says Lerer. “Social anxiety has increased by pupils not going to school and becoming more and more withdrawn.”

They have also witnessed a surge in eating disorders, says Lerer, partly due to people seeing themselves on screen so much during online classes and also as “a way of gaining a sense of control” throughout a year of upheaval.

On “the plus side”, Covid has pushed the topic of mental health into the foreground, notes Lerer. “Until now, Noa had been under the radar, but the pandemic has magnified mental health challenges. This is helping to destigmatise it, but in the Jewish community, we still have a lot of work to do.” She suggests the stigma can be greater in the Orthodox community. “We’ve come a long way, and there is an increasing number of rabbonim who are speaking up about the prevalence of mental health issues and helping to normalise them, but people are still fearful of damaging their family’s reputation.”

The organisation goes to exceptional lengths to maintain the highest levels of confidentiality. Appointments are carefully planned so there is no overlap between clients and service users are known only to staff who work directly with them.

The fact that Noa is an Orthodox organisation is vital to gain clients’ trust, says Lerer. “A lot of the girls we support have barriers when it comes to accessing mainstream services, and they need a culturally sensitive organisation to advocate for them to get the help they need.”

For Leah*, being able to access support from an Orthodox organisation while she was experiencing mental health difficulties was key. “There’s a cultural understanding, so if someone from the Orthodox community makes a life choice, Noa understands why that might be difficult for them, but without judging them. They understand about family dynamics and Shabbat and Yom Tovim.”

Seeking help several years ago at the age of 15, Leah describes “the Noa house” as “a second home” for her. “My parents just told me it was therapy, so I was shocked when I got there and found this amazing organisation with a gym, loads of arts and crafts and a kitchen where you could make smoothies.”

“They gave me the support I needed rather than saying, ‘This is what we can offer you.’ I received amazing therapy, but also extra support from a key worker. Even when I was living outside London, a key worker would call me once a week, and when I left school, they offered me a mentor.”

As Lerer puts it: “We need to meet adolescents where they’re at, so we take a gentle, creative approach. It doesn’t have to be therapy. They might work with a key worker or a mentor, or they might come in for sessions with a personal trainer or for creative art until they’re ready to embark on therapeutic work. Every girl takes a different path to allow her to flourish.”

Despite the pandemic halting most face-to-face sessions, Noa has continued to provide support through Zoom sessions, daily webinars and drop-offs. “We did think about furloughing staff,” says Lerer, “but it was clear that the girls needed us more than ever, so it wasn’t an option”.

“Noa has been phenomenal during the past year,” says Leah. “As well as my Zoom sessions, they dropped off art supplies, food and even a jar with a positive quote for every day. It reminded me that although we couldn’t see them, they were still there for us.”

Sara*, who started going to Noa when she was 15 due to difficulties with both her mental health and her family, says the organisation has been a lifeline during the past 12 months. “The pandemic has been horrific. I struggled the most in the evenings. I’m a student, and I found it really difficult to keep up online. Noa helped find me a tutor.”

Prior to that, Noa assisted in matching her with a foster family and in obtaining a grant for furniture for a flat. “I’m such a harsh critic, but I hold Noa so close to my heart. There is a sense of family, rather than a service. There is a warmth and a sensitivity since they know where you’ve come from and where you’re at.”

Now in her early 20s, Sara would like to see this level of understanding about mental health in the rest of the Orthodox world. “The perspective towards mental health is shifting, but there’s still a lot to do.”

Lerer is aware that Noa plays a unique role in the Orthodox community and says that it’s “heartbreaking” that a lack of funding means that girls are currently being held on a waiting list.

“It takes a lot of courage to ask for help when you are struggling, and no girl should have to struggle alone.”

Noa is running an online matching campaign on April 18 and 19. All donations will be doubled. To find out more about the campaign or to donate to Noa go to www.charityextra.com/noa

*Names have been changed