|Mental health inmate rests in bed [illustrative] 370.(Photo by: REUTERS/Jianan Yu)|
Managing Israel’s psychiatric hospitals
By JAY RUDERMAN
Until Israel takes its place alongside other progressive countries and commits to a national policy of community-based living for everyone, we should all have a hard time sleeping.
Along with Israelis across our nation, I was stunned and deeply disturbed by the
news that last week law enforcement raided a psychiatric hospital in Petah Tikva
and detained for questioning 75 staff members as part of a year-long
investigation that uncovered widespread sexual and physical abuse at the
Two days after the raid, the hospital – which had a patient
population of about 150 – was shut down, and patients were transferred to other
facilities throughout our country.
This is not the first case of abuse at
an institution. Sadly, there have been many. As unsettling as these reports are,
the investigation also showed that there were others who did not directly
participate in the abuse, but knew it was happening, and did not speak
So much about the institutional environment and the way it operates –
with its impersonal procedures, its creation of dependence on the part of those
it serves, its separation from society, and its dearth of community – enables
and supports a culture where abuse can be practiced with impunity.
Israel we need to pick up the pace and dedicate far more emotion, focus and
resources to creating more options for care in the community. It is in this
model and paradigm in which individuals are afforded the best opportunities for
growth and independence.
More than 40 years ago the United States faced
its own Neve Ya’akov scandal – one that resulted when the young investigative
reporter Geraldo Rivera exposed physical and sexual abuse at the Willowbrook
State School, a New York state-run residential facility located in New York
The 28-minute video documentary – Willowbrook: The Last Great
Disgrace – led to massive policy reform and, ultimately, government funding
policies that promoted and supported community-based services for people with
In my native Massachusetts in 1972, a lawsuit was filed in
federal court by parents of children with developmental disabilities living in
state “schools.” Judge Joseph L. Tauro made an unannounced visit to the
Belchertown State School and found appalling conditions.
Tauro’s supervision, which lasted for many years, these institutions were
cleaned up and ultimately closed.
Massachusetts has one remaining
institution that serves a very small number of adults with developmental
disabilities, and it is expected to close very soon. It does still have
state-run psychiatric hospitals.
A more recent federal lawsuit in the US,
called the Olmstead case, has led to a massive shift to community care across
the US. Individuals who had lived in facilities for decades have now been given
the proper support for community living and for the first time are enjoying
their independence in the community.
The arguments about why we must keep
institutions open ring hollow. Some people insist there are “difficult cases”
that require institutionalization. But the fact is that countries around the
world – with the US leading in this area – are closing institutions and more and
more are caring in the community for those with even the most significant
Indeed, in the US, there are 13 states, plus the District
of Columbia, which have eliminated all public institutions for people with
I am not suggesting that transitioning away
from institutional care will eliminate all abuse. But it is harder to commit
such acts, and harder to hide them, when people leave home every day to work,
participate in day habilitation, or to go to school in the
It’s harder to commit and hide abuse when people with
disabilities are treated by doctors and therapists with offices in the
community. It’s harder to commit and hide abuse when local police and safety
officials protect people with disabilities along with all other members of their
The media reports that Dalia, the mother of a 24-year-old man
who was a patient at Neve Ya’akov, told investigating authorities “we complained
to the administrator... we live in fear that tonight he will be hit or they will
inject him. We don’t sleep.”
We trust that the authorities will conduct a
thorough investigation of what occurred at the hospital, will uncover the truth,
will identify the guilty, and will make sure justice is done.
Israel takes its place alongside other progressive countries and commits to a
national policy of community-based living for everyone, we should – like Dalia,
the mother of the patient at Neve Ya’akov – all have a hard time
The writer is president of the Ruderman Family Foundation.