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After a 12-year delay, national mental health reform will have to wait at least another six months, according to Health Ministry director-general Prof. Avi Yisraeli, who told the National Health Council in Jerusalem on Sunday about the difficulties in pushing it through.
The reform, which was due to have been launched on January 1, is meant to transfer responsibility for mental health services from the Health Ministry to the four public health funds, all of which say they are not ready to take it over.
Yisraeli said that due to the Knesset failure to pass the Treasury's Arrangements Bill owing to opposition in the committees, the reform cannot be carried out in time. Ministry officials said that the decision to carry out the reform - proposed by the Netanyahu State Judicial Commission on the Health System and part of the 1994 National Health Insurance Law - was approved by the cabinet on October 4. It still has to go to the Ministerial Committee on legislation to decide which Knesset Committee will process the bill, after which six more weeks will be necessary for hearings and preparing the bill's official text. After the legislative process, there must be more negotiations with six relevant unions, from the doctors to social workers and psychologists.
The Health Ministry's Dov Fass, who has been working on the reform, said that the cost for each consultation with a mental health professional has been set at NIS 160 and that the "average" number of sessions would be 20, which "is enough to meet the needs of patients." Regarding a major objection of opponents of the reform, Fass said that "life crises" such as getting divorced would, of themselves, not be covered, but people who suffer anxiety or depression as a result of such personal events would get help under the reform from their health fund. He also said he hoped the future of the ministry's community mental health clinics, which have for years provided good care at state expense, would be resolved so that they would not have to be closed and all the workers dismissed. There can be a transfer of ownership to the health funds or the professionals could work for new entities and provide services, Fass said.
Prof. Eran Halpern, representing Clalit Health Services, said it was "insane" for the reform to be implemented as written, as it will "be total chaos" as the insurers are not prepared for and don't yet have the means for offering services.
The reform was aimed at reducing the stigma of getting mental health treatment and increasing the amount of funds for this purpose, which in recent years had dwindled when under the ministry's aegis.