Anxiety sufferers overwhelm hospital ERs

Health Ministry wants patients to be transferred to local doctors, social workers, and psychologists.

nahariya runs for cover (photo credit: Ariel Jerozolimski)
nahariya runs for cover
(photo credit: Ariel Jerozolimski)
With large numbers of anxiety attack victims turning to hospital emergency rooms for treatment, the Health Ministry has asked its mental health division to develop a plan that would allow responsibility for these patients to be quickly transferred to local doctors, social workers and psychologists. Acting mental health division head Dr. Ya'acov Poliakovich is preparing such a plan at the request of the ministry's Supreme Committee on Hospitalization. Prof. Arieh Shalev, chief of psychiatry at Hadassah University Medical Center, Ein Kerem, a leading expert in post-traumatic stress disorder, told The Jerusalem Post on Monday that "the idea is a good one in principle, as it can protect hospital emergency rooms from being overwhelmed." "People with anxiety attacks in England and Australia, for example, don't go to hospitals but to community facilities. But while the staff who see such patients do not have to be highly skilled psychiatrists, they do have to be well trained for the job. Such centers must be trusted by the public, or they won't go there. If the effort were amateurish, it would be terrible," he said. In related news, ERAN (Emotional First Aid) said that during the past week it had received 20 percent more calls than usual. The service, run by 1,000 trained volunteers - psychologists, social workers, educational counselors and others - can be reached 24 hours by calling 1201. ERAN invites anyone who is anxious, depressed or emotionally distressed to call. Dr. Danny Brom, a clinical psychologist who heads Jerusalem's Herzog Memorial Hospital's Israel Center for the Treatment of Psychotrauma and Metiv, the capital's walk-in crisis center, said the ministry has been keen on turning Metiv into a model for the entire country. The idea of treating anxiety victims at community centers was raised four years ago by the late Dr. David Applebaum, head of Shaare Zedek Medical Center's emergency department, who later died along his daughter Nava in the Cafe Hillel suicide bombing attack on September 9, 2003. "He thought emergency rooms should not be dealing with such cases. But the idea never got off the ground because Jerusalem's hospitals were opposed to losing the income. They receive NIS 400 from the National Insurance Institute for treating each terror victim, including those with psychological trauma, in the emergency room," Brom said. For the last three years, Metiv's walk-in crisis center - originally funded with seed money by the UJA-Federation of New York to help people shaken by terrorist attacks - has treated some 1,600 people. The psychologists, social workers and other professionals are trained to deal with all types of trauma. The service was available free for two or three years, but as the Federation moved on to other projects, Metiv had to charge NIS 80 to NIS 180 and depend largely on donations. It is now moving from the capital's Malha quarter to the Kiryat Hayovel neighborhood. Brom said that neither the health funds nor the Health Ministry had provided any funding to keep it going. "We set income criteria, and 70% of the people we see don't have enough income to pay even NIS 80, so we charge them less," he said. If the ministry moves responsibility for trauma victims from emergency rooms to community clinics, said Brom, "the question is who will fund it." If family doctors are asked to take on the job in addition to their regular work, the problem is whether they will have the time and receive the proper training, he said.