Psychiatric care to be provided by health funds, not ministry

Starting January 1, 2007, all patients who need psychiatric and other mental health services can go to their insurers' clinics for care.

hirchson budget 88 298 (photo credit: Ariel Jerozolimski)
hirchson budget 88 298
(photo credit: Ariel Jerozolimski)
After a 12-year delay, the Health and Finance Ministries finally signed an agreement Sunday transferring responsibility for mental health services from the Health Ministry to the four public health funds. Starting January 1, 2007, all patients who need psychiatric and other mental health services can go to their insurers' clinics for care, just as they would for a physical illness. This reform was part of the National Health Insurance Law of 1994, which went into effect in January 1995 but without inclusion of mental health services in the basket of health services. The problem was a dispute among the two ministries and the health funds over how much money the insurers would receive to provide these services. The Health Ministry will, however, continue to be responsible for the rehabilitation and integration of the mentally ill into the community, treatment of drug abusers and care of mentally ill prisoners. A total of NIS 1.2 billion will be transferred to the health funds - Clalit, Maccabi, Meuhedet and Leumit - instead of the Health Ministry, to cover the costs of psychiatric care for their members. Over the past decade, as new medications have become available, the ministry has attempted to reduce the number of psychiatric inpatients, referring them instead for treatment in outpatient facilities in their communities. This makes it easier for them to return to life in their homes and with their families. The number of psychiatric beds will be 3,150 and resources that would otherwise have been spent on inpatient care will be rerouted to community facilities. The Treasury has earmarked an additional NIS 160 million, to be distributed over the next four years, for insurers to open and strengthen their community psychiatric clinics, with NIS 30 million more to be spent for this purpose between 2007 and 2009. As well, a total of NIS 40 million will be allocated to the ministry for bolstering its rehabilitation services within communities. With the Health Ministry relieved of much of the burden for providing mental health services, its supervision of psychiatric services will be strengthened so that it can assess how well the health funds are carrying out their new duties. Health Minister Ya'acov Ben-Yizri, who signed the agreement with Finance Minister Avraham Hirchson, voiced his joy over the agreement. "I don't see any reason for separating general medical treatment from psychiatric treatment, and unifying the two will reduce the stigma of mental disorders," he said. "From experience here and abroad, the psychiatric reforms we have been carrying out have been very successful, with patients leaving hospital wards to be integrated into the community." Hirchson added that after a 12-year wait, the transfer of responsibility for mental health care is "the right step that will be good for patients. I see great importance in this reform and think the allocation of an additional NIS 230 million will bring significant improvement in care for this population."