Orlev: Gov't must reform mental-health services

National Council of the Child head Dr. Yitzhak Kadman decries ‘shocking’ pediatric psychiatric treatment, ‘collapsing’ facilities.

Hospital beds 311 (photo credit: Ariel Jerozolimski)
Hospital beds 311
(photo credit: Ariel Jerozolimski)
The Health Ministry conceded on Wednesday that there is a serious shortage of medical manpower in the public psychiatric service it runs, especially in the treatment of children and teenagers. The charge was made in Tuesday’s meeting of the Knesset Committee for Children’s Rights by chairman MK Zevulun Orlev (Habayit Hayehudi) as well as others attending the session.
“The Treasury has not learned its lesson from the Carmel Forest fire tragedy,” Orlev said. “There, the development and reform of the Fire Service was held back. The Treasury regards the mental-health service as a hostage until reform begins.”
A 40 percent decrease in beds for minors in psychiatric hospitals has occurred during the last 15 years, according to data provided by the Knesset research and information department. Dr. Igor Barash, the deputy head of the Health Ministry’s mental-health services said that when National Health Insurance began in 1995, structural reform was carried out and 200 hospital beds were eliminated in the hope that patients would be treated in the community. He added that the government thought more community facilities would be constructed, replacing many of the inpatient facilities. But solutions were not found, especially for children and teenagers.
Dr. Michal Rappaport of the Child Psychiatry Society, said that there are 170 pediatric psychiatrists in the country.
“When a child comes for treatment in a clinic, I allocate a year’s care for him.
Priority is given for serious cases, and ‘light’ cases such as parents‚ divorce or criminality have to wait long months while the problems get more serious,” she said.
“Children discharged from psychiatric hospitals are given drugs that stabilize them, but they need continued treatment, and in many cases, the health funds do not approve the recommended medications.”
The health insurers approve psychiatric drugs only for those with psychosis or schizophrenia, and not those with behavioral problems, she said.
Orlev said that the committee will make a surprise visit to facilities that treat children and have another committee session on the matter in six months. The committee criticized the Treasury’s approach of holding back reform because of a 15-year dispute over the status of these services. It also discovered problems of coordination between the Health Ministry and the Welfare and Social Services Ministry, Orlev said.
National Council of the Child head Dr. Yitzhak Kadman said that state treatment of mentally disturbed children and youths was “shocking” and that facilities are “collapsing.”
The Health Ministry said it is working to advance the reform in which the health funds would provide psychiatric services instead of the ministry, which has inadequate budgets for such an undertaking. Deputy Health Minister Ya’acov Litzman previously had opposed the reform, but he said he reluctantly agreed to it almost two years ago. But it has not yet been implemented due to Treasury opposition.
To provide more pediatric psychiatrists, the ministry said it added 34 more job slots in the last few years and recognized pediatric psychiatry as a “specialty with inadequate manpower,” offering salary bonuses to doctors who specialize in it.