In Israel, growing numbers of psychiatric patients are being treated in the community

From The Jerusalum Post:

As most mental health professionals and patients' families wait breathlessly for Knesset approval of reform that would transfer responsibility for services from the Health Ministry to the health funds, the ministry issued for publication on June 16 its 85-page Mental Health in Israel Statistical Annual 2008 showing that growing numbers of patients are being treated in the community rather than hospitalized.

There are 14 psychiatric hospitals, eight of them state-owned, two by Clalit Health Services, one in the public non-profit sector and three private for the care of people with both psychiatric illness and mental disability. The system also includes 12 psychiatric departments in general hospitals.

The total number of their inpatient beds has declined to 3,453 - thanks to the passage in 2000 of the Community-Based Rehabilitation of the Mentally Disabled Act - compared to 6,299 in 1998. A total of 16,378 people aged 15 and over were hospitalized in such institutions in 2007 for at least a day.

Over 61,000 people received services in outpatient mental health clinics, while more than 14,000 people recovering from acute mental illness underwent rehabilitation in 2007, living in supportive hostels, working in sheltered or supported workshops or participating in special social counselling and activities. In 1999, the number of outpatients treated was only 47,000.

Ninety-seven Holocaust survivors are still being treated and housed in psychiatric hostels.

"All parties today accept that it is of utmost importance to build a network of services comprising social agencies, general and specialized services and civil society to bolster coping and to achieve resilience," Dr. Jacob Polakiewicz, director of the ministry's mental health services, wrote in the Statistical Annual's introduction.

The Clalit Health Fund had by far the most members who needed inpatient and ambulatory psychiatric care, with Maccabi Health Services, Meuhedet and Leumit following behind; 38,843 outpatients who needed treatment for psychiatric illness in 2007 were in Clalit, the largest health fund.

Rates of hospitalization in psychiatric hospitals and psychiatric departments in general hospitals were significantly higher for Muslims than for Jews in 2007, but the gap is much smaller than it was in 1999, as Muslims in recent years have apparently been more willing to seek care before problems become that severe.

The number of suicides committed by mental patients outside and inside hospitals has declined in the past decade, with four outside hospitals and five in hospitals in 2007, compared to 13 outside and four in hospitals in 1999.