In an attempt to provide broader treatment for psychiatric patients, the Health Ministry's regional psychiatrists have been instructed to give preference to initial hospitalization in regular hospitals and not in mental health institutions.
Dr. Gadi Lubin, head of the ministry's mental health division, circulated new rules this week instructing that patients who underwent a severe initial mental health crisis be sent to psychiatric wards in regular hospitals if reason exists to believe there is an underlying physical cause for their problem.
The change is in line with the new reforms in mental health treatment, which will transfer care to the health funds from the Health Ministry. These changes are scheduled to take effect by 2015. So far, psychiatric hospitals were under the direct authority of the ministry, but Deputy Health Minister Yaakov Litzman has pushed to gradually narrow the state's role in such cases.
One of the reasons behind the recent changes is that many psychiatric patients often need such advanced medical tests that require advanced imaging technology, which is available only in the regular hospitals and not in mental health institutions.
The managements of the psychiatric hospitals have objected strongly to the new rules, as most mental health hospitalizations are accompanied by some suspicion for a biological basis for some part of the mental illness.
The new rules improve the patients' situation and allow many tests that are unavailable at psychiatric hospitals, such as various neurological and blood tests, said a senior psychiatrist in the state health system. But the change will take a long time to implement and will require a substantial financial investment - which has still not been provided, he added.
The head of one psychiatric hospital said he did not think it was presently possible to send all those suffering an initial mental crisis to general hospitals, as they have a lack of beds in the appropriate wards. But in cases that have a clear biological basis such as epilepsy, serious drug addiction, fever and disorientation, the possibility of hospitalization in regular hospitals should be considered, he said.
At the end of 2010 there were 3,451 beds available for psychiatric patients, a 49% drop since 1995. Only 10% of the beds available for psychiatric treatment are in the general hospitals.
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