Abandoning the psychiatric patients
While regular hospitals receive hundreds of millions of shekels in donations, psychiatric clinics hardly receive funding at all. The result is extreme neglect.
Have you visited the new psychiatric ward named after Sammy Ofer? Have you seen the new autistic ward in the Abarbanel Mental Health Center named after Ted Arison? You haven't and probably won't in the near future.
While regular hospitals receive hundreds of millions of shekels in donations, the psychiatric hospitals and community mental health clinics hardly receive any donations at all. The result is extreme neglect.
Since the state stopped budgeting hospital infrastructures, only medical centers that manage to raise donations can offer their patients a structure, medical equipment and adequate beds.
Does the psychiatric hospitals' problem lie with the fund-raisers' weakness? Would it be solved if their representatives had reached the professional level of the fund-raisers employed by hospitals like Sheba Medical Center? Or are the donors to blame?
Major philanthropists like to see their name beside words like "emergency medicine" or "cardiac ward." Perhaps an attempt should be made to persuade them that the words "depression" or "autism" won't blemish their image? There's no certainty this would work. Donors' decisions are also associated with the medical situations they can picture themselves in. While a middle-aged philanthropist can imagine needing the services of the cardiac ward, he cannot see himself needing psychiatric hospitalization.
So perhaps something in the fund-raising mechanism should change. Perhaps a national fund-raising body should be set up for the Israeli health system. This body would set the national order of priorities and ensure the mental health system is not deprived. The state could also charge tax on donations and distribute the money to some of the hospitals that cannot raise funds.
However, beyond the risks these solutions involve (like affecting the amount of donations), the main question is whether that's the direction in which we should go. After all, the state is responsible for the condition of psychiatric hospitals. The state is the one that stopped budgeting the health system properly, creating a situation in which the money for infrastructures comes solely from donations. True, the state must also buy tanks, and it's much harder to find private donors to write a check for that purpose. But the state's washing its hands of the problem is distorted, especially in the mental health system, precisely because the need for infrastructure there is relatively small.
In view of Israel's shirking responsibility for its psychiatric patients, there is no other way but to promote mental health reform and put the health maintenance organizations in charge of mental treatment. The clients will not let any HMO force them to wait for a year and a half for a psychiatric diagnosis, just as they would not accept an HMO suggestion to wait a year and a half for a catheterization. They would demand it immediately.
The decision to privatize psychiatric care is not risk free, but in the present circumstances, in which anyone who can afford it finances a relative's psychiatric care privately, the mental health system has already been privatized. The cost has simply been passed on to the people.
Until the state decides what to do, low-income psychiatric patients will continue to fall between the cracks of the public mental health system, which itself is in urgent need of infrastructure treatment.
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