Change in Budget Law Forced Delay to Mental Health Reform

Health Minister Yaakov Ben-Yizri announced yesterday that the health maintenance organizations will take over responsibility for psychiatric hospitalization and community mental health treatment in June instead of January.

The controversial reform, under which the Health Ministry will no longer be responsible for mental health services, is being delayed because it no longer falls under the Economic Arrangements Bill and must now be passed as a separate law.

In a response to criticism from mental health professionals, Ben-Yizri said the legislative process will involve the "complete agreement of both sides."

Ben-Yizri was speaking at an Israel Management Center conference at Kfar Hamaccabiah yesterday, where tension among the Finance Ministry, Health Ministry, HMOs and leading mental health professionals over the impending changes was evident.

According to the proposed reform, the Finance Ministry will allocate an additional NIS 230 million for improving the quality of mental health services between 2007 and 2010. This extra funding comes on top of a NIS 1.2 billion increase in the health basket containing subsidized medications and medical treatments.

However, several leading mental health professionals said they object to the changes.

"I want the mentally ill to receive better treatment than they have received until now," said Prof. Shuki Shemer, the director general of the Maccabi HMO. "If [the finance and health ministries] suggest providing the same service, I have no reason to get involved."

Shemer said NIS 300 million should be allocated "to give the patients better treatment" and recommended that others sign a joint declaration by the finance and health ministries and the HMOs to resolve the lack of confidence among the three parties.

The Israel Medical Association also objects to the plan, said its chairman, Dr. Yoram Blachar.

"In recent years, the number of beds in psychiatric hospitals has been reduced by 4,000, and the inequality among patients is increasing," he said.

Prof. Avi Bleich, chairman of the Israel Psychiatric Association, criticized the Finance Ministry for its role in the proposed changes.

"The treasury's position is 'Take this, or go away,'" he said. Bleich said there is a serious hospitalization crisis, with some 100,000 people with serious mental illness who at times need to be hospitalized, but only 3,000 hospital beds.