Thirteen years after the project received formal approval, Tel Aviv’s Ichilov Hospital finally opened its first inpatient psychiatric ward last week, admitting its first patients to the 34-bed ward.
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The hospital also hopes to open a second psychiatric ward and is seeking donors to finance a building to house all its psychiatric care programs.
The current ward is an open one, meaning it will only accept patients who have been hospitalized voluntarily and don’t need to be detained. It has separate rooms for men and women, and some rooms will be set aside for victims of sexual trauma. The ward will be run by Prof. Miki Bloch, a specialist in women’s mental health issues.
Ichilov is one of Israel’s largest hospitals, which makes it particularly surprising that it lacked an inpatient ward for psychiatric treatment. Other major hospitals – like Jerusalem’s Hadassah and Haifa’s Rambam – have had such wards for years.
The Tel Aviv hospital has a large psychiatric staff, comprising some 250 workers, which runs a variety of outpatient clinics.
“Today, one out of every four people suffers from psychiatric problems at some level,” said Prof. Shaul Schreiber, who heads the hospital’s psychiatric division. “In my experience, as someone who has been working in the mental health field for years and seen more than a few cases of people diagnosed as having psychological problems, I believe it’s better for the first hospitalization to be within a general hospital and not in a specialized psychiatric hospital.”
The new inpatient ward, he added, will enable every patient “to get the most comprehensive and suitable treatment for every situation and every illness.”
Ichilov first received approval for the ward in 2002, and received approval for a second ward the following year. At that point, the hospital began planning a new building that would contain all its psychiatric services, both inpatient and outpatient. The plan received all the necessary approvals, and the hospital had hoped to complete construction by 2018. So far, though, it hasn’t managed to raise the money needed. Consequently, hospital director Prof. Ronni Gamzu decided not to wait for the new building, and instead to open the first inpatient psychiatric ward in the hospital’s existing facilities. For now, the ward is situated next to the internal medicine department.
“Today, for the first time, Tel Aviv residents who need this service have the option of going to an inpatient ward within the city,” Gamzu said.
General hospitals account for only about 10 percent of psychiatric beds in Israel; most inpatient psychiatric care is done in specialized hospitals. According to the Health Ministry’s most recent report on the subject, published last January, Israel had a total of 3,503 psychiatric hospital beds at the end of 2014, of which only 361 were located in general hospitals.
The new unit at Ichilov is, in part, a response to a nationwide shortage of psychiatric hospital beds. Over the last 15 years, the number of such beds has plummeted by 52 percent. As a result, Israel has only 0.42 psychiatric beds per 1,000 people, compared to 0.88 in 2000, when it had 5,619 beds.
This decrease was largely deliberate, reflecting the view that psychiatric hospitalization should be reduced in favor of treatment within the community, and was incorporated into agreements between the health and finance ministries. But the Health Ministry subsequently concluded that it had overachieved, and has since decided to approve a modest number of new psychiatric beds.
The fact that the new ward was opened in a general hospital rather than a psychiatric one stems from the view that, to the degree possible, a patient’s psychiatric and physical problems should be treated in tandem rather than at separate institutions. Putting psychiatric patients in general hospitals is also aimed at reducing the stigma of psychiatric hospitalization.
The general hospital with the most psychiatric beds is Sheba Medical Center, Tel Hashomer, which has 142 beds in three wards. It is followed by Haifa’s Rambam Medical Center (40); Jerusalem’s Hadassah University Hospital, Ein Karem (39), Safed’s Rebecca Sieff Hospital (35) and Ashkelon’s Barzilai Medical Center (30).