Chain of Mental Health Clinics Offers Haredi Patients a Unique Bonus: Secrecy

A chain of mental health clinics treating mainly the ultra-Orthodox community promises its patients secrecy, something that is not given to people treated by the public health system, even while the chain’s services are paid for by the health maintenance organizations.

Senior HMO officials say the Bayit Cham chain promises its patients complete secrecy, which patients treated at HMOs are not guaranteed. It also invites them to come directly to its clinics, rather than going through the HMOs, and promises that their names won’t be given to the HMOs, only the last four digits of their identity card number.

These benefits have been criticized by officials in the public mental health system, who say the inequality is unjustified and wonder why the same benefits aren’t granted all patients.

In a tape of a patient’s conversation with the Bayit Cham hotline that Haaretz obtained, the patient asks whether he needs a referral from his HMO. “You don’t need any referral,” the hotline operator replies. “You sign here on Form 17 – that’s the request we send to the HMO.”

When the patient says he “has a problem with my family doctor knowing about this,” the operator replies, “No information is passed on. That’s unique to Bayit Cham, that no information is transferred to the HMOs. We request reimbursement from them at the highest levels of the HMOs.”

Bayit Cham, which provided services to the Health Ministry before a reform of the mental health system transferred responsibility for these services to the HMOs, runs eight clinics, mainly in ultra-Orthodox areas. The organization is headed by Rabbi Arie Munk, whom the ultra-Orthodox consider a leading authority on mental health issues.

In a past interview with the ultra-Orthodox radio station Kol Barama, Munk declared that no information about Bayit Cham’s patients is passed on to the HMOs. But in a conversation with Haaretz, he qualified this statement.

“Factually speaking, only the necessary information is transferred,” he said. “The only information that reaches the primary care physician at the HMO is information about medications and any fears about suicide.”

HMO officials said Bayit Cham has a unique agreement with the HMOs that not only lets its patients skip obtaining a Form 17 from a community mental health clinic, but also imposes stringent limitations on transferring personal information.

“There is great pressure on the HMOs by the Health Ministry to make mental health services accessible to the ultra-Orthodox population,” one senior HMO official explained. “They have more power than the HMOs, given the religious-ultra-Orthodox lobby, and they use it.”

“The agreement with Bayit Cham is different from the one with the community mental health clinics, and that’s a result of those same pressures,” he added.

According to Maccabi Health Services,”The agreement with the external service providers is uniform,” Meuhedet said that “the agreement does not include an exemption from transferring information to the HMO, just as we haven’t exempted any other element from doing so.” Clalit maintained that “communication is in accordance with Health Ministry guidelines,” and according to Leumit, “The agreement is about to be signed, and at this stage the details cannot be publicized.”

The Health Ministry said Bayit Cham, like any other private entrepreneur operating mental health clinics, has been working according to ministry procedures since 2009. “When we discussed the situation with the CEO, we were told that as opposed to what was claimed, the psychiatric information is in fact sent to the primary care physician in the HMO according to the guidelines,” the ministry said.