Yardena (not her real name) suffers from schizophrenia and depression and is in dire financial straits. So she asked the welfare department of her southern town for public housing and food assistance. After learning that Yardena was being treated at a government-sponsored mental health clinic, the welfare department said it couldn’t help her and that she had to talk to the clinic’s social worker. But the social worker said she herself had no power to help and referred Yardena back to the welfare department. Yardena, 60, was so frustrated at this bureaucratic impasse that she repeatedly threatened to commit suicide.
Her case is not unique. Poor people with psychological problems often fall between the cracks at the social affairs and health ministries.
The already overburdened local welfare departments, which answer to the Social Affairs Ministry, categorically refuse to help many people with mental health problems. Instead, they refer them to the Health Ministry, which is authorized by law to provide the mentally ill with a range of rehabilitative services.
But obtaining these services from the Health Ministry is often very difficult, both because applicants must be at least 40 percent disabled by their psychological condition to qualify, and because the application process is lengthy and complex. Many people wind up getting help from neither ministry.
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In addition, even successful applicants don’t get the same services from the Health Ministry that they would from a local welfare department. For instance, the ministry doesn’t offer ongoing or emergency financial assistance. It also doesn’t provide help in dealing with other agencies, personalized guidance by a social worker, subsidized day care or many other types of assistance that are only available from the municipal welfare departments.
As a result, three organizations recently urged Social Affairs Minister Haim Katz to order the welfare departments to provide full service to people with psychological or psychiatric problems. The three, the Association for Civil Rights in Israel, the Social Rights Centers at Sapir College and the Bizchut Human Rights Center for People with Disabilities, all said they have encountered many cases similar to Yardena’s.
Bizchut, for instance, cited a case in which the Jerusalem welfare department refused to provide a couple affected by psychological disabilities with parenting support — another service the mental health clinics don’t provide. In the absence of such support, the organization said, the couple’s children were ultimately taken away from them.
The local welfare departments base their stance on a 1973 regulation governing the division of responsibility between health and welfare agencies in helping people with mental health problems. The regulation states explicitly that someone being treated at a mental health clinic, or who has been released from psychiatric hospitalization, isn’t entitled to services from the municipal welfare departments.
Maskit Bendel, a lawyer at the Association for Civil Rights in Israel, said the country ought to have explicit legislation guaranteeing access to social services. “Those hurt by the lack of such legislation are the poorest, most excluded and weakest members of society,” she said, and include those with mental health problems.
The Social Affairs Ministry referred questions on the subject to the Health Ministry, saying that it is the ministry is responsible by law for such services. The Health Ministry issued a statement saying: “People with psychological disabilities are entitled to receive welfare and health services like any other resident of the country. The Health Ministry is constantly working with the Social Affairs Ministry to ensure that this population can fully exercise its rights in both systems.”