Mental health is dying and there is no one to reach out: a year-and-a-half wait for treatment

Since the "mental health reform" the waiting times for mental health care have only lengthened and no one is supervising the provision of the service and the quality of the treatments.

What awaits those who need help or emotional support in the State of Israel?

That you will not know

Dr. Jordan Mendelssohn

26/12/2021

Sunday, 26 December 2021, 10:22 Updated: 11:17

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Who among us does not know which Ruthie? Ruthie (pseudonym), 32, grew up in a home where she was exposed to mental, verbal and financial violence by her father. Her childhood and adulthood were fraught with social difficulties, attention and concentration problems and low self-esteem. After being discharged from the army, she applied for psychological treatment at her HMO. Despite the obvious need, there were no vacancies and Ruthie went on a wait of over a year, during which she gave up. With her impressive strengths she enrolled for a bachelor’s degree at the university and graduated with honors, began working with at-risk youth, but due to the low salary and financial difficulties she ran into, was forced to leave the field she loved.

Since then, and over the past five years, her mental state has deteriorated.

She switches jobs, stamps unemployment intermittently and experiences anxiety attacks with increasing frequency.

She recently became pregnant and this motivated her to try again, 'for the future of her children' as they say ... So she went to the mental health clinic in Holon - and was told that there was a wait of a year and a half!

The clerk was in shock when she nevertheless asked to enter the waiting list.

Ruthi did not give up and also turned to the independent therapists that the fund offers, with a deductible of NIS 130 per session.

And she also heard from them again and again that they have no place and she is expected to wait many months.

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And so, we are witnessing an endless circle - Ruthie has no money for a private psychologist and meanwhile her mental state is deteriorating, her employment situation is following suit, and the hope of breaking that circle is dwarfed.

Those who do not have the money to pay a private psychologist will wait many months, and in the meantime may deteriorate further.

Woman in care (Photo: ShutterStock)

Less than one-fifth of those in need of mental health care receive it, and the waiting time can range from a year and a half to two years.

More than six years ago, the 'Mental Health Reform' passed with great fanfare - one of its flagship symbols was increasing availability and shortening queues.

Six years have passed, we have succeeded in passing reform.

So how in such a reality are the waiting queues not only not getting shorter, but getting longer and longer?

We have been working for 6 years on a CEO circular regarding waiting times

The answer is very simple and therefore also very frustrating: from the day the "mental health reform" passed, the Ministry of Health removed the little regulation that existed on the field of mental health and thus left the field hacked. That loophole allowed the HMOs to do with it almost as much as they pleased. Mandatory CEO circulars that were in the past and regulated what a mental health clinic is, who the staff is, how it is built, etc., have been canceled - and have not yet decided on new procedures. , The draft is circulating in the corridors of the office, and again and again she is unhappy.

And the truth? Maybe it's good that she's not happy, because this is not the reform that will save her mental health from dying. Although the draft specifies binding waiting times - three weeks for initial reception, one month for treatment - it is impossible not to see the perforated network that this draft

:

In such a situation, where the funds are required to meet a set waiting time for an undefined service, what prevents them from giving hundreds of people only 2-3 sessions, and showing a drastic improvement in the 'waiting time for treatment' index?

even though a state health law does define services, which are regulated by licensing and supervision by the state.

A medical department circular from last month, for example, also highlights the need enshrined in state health law to provide a clinical psychological service in mental health (individual, couple, systemic and group therapy, use of psychological tests, staff training and preventive interventions).

However, there is no similar reference at the level of a mental health clinic in the proposed draft.

If so, waiting queues for which service will the circular be enforced?

The regulation has been removed, the domain has been breached, and the HMOs are doing whatever they can.

Knesset debate on mental health reform, July 2018 (Photo: Walla! NEWS, -)

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A few weeks ago, Mark Musfir, a clinical psychologist and attorney, filed a petition in the Supreme Court against the health minister and the director general of the Ministry of Health demanding the publication of this draft, which was never published or implemented, and anchoring standards for how public psychology is treated. The Ministry of Health is expected to give its answer soon. He has two options: to continue declaring the importance of mental health, when in practice, apart from directing local budgets to psychiatry alone, there is no real work to change the system, or - to return to the desk, convene all relevant professionals, exercise real regulation on the funds and guide them: temporary Waiting for treatment, professional level of treatment, professional judgment in the manner of treatment.

What is right for the health of the body, should be right for the health of the mind, after all the title of the reform was: body and mind, one are.

• health

• psychology

Tags

• Mental Health

• Psychotherapy

• psychology

• Psychologists

• depression

• anxiety