I've been wanting to write this column for three weeks now. But that's how it is with us, a security incident haunts a political event, and here we are already deep in the summer vacation. Our hearts are with the wounded from Tel Aviv and with the mourners in Beit El, the thoughts are with our heroic soldiers who fought the terrorists in Jenin. Still, I decided I wouldn't wait until next week. Enough procrastination.
This time I dedicate this column to another war, no less important than Operation Bayit Vagan: the war for the psychological-pedagogical well-being of Israeli students. The summer vacation is a wonderful opportunity to do everything possible so that children and teenagers can start the next school year properly. For thousands of students, this will not happen, because they have been waiting in line for months for a neurological or psychiatric diagnosis.
When there is a traffic jam in the queue for passports in Israel, the state mobilizes to eliminate the endless wait for the long-awaited passport. The Interior Ministry launched a "passport operation" and issued 425,35 passports in <> days. This is a life-saving operation, because after all, what are we and what are our lives without a small jump abroad. But for some reason, the Ministry of Health is not embarking on a similar operation to eliminate the appointment for various diagnoses. Let parents and students wait, and another school year will begin without the system being able to provide the child with the appropriate response.
Bat-Chen Epstein Elias's important article "Lost," published in the recent Shabbat supplement, described the sad situation of the coronavirus generation, refugees from the pandemic, youth who were unable to return to school and a healthy life. Even after the virus no longer threatens our lives, its damage and scars threaten the lives of our children. But the mental health system was in dire shape even before the pandemic.
Mother and community coordinator: "I was told they might make an appointment for our youngest son for November. This means waiting at least ten months for diagnosis. We wanted to choose a suitable framework for first grade, but without a diagnosis it is very difficult to decide where to enroll him."
The acute shortage of psychiatrists in Israel, and child psychiatrists in particular, is recognized. We have already dealt with it in "On It" more than once. But even for a neurological diagnosis of ADHD, you have to wait about ten months. For example, A., a mother of five and community coordinator from central Israel, says: "I've been waiting for five months for a neurological diagnosis for our youngest son, and they told me that in two months they'll contact me, and maybe they'll schedule an appointment for November.
"That means waiting at least ten months for a diagnosis. The boy is 7 years old. Sweet but frenetic. Last year we left him in kindergarten, and this year we wanted to choose a suitable framework for first grade, but without the diagnosis it is very difficult to decide what the appropriate framework is. We are currently in a situation where he will start a school not in a suitable framework. I have experience with two older children who have been diagnosed. We transferred one of them to a small class following the diagnosis, and that really saved him. Diagnosis, if you really follow the recommendations afterwards, is critical. Something that can actually save the child."
Fear for their safety
The person who approached the Ministry of Health, and specifically the Minister of Health, Moshe Arbel of Shas, is Maor Zemach, chairman of the National Security Officers Association. The role of regular visiting officers is to prevent dropouts and deal with dropouts from the education system.
In a letter to Minister Arbel dated June 16, Zemach writes as follows: "As those responsible for dropping out, we thoroughly investigate the reason for the lack of regular attendance at school and the lack of academic functioning, and discover that these students are in real distress, which is not treated by a professional because no diagnosis has yet been made. The wait for an appointment for a psychiatric diagnosis or evaluation is long and prolonged.
"In the meantime, the children are accumulating learning gaps and experiencing frustration and mental difficulties, which are getting worse. There is concern for the physical and mental well-being of these students. The National Security Officers Association, which represents hundreds of security officers in Israel, calls for immediate operational action vis-à-vis the health fund and hospitals in order to promote these appointments. The 'diagnosis and treatment' operation, as was done in eliminating the passport queue, will ensure that these children will be able to start the next school year in the best possible way and thus save their lives, in the sense of saving one life in Israel as if it had saved an entire world."
When I ask Zemach how it is possible to embark on such an operation, since a diagnostician needs more professional training than an official issuing a passport, he explains that there are several steps that can be taken. "First, we need to prioritize children in neurological and psychiatric diagnoses throughout the summer vacation. During this period, every neurologist or psychiatrist in the public service should add an additional two hours a week for diagnosing children.
"It is also possible to temporarily recruit pensioners in the field. At the same time, the state can distribute vouchers and subsidize diagnoses in private institutes. I spoke to a senior neurologist at one of the big hospitals, and she told me that neurologists prefer not to make these diagnoses because they want to deal with areas that are more professionally challenging. She said that quite a few family doctors have been specially trained so they can make neurological diagnoses, but they are just lazy and don't want to deal with it. She agreed with me that we should do marathon diagnoses, add two more hours a week to every neurologist in the hospital's outpatient clinics for diagnoses, and also incentivize trained family doctors to join the operation."
"There is importance in mental response"
Minister Moshe Arbel has not yet responded to Zemach's letter. Our appeal to the Ministry of Health and the Minister's Office was answered with the following response: "The Minister of Health and the Ministry of Health see great importance in a mental health response for children and adolescents and is working towards solutions both in the short and long term. The considerations facing the mental health system in examining possible solutions are purely professional considerations, which prioritize treatment according to the clinical need of children and youth, who require an immediate, accurate and sensitive mental health response.
"In addition, the Ministry is working in a number of ways to continue to improve the availability of appointments at the HMOs in the field of child development as well, including diagnoses. Many of the existing solutions can and should be provided within a system, even without the intervention of the mental health system. Therefore, a dialogue is currently underway between the Ministry of Health, the Ministry of Education and the Child Psychiatry Association in order to find practical solutions."
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