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The Reform of Rehabilitation in the Community of Persons with Psychiatric Disabilities: Lessons from the Israeli Experience

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Abstract

Purpose is to present the mental health rehabilitation reform enacted in Israel in 2000, and to analyze the challenges it faces in its second decade of implementation. Lessons are drawn with regard to other jurisdictions interested in reforming mental health services. Besides reviewing the reform’s accomplishments and its contribution to the changes that have occurred in mental health services, the article also assesses the dangers it has to contend with. Analysis focuses on the system’s clients, budget, personnel and services—and on its functional environment. During the past decade, the rehabilitation services have considerably expanded. However they cover only about one-fifth of the target population. Paper discusses the mutual dependency between the rehabilitation services and the recently implemented (mid-2015) mental health insurance reform, emphasizing the importance of the rehabilitation system’s efficient and effective functioning to the success of that reform and improvement of the mental health services in general.

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Notes

  1. For details on the Israeli healthcare system, see: Bin-Nun et al. (2010).

  2. Health funds, Kupot Holim in Hebrew, are similar to HMOs in the United States. According to the National Insurance Law (1994), residents must enroll in one of the four health funds responsible for delivery of health services based on a basket of services according to law and the government’s orders.

  3. The Arrangements Law is a government bill presented to the Knesset each year alongside the Budget Law, incorporating government bills and legislative amendments needed for the government to fulfill its economic policy. First legislated in 1985 as emergency regulation to supplement the economic stabilization program, it has since become a unique (and controversial) instrument used by the government to initiate legislation, complete legislative acts, and stall or eliminate private members’ bills already legislated. (Based on the explanation appearing in the official Knesset website, available at https://www.knesset.gov.il/lexicon/eng/hesderim_eng.htm).

  4. A transfer payment is a one-way payment of money for which no money, good or service is received in exchange. Governments use such payments as a means of income redistribution by giving out money under social welfare programs such as social security, old age or disability pensions, unemployment compensation, etc. Transfer payments are excluded in computing gross national product. (Condensed from the definition of “transfer payment” in online Business Dictionary, at http://www.businessdictionary.com/definition/transfer-payment.html).

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Authors and Affiliations

  1. Zena Harman Professor (Emeritus) of Social Work, The Hebrew University of Jerusalem, Jerusalem, Israel

    Uri Aviram

  2. Ruppin Academic Center, Emek Hefer, Israel

    Uri Aviram

  3. Taub Center for Social Policy Studies in Israel, Health and Welfare Policy Programs, Jerusalem, Israel

    Uri Aviram

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  1. Uri Aviram
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Correspondence to Uri Aviram.

Additional information

An earlier version was published in State of the Nation Report: Society, Economic and Policy in Israel, edited by D. Ben David (2013), Jerusalem, Taub Center for Social Policy Studies in Israel (pp. 347–365).

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Aviram, U. The Reform of Rehabilitation in the Community of Persons with Psychiatric Disabilities: Lessons from the Israeli Experience. Community Ment Health J 53, 550–559 (2017). https://doi.org/10.1007/s10597-016-0058-7

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