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Impact of the mental health reform in Israel on health care and mortality among people with severe mental illness

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Abstract

Objective

Reports show disparities in the health care of people with severe mental illness (SMI). Yet, the moderating effect of mental health reforms on the health care disparities remain unexplored. The current study aimed to investigate the outcomes of the mental health reform in Israel on the use of health services among people with SMI.

Method

A case–control epidemiological study comparing the use of health services 3.5 years before and after the mental health reform for service users diagnosed with schizophrenia, schizoaffective disorder, and bipolar disorder. Data on health services included: blood cholesterol test (LDL), hemogalobin-A1C test, and visits to general practitioners (GPs) and specialists. Mortality was recorded.

Results

Following the reform the number of visits to GPs was decreased among service users of the three SMI groups, as well as visits to specialists among service users with a schizoaffective or bipolar disorder. Following the reform service users of the three SMI groups showed no-change in the performance of LDL test. Complex findings were noted with regard to the performance of Hemoglobin-A1C test. Mortality rates were higher among service users with SMI and the relative risk were similar before and after the reform.

Conclusions

Users of the three SMI groups showed no benefits of the mental health reform in terms of use of health services. Improved health care can be attained by a closer collaboration between the primary physicians and community mental health services.

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Funding

The study was supported by The Israel National Institute for Health Policy and Health Services Research granted to Prof Gal and Prof Kodesh (Grant number r/59/2018).

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Authors and Affiliations

  1. School of Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel

    Gilad Gal

  2. Department of Community Mental Health, University of Haifa, Haifa, Israel

    Itzhak Levav & Arad Kodesh

  3. Department of Mental Health, Meuhedet Health Services, Tel Aviv, Israel

    Arad Kodesh

Authors
  1. Gilad Gal
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  2. Itzhak Levav
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  3. Arad Kodesh
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Contributions

All authors were part of the study plan, took part in writing the manuscript and reviewed it.

Corresponding author

Correspondence to Gilad Gal.

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Conflict of interests

The authors declare no competing interests.

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Gal, G., Levav, I. & Kodesh, A. Impact of the mental health reform in Israel on health care and mortality among people with severe mental illness. Soc Psychiatry Psychiatr Epidemiol (2023). https://doi.org/10.1007/s00127-023-02580-3

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