Mental Health Reforms in Europe: Israel's Rehabilitation in the Community of Persons With Mental Disabilities Law: Challenges and Opportunities

Abstract

This column describes an innovative, government-sponsored, countrywide mental health reform focusing on rehabilitation and community integration of persons with serious mental illness, which was enacted into law in Israel in 2000. The reform was part of the country's efforts to shift the locus of treatment and care from psychiatric institutions to the community. The authors review preliminary evidence of the impact of reform and offer cautionary notes regarding the future direction of its implementation. The decade after the law's enactment saw an impressive increase in rehabilitation services, a significant reduction in the number of psychiatric beds, and major changes in government budget allocations. The authors examine factors that may endanger the viability of reform and discuss lessons to be learned from the Israeli experience.

A strengths-based case management service for people with serious mental illness in Israel: A randomized controlled trial

“…Results of the current study support the benefit of providing a case management service within a mental health system, and particularly as part of the ongoing psychiatric rehabilitation "basket of services" in Israel, which has already shown implementation success (Aviram et al, 2012;Roe et al, 2010a). Offering this service as part of the "basket of services" might become the policy change leading the system to its next level of development, in that it can contribute to improving the link between the individual's goals/needs and the variety of PRS.…”

“…Those services aim to address key needs, and include case management services to facilitate optimal use of the services to meet those needs. While services in areas such as employment, education, or housing were rapidly developed and extensively consumed (Aviram et al, 2012;Roe et al, 2010a), the development and implementation of a systematic case management service lagged behind, even though the need for such a service was previously recommended (Aviram, 2010;Aviram et al, 2012;Roe et al, 2010a).…”

Experiencing the relationship with a sibling coping with mental health problems: Dilemmas of connection, communication, and role

“…Persons caring for a family member who is coping with prolonged mental health problems are prone to high levels of emotional distress including depression, anxiety, and even post‐traumatic stress disorder (Jansen et al., ; Tomlinson, Onwumere, & Kuipers, ). In the process of deinstitutionalisation, the focus of rehabilitation and treatment has shifted to the community, and families have to cope with meeting concrete and emotional needs of the member diagnosed with mental health problems (Aviram, Ginath, & Roe, ; Saunders, ).…”

Translation of the World Mental Health Survey Data to Policies: An Exploratory Study of Stakeholders’ Perceptions of How Epidemiologic Data Can Be Utilized for Policy in the Field of Mental Health

“…It was only in 2012 that a mandate was finally passed to create universal coverage for mental health care. 26 Although the survey didn't necessarily play a direct role in inducing policy change, the improved political context of the time along with the results which indicated how many people were not getting treated, helped to place pressure on the government to act.…”