In May 2012, the health system began implementing the historic Insurance Reform. This reform clarified, for the first time, the legal entitlement to mental health care and transferred the responsibility for the provision of mental health services from the government to the health plans. In response to a request be the government, MJB has taken on a key role in shaping and evaluating the reform and has initiated a series of studies monitoring its implementation. This study was carried out in the transition period between the 2012 resolution on implementing the reform and its full implementation in 2015.
A comprehensive survey was conducted in 2013, among a representative sample of the adult population in Israel (age 22+). The study questionnaire focused on issues that could be affected by the mental health reform. These included patterns of seeking treatment for mental distress; availability and accessibility of the services; reasons for not receiving treatment; patterns of utilization of the mental health services; satisfaction with the service; and the role of the family physician in referrals and treatment of mental health issues. The study also made it possible to estimate the prevalence of mental distress within the general population and to describe its characteristics.
Extensive prevalence of mental distress: One in five respondents reported that in the previous year they had experienced mental distress that was difficult to cope with alone.
Extent of diminished functioning due to mental distress: Over half of the respondents who reported mental distress in the previous year noted that it had considerably impaired their daily functioning.
Patterns of seeking treatment: One in three respondents who had experienced mental distress in the previous year had sought professional help (from a psychiatrist, psychologist/psychotherapist or family physician).
The reasons for not seeking professional assistance included: a wish to deal with it alone, lack of belief that the treatment would work, lack of access to information on available services, and the cost of treatment.
The study also raised the need to continue monitoring trends of seeking treatment, waiting times for appointments, satisfaction, and the transfer of patients from the private to public sector and vice versa. It also highlighted the need for another study that would examine these issues among the population of mental care recipients.
The study findings have been presented to the Mental Health Division at the Ministry of Health and at a wide variety of conferences and professional meetings. In the future, they will serve as a baseline for comparison with the situation after implementation of the reform.