Work Practices, Provision of Care and Attitudes towards the Mental Health Insurance Reform among Psychologists, Psychiatrists and Social Workers

The State of Israel is about to transfer responsibility for mental health services to the health plans as part of the mental health insurance reform. This entails considerable changes for the entire population, for the mental health professionals and for the health plans that will assume this new responsibility . For the health plans, intensive and extensive work with the mental health professionals – particularly psychologists and social workers – will be a relatively new experience.  For the professionals, working in a managed care framework – which includes curbing costs while ensuring quality of care through regulation and monitoring of the treatment process and outcomes – will entail significant adjustment as well.

This report – presenting the findings of the first comprehensive study of mental health professionals in Israel – is part of a broad effort to evaluate the transfer of responsibility. It focuses on two main aspects of this transition:

  • To what extent to the professionals view the reform as positive or negative?
  • To what extent are current practices compatible with a managed care framework?
  • Are there differences between psychiatrists, psychologists and social workers with regard to these questions?

The study included in-depth interviews with leading professionals and a national postal survey of a sample of certified specialists in clinical or medical psychology of working age; all psychiatrists of working age; and a sample of social workers employed in Ministry of Health mental health frameworks. The survey was conducted from December 2011 through May 2012 (i.e., prior to the decision to transfer responsibility for mental health care to the health plans by government directive).

The report provides comprehensive information about: the personal and educational backgrounds of the professionals; the nature of their work; their approaches to treatment; and their relationships with other professions in the health system. Additionally, the report sets out the professionals’ perceptions of the likely impact of the reform on: their work practices and processes; the treatment process; the patients; the professional standards and quality of care; the processes of training and specialization; the future labor market; and the accessibility and availability of treatment.

The findings will assist the health plans in deepening their understanding of the professionals and their approaches to care, thereby helping to improve their communication with the professionals.  In addition, the findings constitute a baseline for examining and measuring forthcoming developments. A follow-up study is planned, to examine the impact of the reform on the professionals.

The study was funded with the assistance of a grant from the National Institute for Health Policy Research.