People with Severe Mental Disorders in Israel: An Integrated View of the Service Systems

The importance of community rehabilitation for people with severe mental disorders has earned growing recognition in recent years as reflected by a significant increase in the availability of rehabilitation services and the legislation of the Community-Based Rehabilitation of the Mentally Disabled Act (2000). The development of a rehabilitation system also follows an attempt to significantly downsize psychiatric hospitalization. Hospitalization days have decreased dramatically in the past two decades, which makes it even more important to provide rehabilitation services in the community.

In the light of these developments, a need arose to expand the database of people requiring rehabilitation and the services they receive. The Ministry of Health and the Myers-JDC-Brookdale Institute therefore launched an attempt to estimate the number of people with severe mental disorders who constitute the potential target population for rehabilitation, the extent to which this population benefits from rehabilitation services, and the type of rehabilitation services they have received.

The project created, for the first time in Israel, an integrated, multi-year database of persons known to the relevant systems, their characteristics and the services they receive. The integrated data include information on psychiatric hospitalization, receipt of disability benefits from the National Insurance Institute (NII), of rehabilitation from the Ministry of Health’s mental-health system or the NII, of treatment at government mental health clinics, at the Ministry of Social Affairs and Social Services or at the Addiction Units. On the basis of these data, the report examines the extent to which rehabilitants of one service system also benefit from services from other systems. Finally, the report surveys the various systems supplying services to people with severe mental disorders, with emphasis on services offered by rehabilitation systems.

The integration of data from the various systems permits important insights into the size of the population suffering from severe mental disorders and the scope of services offered them in Israel. The study shows that the population of people suffering from severe mental disorders is significantly larger than the number of people identified by each system separately. It is estimated at 120,000 to 160,000. Similarly, the study findings point to the fact that most of the people identified as suffering from severe mental disorders did not and do not receive rehabilitation from the mental-health system or NII, and that there are significant differences in the proportion of rehabilitation recipients by population and geographical district, a circumstance worthy of attention.

The database created by the study and its findings provides a platform for promoting the planning and development of services aimed at helping people with severe mental disorders to live as independently as possible within the community. The findings stress the need for steps to examine both the rehabilitation requirements of people who, to date, have not received rehabilitation services and the ways to address the requirements.

The study was made possible thanks to the extraordinary cooperation of the agencies concerned that made their data available and helped us interpret them, as well as to the Central Bureau of Statistics for encrypting the data to preserve confidentiality.

The study’s financing was made possible thanks to a generous grant from the Laszlo N. Tauber Family Foundation, which opened its Israeli offices in 2007 and strives to promote the field of mental health, especially psychiatric rehabilitation.