Israel’s mental health insurance reform went into effect in July 2015, transferring responsibility for the provision of mental health services from the government to the health plans. Shortly before the reform’s implementation, the Myers-JDC-Brookdale Institute surveyed psychiatrists, psychologists and social workers about their work patterns and their attitudes towards the reform and its expected impact. In this study, three years into the reform, a repeat survey was conducted.
a) To examine the work patterns and delivery of care of mental health professionals; b) to examine the changes that took place in the wake of the reform by comparing the findings to those of the 2012 survey; c) to examine the professionals’ perceptions of the impact of the reform.
A survey by internet or telephone was conducted in January-September 2018 among representative samples of 996 psychiatrists and 866 psychologists, and among 421 mental health social workers employed in Ministry of Health frameworks.
In the comparison of the two studies, changes were found corresponding to several of the goals of the reform, such as tighter supervision of the work of therapists, an increase in the rate of professionals reporting that they were conversant with evidence-based knowledge and care, and that they took financial considerations into account regarding treatment. Other findings, such as a wider gap between primary care and mental health, a heavy workload in public clinics, and the sense of some professionals that they found it difficult to provide quality care show that there is still a long way to go to achieve the goals of the reform in full. For some of the aspects examined, a gap was found between the professionals’ reports of their work patterns (which attest to merely minor changes) and their perceptions
of the realities in which they reported major changes.