Meeting Mental Health Needs: Service Delivery in Israel

Alexander M. Ponizovksy, MD, PhD (Editor)
Department of Mental Health Services, Ministry of Health, Jerusalem, Israel

Alexander Grinshpoon, MD, MHA, PhD
Sha’ar Menashe Mental Health Center, Hadera, Israel

Series: Mental Illnesses and Treatments
BISAC: MED102000

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This book summarizes findings of studies that are united by a common theme of needs of psychiatric patients in Israel. The studies were performed from 2001-2010, in the Research Unit of Mental Health Services at the Ministry of Health and were motivated by the authors’ need to learn more about the met and mainly unmet needs of mentally ill people, and an urgent demand to develop innovative health services or adjust the existing ones to both meet the needs and improve the quality of care and quality of life of their patients. Although the conception of need is a composite one and can be defined in multiple ways to include different aspects of common wishes motivating human activities and ways of their fulfillment, the authors’ used the Bradshaw definition of need (1972) as “perceived” need or what individuals believe they require.

Within the context of health care, a need was considered a lack of health or welfare, or a lack of access to care. All the investigations were conducted in parallel with the Mental Health Reform in Israel and therefore reflect the specific needs and demands of deinstitutionalization. The selection of topics, the emphasis on briefly summarizing research findings rather than exhaustively reviewing the scientific literature and providing practical recommendations are intended to make the book an interesting and useful resource for policy-makers, clinicians, and other health professionals, such as clinical psychologists, social workers, occupational therapists, general and family medical practitioners, nursing personnel, family members and other support persons, and perhaps mentally ill persons themselves. (Imprint: Nova Biomedical )

Preface

Acknowledgments

Chapter 1. Identification of Needs among Patients with Severe Mental Illness

Chapter 2. Assessment of Needs

Chapter 3. Matching Needs with Mental Health Services

Chapter 4. Mental Health Services in Israel

Chapter 5. Community-Based Rehabilitation Needs

Chapter 6. Mental Health Legislation-Consumer's Perspective

Chapter 7. Need for Mental Health Services and Treatment Lag

Chapter 8. Health Service Needs under Terrorism

Chapter 9. Psychiatric Emergency Services

Chapter 10. Oral Health Needs of Patients with Mental Illness

Afterword What is the Significance of this Book?

About the Authors

Index

"In the period of mental health reform and the transfer of mental health care to the community this book is a valuable and practical contribution to the literature that will benefit health care providers, medical administrators, social workers, psychiatrists, psychologists and families of individuals with special needs in mental health domains. The book is essential for all professionals in the field of community mental health." - Moshe Kotler, MD, President, Israel Psychiatric Association and Director Beer Yaakov-Ness Ziona Mental Health Center, Israel

"This book is an important contribution to the understanding of the patients with severe mental illness and the mental health services in Israel. The field of mental health has been neglected for many years. In July 2015 the responsibility for mental health care will be transferred to the health funds, which are already in the process of establishing the service. It is the right time now to focus on fulfilling the needs of the patients and to consider these needs in their planning. The book is based on studies done in Israel and as such may be very useful to policymakers and mental health professionals. Congratulations to the authors for their contribution to improve mental health services in Israel and worldwide." - Professor Zvi Zemishlany, Director, Geha Mental Health Center, Israel, Past President of the Israel Psychiatric Association, Board Member of the European Psychiatric Association (EPA)

"The book Meeting Mental Health Needs presents broadly for the first time and academically in an in-depth fashion, mental health services in the State of Israel from the combined perspective of health needs and the organization of services by the Israeli system." READ MORE... - Shifra Shvarts, PHD, Professor

"Patients with mental disorders have more unmet needs than healthy individuals, though; the frequency of unmet needs varies substantially across need domains. There is a major gap between a need for help and the actual help received from mental health services." READ MORE... - Professor Eliezer Shalev, MD, Dean, Rappaport Faculty of Medicine, Professor, Minnie and Ruben Finkelstein Academic Chair Technion-Israel Institute of Technology

Chapter 1

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Chapter 8

Ben-Gershon B, Grinshpoon A, Ponizovsky A. Mental Health Services Preparing for the Psychological Consequences of Terrorism. J Aggres Maltreat Trauma 2005;10:743-753.
Bleich A, Gelkopf M, Solomon Z. Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. J Am Med Assoc 2003 6;290:612-620.
de Jong JTVM, Komproe IH, Van Ommeren M, El Masri M, Araya M, Khaled van de Put W, Somasundaram D. Lifetime events and posttraumatic stress disorder in four post-conflict settings. J Am Med Assoc 2001; 286:555–562.
DeLisi LE, Maurizio A, Yost M, Papparozzi CF, Fulchino C, Katz CL, Altesman J, Biel M, Lee J, Stevens P. A survey of New Yorkers after the Sept 11, 2001, terrorist attacks. Am J Psychiatry 2003;160:780–783.
DiGiovanni C. Pertinent psychological issues in the immediate management of a weapon of mass destruction event. Mil Med 2001;166(12 Suppl):59-60.
Druss BG, Marcus SC. Use of psychotropic medications before and after Sept 11, 2001. Am J Psychiatry 2004;161:1377–1383.
Fullerton, Ursano and Norwood, Terrorism and Disaster: Individual and community. Mental Health Interventions. Cambridge University Press, Cambridge, UK, 2003.
Freilich C. The Armageddon scenario: Israel and the threat of nuclear terrorism. In: Midease Security and Policy Studies No. 84. The Begin-Sadat Center for Strategic Studies, Bar Ilan University, April 2010, http://www.biu.ac.il/Besa/MSPS84.pdf (accessed 13.11.2013).
Galea S, Boscarino J, Resnick H, Vlahov, D. Mental health in New York City after the September 11 terrorist attacks: results from two population surveys, in Mental Health United States 2002. Rockville, Md, Substance Abuse and Mental Health Services Administration, 2004, pp. 89–97.
Gelkopf M, Solomon Z, Bleich A. A longitudinal study of changes in psychological responses to continuous terroris. Isr J Psychiatry Relat Sci 2013;50:100-109.
Human Rights Watch web site: www.hrs.org/reports/2002/isrpa
Israel Ministry of Foreign Affairs. http://www.mfa.gov.il/mfa/foreignpolicy/ terrorism/palestinian/pages/ 2013.
Kohn R, Saxena S, Saraceno B, Levav I: Treatment gap in mental health care. Bull World Health Org 2004;82:858–866.
Kutz I, Bleich A. Conventional, chemical and biological terror of mass destruction: Psychological aspects and psychiatric guidelines. In J. Shemer & Y. Schoenfeld (Eds.), Terror and medicine. Lengeirich, Germany: Science Publishers, 2003, pp. 533-544.
Levav I, Novikov I, Grinshpoon A, Rosenblum J, Ponizovsky A. Health services utilization in Jerusalem under terrorism. Am J Psychiatry 2006;163:1355-1361.
Mental Health in Emergencies: Mental and Social Aspects of Populations Exposed to Extreme Stressors. Geneva, World Health Organization, 2003.
Nakar S, Kahan E, Nir T, Weingarten MA. The influence of SCUD missile attacks on the utilization of ambulatory services in a family practice. Med Confl Surviv 1996;12:149–153.
Somer E. Exposure to repeated acts of terrorism: perspectives from an attacked community Based on a paper presented at a colloquium at the Alice Salomon University of Applied Sciences, Berlin, Germany, February, 2007 Klinische Sozialarbeit 4(Sonderausgabe) 2008, pp. 6-11.
Strous R. Ethical considerations during times of conflict: Challenges and pitfalls for the psychiatrist. Isr J Psychiatry Relat Sci 2013;50:122-129.
Waxman D. Living with Terror, not Living in Terror: The Impact of Chronic Terrorism on Israeli Society. Perspectives on Terrorism 2011. Terrorism Research Initiative 2011;5:4-26.
Weinberg M, Besser A

, Campeas M, Shvil E,Neria Y. Civilians Exposed to Terrorism and War Trauma in Israel: The Role of Intra–and Inter– Personal Factors. Advances in Psychology Research. Volume 94 Nova Science Press, 2012. https://www.novapublishers.com/catalog/product_ info.php?products_id=33577.
Weizman R, Laor N, Barber Y, Selman A, Schujovizky A, Wolmer L, Laron Z, Gil-Ad I. Impact of the Gulf War on the anxiety, cortisol, and growth hormone levels of Israeli civilians. Am J Psychiatry 1994;151:71–75.
Yagur A, Grinshpoon A, Ponizovsky A. Primary care clinic attenders under war stress. Isr Med Assoc J 2002;4:568–572.

Chapter 9

Ben-Gershon B, Grinshpoon A, Ponizovsky A. Mental Health Services Preparing for the Psychological Consequences of Terrorism. J Aggres Maltreat Trauma 2005;10:743-753.
Bleich A, Gelkopf M, Solomon Z. Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. J Am Med Assoc 2003 6;290:612-620.
de Jong JTVM, Komproe IH, Van Ommeren M, El Masri M, Araya M, Khaled van de Put W, Somasundaram D. Lifetime events and posttraumatic stress disorder in four post-conflict settings. J Am Med Assoc 2001; 286:555–562.
DeLisi LE, Maurizio A, Yost M, Papparozzi CF, Fulchino C, Katz CL, Altesman J, Biel M, Lee J, Stevens P. A survey of New Yorkers after the Sept 11, 2001, terrorist attacks. Am J Psychiatry 2003;160:780–783.
DiGiovanni C. Pertinent psychological issues in the immediate management of a weapon of mass destruction event. Mil Med 2001;166(12 Suppl):59-60.
Druss BG, Marcus SC. Use of psychotropic medications before and after Sept 11, 2001. Am J Psychiatry 2004;161:1377–1383.
Fullerton, Ursano and Norwood, Terrorism and Disaster: Individual and community. Mental Health Interventions. Cambridge University Press, Cambridge, UK, 2003.
Freilich C. The Armageddon scenario: Israel and the threat of nuclear terrorism. In: Midease Security and Policy Studies No. 84. The Begin-Sadat Center for Strategic Studies, Bar Ilan University, April 2010, http://www.biu.ac.il/Besa/MSPS84.pdf (accessed 13.11.2013).
Galea S, Boscarino J, Resnick H, Vlahov, D. Mental health in New York City after the September 11 terrorist attacks: results from two population surveys, in Mental Health United States 2002. Rockville, Md, Substance Abuse and Mental Health Services Administration, 2004, pp. 89–97.
Gelkopf M, Solomon Z, Bleich A. A longitudinal study of changes in psychological responses to continuous terroris. Isr J Psychiatry Relat Sci 2013;50:100-109.
Human Rights Watch web site: www.hrs.org/reports/2002/isrpa
Israel Ministry of Foreign Affairs. http://www.mfa.gov.il/mfa/foreignpolicy/ terrorism/palestinian/pages/ 2013.
Kohn R, Saxena S, Saraceno B, Levav I: Treatment gap in mental health care. Bull World Health Org 2004;82:858–866.
Kutz I, Bleich A. Conventional, chemical and biological terror of mass destruction: Psychological aspects and psychiatric guidelines. In J. Shemer & Y. Schoenfeld (Eds.), Terror and medicine. Lengeirich, Germany: Science Publishers, 2003, pp. 533-544.
Levav I, Novikov I, Grinshpoon A, Rosenblum J, Ponizovsky A. Health services utilization in Jerusalem under terrorism. Am J Psychiatry 2006;163:1355-1361.
Mental Health in Emergencies: Mental and Social Aspects of Populations Exposed to Extreme Stressors. Geneva, World Health Organization, 2003.
Nakar S, Kahan E, Nir T, Weingarten MA. The influence of SCUD missile attacks on the utilization of ambulatory services in a family practice. Med Confl Surviv 1996;12:149–153.
Somer E. Exposure to repeated acts of terrorism: perspectives from an attacked community Based on a paper presented at a colloquium at the Alice Salomon University of Applied Sciences, Berlin, Germany, February, 2007 Klinische Sozialarbeit 4(Sonderausgabe) 2008, pp. 6-11.
Strous R. Ethical considerations during times of conflict: Challenges and pitfalls for the psychiatrist. Isr J Psychiatry Relat Sci 2013;50:122-129.
Waxman D. Living with Terror, not Living in Terror: The Impact of Chronic Terrorism on Israeli Society. Perspectives on Terrorism 2011. Terrorism Research Initiative 2011;5:4-26.
Weinberg M, Besser A

, Campeas M, Shvil E,Neria Y. Civilians Exposed to Terrorism and War Trauma in Israel: The Role of Intra–and Inter– Personal Factors. Advances in Psychology Research. Volume 94 Nova Science Press, 2012. https://www.novapublishers.com/catalog/product_ info.php?products_id=33577.
Weizman R, Laor N, Barber Y, Selman A, Schujovizky A, Wolmer L, Laron Z, Gil-Ad I. Impact of the Gulf War on the anxiety, cortisol, and growth hormone levels of Israeli civilians. Am J Psychiatry 1994;151:71–75.
Yagur A, Grinshpoon A, Ponizovsky A. Primary care clinic attenders under war stress. Isr Med Assoc J 2002;4:568–572.

Chapter 10

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Grinshpoon A, Zusman SP, Weizman A, Ponizovsky AM. Dental health and the type of antipsychotic treatment: a study in schizophrenia patients. Isr J Psychiatry Relat Sci 2014 (in press).
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