Researchers: Denise Naon¹, Dori Rivkin

Background: In July 2015, the mental health (MH) insurance reform was introduced, transferring responsibility for the provision of MH services from the government to the health plans (HPs), bringing together mental and physical healthcare. One target population of the reform is recipients of a general disability benefit from the National Insurance Institute due to a MH condition (people with severe mental illness – PSMI). Although they have extensive MH needs, they are largely on the margins of social and research discourse.

Objectives: To map the extent of utilization, patterns of utilization, and PSMI's experience of MH services – psychiatric hospitalization, psychiatric rehabilitation (PR) and ambulatory MH care – by accessibility and availability of service provision systems and by characteristics of the consumers –at the start of assimilation of the reform.

Method: Telephone consumer survey of 350 PSMI. The data analysis compared those who have a mental disability alone and those with additional disabilities.

Findings: In the past year, almost all PSMI received clinical MH treatment in the community. About a third were hospitalized in the past five years and about a third currently receive PR services. Those with additional disabilities use each of the types of services to a lesser extent than those with only a mental disability. The main barriers to service use, particularly to the PR services, are lack of information about rights and relevant types of help, difficulties navigating through the fragmented service system and deficient continuity of care.

Recommendations: Main recommendations: Make information about the services and interfaces between them accessible to the target population and expand treatment and rehabilitation services in the ambulatory system. Since following implementation of the reform the HPs are meant to act as an inclusive coordinator, it is recommended that they form an infrastructure to ensure transfer of information, outreach, and continuity of care.

Research end date: 12/2016