Психическая реабилитация

Establishing a national system for identification, treatment and national rehabilitation from war trauma.

• •Establishing a national headquarters for mental rehabilitation and recovery, with inter-ministerial authority, which will lead a multi-year national program and coordinate the work of the ministries, including the health, defense and education ministries, National Insurance, the health funds and local authorities.
• •The headquarters will not replace the existing systems; its role will be to set national goals, regulate the division of responsibility, conduct regular monitoring and research on the state of the population and map needs, services and budgets.

The goal: a national mental-health response based on five guiding principles.

• •A proactive response: the state takes responsibility for its citizens.
• •We will lead outreach to at-risk populations, early identification of distress and a systemic outstretched hand, before deterioration.
• •A graduated response: the system will offer a continuum of responses, from community support and short-term accompaniment to intensive treatment and rehabilitation.
• •A recovery-oriented response: the system must change its approach from one of determining disability percentages and entitlements to one of rehabilitation and recovery.
• •The goal is to help the person return to family life, the community, studies and work.
• •An accessible and continuous response: every person will have a clear address, with minimal bureaucracy and without needing to retell their story in every system.
• •In complex cases, personal accompaniment will be given that connects all the services and rights.
• •A professional response: we will invest in manpower, set binding standards and measure results.
• •We will integrate technology that will help with triage, guidance, documentation and follow-up, to make the best use of the professional workforce for the benefit of patients.

Establishing a national system for early identification and proactive outreach, with emphasis on populations at heightened risk.

• •Conducting proactive outreach and a broad basket of responses for populations at heightened risk, such as bereaved families, victims of hostile acts, Nova survivors, returned hostages and their families, families of wounded IDF soldiers, reservists, and communities evacuated from their homes.
• •The proactive contact will help locate those who need more comprehensive help and refer them to further treatment.
• •Expanding resilience systems in local authorities and the Body and Mind program, so that every authority has a professional address, a work plan and a coordinated system among health, welfare and education.
• •Strengthening mental literacy in schools and training education staff to identify signs of distress and refer for help.
• •Strengthening the psychological-educational service and mental-health responses within schools, as a central tool for early identification of signs of distress among children.
• •Expanding training for identifying and preventing suicidality: investing in locating people at risk by training people in key positions to identify signs of distress, including commanders, family doctors and education staff.
• •Conducting training for care workers to deal with suicidal threat.
• •In addition, developing intermediate responses and alternatives to hospitalization and ensuring continuity of care after a crisis.

Offering an accessible, professional and comprehensive response to reservists and their families.

• •The state must care for those who went out to serve it.
• •We will reach out to discharged soldiers and reservists at set points during service and after returning home, and offer them and their family members a tailored basket of responses such as groups for processing combat experiences, family accompaniment and help returning to the labor market.
• •We will emphasize minimal bureaucracy, a clear and simple address for getting help for them and their family members, and proactive outreach by the state, to help them return to life.
• •Such a system will make it possible to prevent deterioration and identify in time those who need more intensive help; these will be referred for further treatment in the relevant frameworks.

Shortening the time from referral to receiving recognition, and providing certainty, accompaniment and assistance in the process.

• •The current situation, in which a person in distress has to wait many months for assessment, diagnosis or treatment, requires deep change.
• •We will set binding and transparent response times.
• •The national headquarters will monitor waiting times, set clear targets and track their implementation in the various systems.
• •In particular, we will emphasize shortening waiting times and making the recognition process in the Defense Ministry's Rehabilitation Division accessible.
• •We will make shortening the wait for recognition a central goal.
• •We will fully implement the measures formulated by the Mor Yosef Committee to make the recognition processes accessible and efficient, including proactive information gathering, reducing bureaucracy and embedding digital systems to simplify the application process and initial triage.
• •We will ensure applicants receive initial treatment and accompaniment even before the process is completed, and set for every applicant a contact person, a clear track and binding, transparent timelines.
• •In the long term, we will work to coordinate and unify the medical-assessment stages common to the different systems, to reduce duplicate committees and tests and make the best use of resources.
• •Any change will be made while preserving the unique rights granted to each population.

Building a rehabilitation system that returns people to life: helping with return to employment, backing families and tailoring treatment to personal needs.

• •Changing the system's center of gravity: from determining eligibility and disability percentages alone to a process whose goal is recovery and return to functioning, each person according to their condition.
• •Recognition of rights will remain an essential safety net, but services and incentives will be built so as to promote independence, integration and rehabilitation.
• •Implementing a national model of graduated care.
• •The system will offer a continuum of responses: from guided self-help, community and group responses, individual treatment in the community, up to intensive rehabilitation and hospitalization.
• •The type of response will be set by clinical need and level of functioning, and will allow better use of the workforce and more varied responses better tailored to the different needs.
• •Expanding occupational rehabilitation and offering tracks for gradual return to work, vocational training and accompaniment at the workplace, with emphasis on victims of hostile acts, combat-trauma sufferers and reservists who have difficulty readjusting and returning to routine.
• •Helping employers make adjustments and opening a tailored track for assisting the self-employed.
• •Changing the incentive structure so that increased income from work does not lead to a sharp and immediate loss of allowances and support, which creates a negative incentive to work and return to functioning.
• •Recognizing the family as a partner in the rehabilitation process and as a population that sometimes needs a response in its own right.
• •Spouses, parents and children will receive guidance, treatment and accompaniment as needed, and a person coping with complex injury will receive personal accompaniment so that their family does not have to manage the relationship with the state alone.

Strengthening the public mental-health system.

• •To increase the number of therapists in the public system, to create a system able to give a quality response to the population's needs and to close the gap with developed countries, we will increase public investment in mental health by at least NIS 1.5 billion.
• •We will set a minimum number of positions (staffing ratios) in all mental-health professions.
• •We will lead a long-term program to increase the number of therapists: working to increase the number of specialist psychologists by streamlining the residency system, expanding incentives for working in the public service for therapists in mental-health professions, with emphasis on work in the periphery.
• •We will work to increase the number of psychiatrists and advance dedicated investment in encouraging specialization in occupational and rehabilitative psychology, which are especially important in coping with the national crisis.
• •We will develop hospitalization alternatives, from intensive community treatment and day frameworks to balancing homes, to ensure that those who do not need full psychiatric hospitalization receive a suitable framework, and we will keep hospital beds for those who truly need them.
• •We will set tailored standards for every service funded by public money, in the health funds, hospitals, local authorities or through external providers.
• •We will require professional training and oversight, and conduct a systematic examination of the effect of treatment on functioning and quality of life.
• •In this way we will ensure that the budget intended for mental health reaches professional, effective responses for the benefit of patients.