Researchers: Shlomit Tsafrir^1,2, Yoav Kohn^3,4

Background: Pediatric mental disorders are highly prevalent, affecting an estimated 12–20% of children worldwide. Despite this, only a fraction receives adequate treatment, with service gaps particularly evident among socioeconomically disadvantaged populations and ethnic minorities.

Objectives: To examine patterns of service utilization in pediatric mental health in Israel, and to identify barriers to access from retrospective administrative data and prospective parental reports.

Method: The study was conducted in two phases. Phase I was a retrospective analysis of all referrals (N=3,446) to the Kiryat Yovel child and adolescent mental health clinic in Jerusalem (2015–2019). Phase II employed structured questionnaires with parents (N=300) in three clinics (Kiryat Yovel, Emek, and Sheba), exploring sociodemographic characteristics, service utilization, and perceived barriers to care.

Findings: Phase I demonstrated disparities: boys (70.1%) and Jews (94.5%) were significantly overrepresented compared to their proportion in the general Jerusalem population, while children from low socioeconomic clusters (22.4% vs. ~40%) and non-Jews were underrepresented. Service utilization increased steadily during the study years. Phase II revealed systemic rather than attitudinal barriers: long waiting times, lack of nearby services, and insufficient information regarding entitlements and treatment options. Stigma emerged as a relatively weak barrier.

Conclusions: In Israel, the 2015 mental health reform aimed to improve accessibility by transferring services to the health funds. The findings suggest this reform may have reduced stigma associated with seeking care. However, significant systemic barriers remain, including long waiting times, workforce shortages, and insufficient geographical and cultural coverage, which continue to limit equitable access.

Recommendations: Policy should focus on expanding geographical and cultural accessibility, increasing the mental health workforce, improving transparency and information, and strengthening early detection and referral mechanisms across education, welfare, and primary care. Establishing a national monitoring system is essential to track disparities and guide resource allocation.

Research end date: 08/2025