Researchers: Aviad Tur-Sinai¹

Background: Israel’s mental-healthcare reform aims to fulfill the principle of availability of and access to mental-health services. However, information is lacking about the dynamics of demand for and supply of ambulatory services, as well as the gap between demand for and supply of the services, during the first few years of implementation of the reform. In this study, this information is provided on the basis of a series of socioeconomic indicators.

Objectives: 1. To learn about patterns and disparities in the supply of ambulatory services and over the years;
2. To learn about changes in patterns of demand for ambulatory services over the years;
3. To determine whether supply of and demand for ambulatory services have been converging over the years;
4. To learn about subjective perceptions of hardships and challenges in implementing the reform.

Method: A mixed quantitative-qualitative methodology is used.

Findings: 1. In localities that rank low on the socioeconomic index, supply of services has declined somewhat over the years. In localities that fall into the middle and upper parts of the index, supply of services has grown over the years.
2. Demand for services has been increasing overall but demand in localities that rank very high on the socioeconomic index has fallen slightly.
3. Several years after implementation of the reform began, the supply of mental-health services exceeds demand only in very affluent localities; in all the others, with emphasis on Arab and Haredi localities, the opposite situation prevails.

Recommendations: Healthcare-system policymakers should promote a program for the expansion of the pool of mental-health professionals, consider possibilities of economic incentives for mental-health professionals, and expand the deployment of mental-health clinics countrywide.

Research end date: 11/2023