BGU | MY PATH, Haim Doron, MD

CHAPTER 8

Psychiatry, Rehabilitation, Geriatrics, and Dentistry in Clalit

Psychiatry in Clalit From its beginnings, Clalit did not fall into the trap of erroneously separating the mind and body, i.e., mental health and physical health. Both Dr. Tova Yeshurun Berman, my predecessor as medical director of Clalit, and I, emphasized mental health, both hospital-based and community- based. With the assistance of the “Invalid Fund,” Clalit built two specialized mental health hospitals, Geha Hospital in Petach Tikva and Shalvata Hospital in the village of Magdi’el south of Kfar Saba, which today is part of the amalgamated Ramat Hasharon municipality. And Clalit opened a third facility, Talbiya Psychiatric Hospital in Jerusalem’s Talbiya neighborhood. It is in a building leased from the Greek Orthodox Church. These three mental health facilities were affiliated with schools of medicine and always on a high academic level. From the outset, the directors were eminent physicians: Prof. Zvi Winnick at Talbiya; Prof. Zvi Weissenbek at Geha, and R. Yafe at Shalvata. Prof. Winnick was a key figure in the development of psychiatry at the medical school in Jerusalem, and Prof. Weissenbek and Yafe did the same at the Tel Aviv University’s medical school. Moshe Soroka, when he was Clalit's director-general, was the one who built the new Geha Hospital on the Beilinson campus. It reflected the outlook that one should not separate hospitalization of psychiatric patients from other hospitalized patients, thus stigmatizing the psychiatric patients. I considered it my responsibility to establish psychiatric departments at Clalit’s general hospitals. Therefore, in addition to the mental health departments in the Jezreel Valley (Emek Hospital) and in Haifa (Carmel Hospital), already discussed, 105 I also established psychiatric departments at Kaplan in Rechovot, and Soroka in Beer Sheva. 106 We also viewed mental health as one of the important areas for family doctors to address in caring for the community and an important component in the vitalization of family medicine. The field of family medicine emphasizes mental health. Family physicians do not encounter just full-blown cases of serious mental illness that affect a small portion of the population. Mental or emotional distress is common. The concept of mental or emotional distress includes anxiety, depression, low morale, and stress, even when the clinical symptoms don’t stand up to a specific psychiatric diagnosis. Sometimes the symptoms are linked to grief, loss of a family member, a serious illness, divorce, being fired or problems in the workplace, as well as stressful economic circumstances, or flare-ups in Israel’s security situation. In an in-depth study by the late Prof. Revital Gross and Dr. Shuli Brammli-Greenberg from the Brookdale Institute, twenty-five percent of the respondents reported they had sensed such feelings of mental or emotional distress in the past year, and thirty- two percent reported they had experienced such feelings at some time in their lives. Forty four percent of the respondents said they had sought professional help, and thirty seven percent turned to their family physician. Therefore, the role of the family physician in such situations is important, even very critical. 107 As a member of the Ministry of Health’s health council at the time mental health services in Israel were being reformed, I criticized the fact that those leading the reform had not given ample attention to the need to prepare family physicians for their mental health role. 105 Re Emek and Carmel hospitals: see chapter 6 106 Soroka’s inpatient department existed until 1978 when the government opened a mental health hospital in Beer Sheva. After that, Soroka medical center provided only ambulatory psychiatric services. 107 Revital Gross, Shuli Brammli-Greenberg, Bruce Rosen, Nurit Nirel, and Ruth Waitzberg. “Mental Distress and Patterns of Getting Help Prior to the Transfer of Responsibility for Mental Health to the Health Plans: A Service Consumers' Perspective,” Myers, JDC Brookdale research report, 2009. Available at: https://brookdale- web.s3.amazonaws.com/uploads/2018/01/538-09-Mental-Distress-ES-ENG.pdf

66