Adult Psychiatry in Israel Ø Started with the

Adult Psychiatry in Israel Ø Started with the creation of the State, first in asylums, then in psychiatric hospitals , moving today towards general hospitals. Ø To-day, 900 adult psychiatrists for 4. 5 million adult citizens.

Inpatient psychiatric beds at the end of each year 1992 -2001

Inpatient Psychiatric beds 2001

Psychiatric hospitals and psychiatric departments in general hospitals First admissions to inpatient care and day hospitalization by religion, 2001

Governmental Outpatient Clinics Distribution by age and gender 2002

Infant, Child and Adolescent Mental Health in Israel:

Lag between adult and child psychiatry implementation in Israel It is only in 1975 that the need for child psychiatry as a profession in its own right became evident in Israel, much after adult psychiatry.

Israeli Child and Adolescent Psychiatry: Its developmental course Inpatient wards for adolescents & children Outpatient clinics for adolescents & children Community-based Infant Mental Heath Units

Ratio of Child psychiatrists versus population 100 expert child & adolescent psychiatrists for ~ 2 million children & adolescents. - Unevenly distributed around the country. Some of them work only in private practice. - No expert clinics in Israeli Arab population. Very few Israeli Arab Child Psychiatrists.

Inpatient wards distribution 360 beds are allocated to adolescents and children: - 70 for children (in 2 psychiatric hospitals: Nes Zionah and Eitanim (Jerusalem) - 290 for adolescents, spread in 10 hospitals, mostly psychiatric, some in general hospitals.

Special inpatient ward The ministry of Health Department for Addictions (1990) has opened an inpatient ward for drug-addicted adolescents in Lifta, Jerusalem.

Ambulatory child psychiatry: its impact on the profession Enlargement of the field: from mainly psychosis and autism, to depression, anxiety, attentional and school difficulties. . “Hard” to “Soft” child psychiatry.

Psychiatric hospitals and psychiatric departments in general hospitals Inpatient beds 2001

Outpatient child and adolescent clinics: Where ? Within each of the Psychiatric hospitals. Within some of the General hospitals. Community-based.

Last but not least: 0 -5 yrs old children Ø Ø Research brought clinicians’ attention to the existence of emotional life of infants and toddlers and to early signs of distress. A new field rose in the early 80 s: Infant psychiatry, as a tool for preventive child psychiatry. In Israel, it started 7 years ago, at Geha Center.

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Outpatient referrals nb. in 2000 6. 6 per 1000 children & adolescents were referred to government outpatient clinics: - 0. 8 aged 0 -5 yrs (boys=girls) - 4. 6 aged 6 -12 yrs (boys 3 times girls) - 4. 1 aged 13 -17 yrs (boys a bit>girls). HMOs clinics are not yet computerized fully enough to have overall statistics.

Implications of the Reform for children and adolescents psychiatry Ø Ø 6. 5 mental health positions per 100. 000 Israeli citizens will be allocated and most of the services will be transferred to general pediatric hospitals. Ministry of Health has started training of 13 new Child and Adolescent Psychiatrists, 2 of them are Israeli Arab M. D. s.