Can the new health minister end Israel’s mental health stigma?

Health Minister Nitzan Horowitz took a bold step toward fighting the mental health stigma in Israel with his first official visit to the Yehuda Abarbanel Mental Health Medical Center.

“The choice… is not accidental,” the health minister said. “The first visit symbolizes my priorities.”

He made the decision to go to Abarbanel on the same day that 125 new cases of coronavirus were diagnosed and health officials were examining the prospects of another outbreak of the disease – one that makes people physically sick and even kills.

But Horowitz stood there at the mental health center and told the public that for too many years mental health has taken a backseat, that people with mental illness suffer from being stigmatized and their care underfunded.

“In my tenure as health minister, mental health and psychiatric medicine will move from the bottom of the list of priorities to the first line of issues that I will work to strengthen and promote,” he said.

Horowitz took his role as the COVID-19 crisis was waning in Israel. Despite rising numbers and even with the Delta variant spreading in some pockets of the country, most health experts believe that Israel is unlikely to experience a public health crisis like it did earlier this year and last.

Rather, the people of Israel are suffering a mental health pandemic of depression, substance abuse, post-traumatic stress and even suicide.

Mental health and psychological issues could have much harder and much longer-term effects than the disease itself.

For starters, resilience has declined dramatically, with a team of Tel Aviv University researchers reporting earlier this month that the level of personal resilience experienced by Israelis hit a two-year low during the recent Gaza escalation.

The researchers measured resilience on a scale of one (lowest) to five (strongest). In 2018, Israelis’ level of resilience was 4.68. At the height of the pandemic, in October 2020, it fell to 4.28. In January 2021, during the third wave, it dropped to 3.48. During the recent operation in Gaza it plummeted to 2.47.

Other studies showed that Israelis’ levels of anxiety and depression increased significantly over the past year, so that as much as one in three people in Israel suffered from extreme or highly extreme symptoms of anxiety.

And Israel’s main crisis hotline reported receiving an unprecedented level of suicidal calls last year.

“When diseases strike, experts say, they cast a shadow pandemic of psychological and societal injuries,” an article published in May 2020 by The Washington Post read.

“The shadow often trails the disease by weeks, months, even years. And it receives scant attention compared with the disease, even though it, too, wreaks carnage, devastated families, harms and kills.”

But it is not just since the COVID pandemic.

Israel has been struggling to embrace and support people with mental illness for decades.

In 2012, the health minister transferred the provision of mental health services from the Health Ministry to the health funds. The idea was to allow for the unification of the system so that people could receive integrated mental and physical health care.

But massive needs for the mental health system remain.

People report waiting in long lines. For some people, especially those with lower socioeconomic status, it is near impossible to get the needed social services.

If the general healthcare system is starved, the mental health system is anorexic.

And this is despite the country becoming aware that depression crises will within a few years become the most common reason for impaired function in the world of medicine, according to the Health Ministry website.

“Mental health patients are entitled to exactly the same level of medical care as in any other medical field,” Horowitz stressed on Tuesday. “I will not accept a situation where patients will have to sleep on mattresses on the floor.

“Mental health institutions suffer from a severe lack of resources and budgets,” he continued. “I set myself a key goal: To increase the resources of the psychiatric system, improve the quality of care, the scope of manpower, medical equipment and hospitalization conditions of patients.”

A study published in December showed that one in five Israelis suffer from depression. This means that most people know someone with the disease but they might not even be aware. And that is because no one talks about it.

Horowitz sent a message that it is time to remove the stigma from mental health.

“Psychiatric patients are just like any other patient,” the health minister stressed. “There are diseases of the lungs, there are diseases of the digestive system, there are diseases of the heart and there are diseases of the brain. Illness is disease. A patient is a patient. This stigma needs to pass from the world.”

Horowitz was likely courted by every major hospital and health fund and asked to make his first visit there. Mental health is a lot less glamorous than COVID or cancer wards, where photos can be snapped with permission of frail patients in the hallways, or of the Start-up Nation’s innovative treatments the country has to cure them.

But the health minister sent a beautiful message on Tuesday: “We will break through the barrier of shame.”