Abstract
A number of related changes have evolved over the past 25 years: the development of a truly national disaster mental health service in Israel; progress in the science of risk, resilience and evidence base care for those suffering from traumatic stress related disorders; and the development of conceptual models of population level disaster mental health response in the context of emergency management systems such as the Incident Command System.In a recent IJHPR article, Bodas, et al. report on the dynamic history of disaster mental health response in Israel, which informed by the all too numerous real world events affecting the region. What is most striking is that the system now in place reflects true “lessons learned” in that problems and issues identified in incidents informed deliberative planning, and the current system reflects many iterations of “lessons observed and learned”. There appears to be commitment across sectors of government in Israel that the mental health consequences of disasters and terrorism are important and a priority. This is advanced thinking and sound policy.As the system in Israel continues to evolve, additional possibilities are offered for further consideration, based on the author’s US-centric experience, to advance emergency response systems in Israel, the Middle East and around the world.
Highlights
The recent IJHPR paper by Bodas and colleagues [1] provides a detailed overview of Israel’s national efforts to develop an emergency mental health system, in light of a series of armed conflicts and terror attacks.Since it began in the 1980’s, the emergency mental health system in Israel has evidenced considerable change and growth in terms of service delivery settings, coordination, payor/funding mechanisms, scope of services and levels of care
Novel disaster models for services to children have been developed in Israel, but it is not clear if they are being used in the model currently employed [9] and it is unclear whether a national strategy for the needs of children is operative. Another known population with significant natural resilience, and elevated risk, is the responder population. It is not clear from the Bodas et al article how they are served in the Israeli emergency mental health system—either in services provided by the Home Front Command or elsewhere
Location of care Given the unique nature of the threats encountered and the population distribution coupled with surge demands in hospital emergency departments, the Israeli emergency mental health program has evidenced great changes in locations of care—all informed by lessons learned from real world events
Summary
Since it began in the 1980’s, the emergency mental health system in Israel has evidenced considerable change and growth in terms of service delivery settings, coordination, payor/funding mechanisms, scope of services and levels of care. This commentary will consider the following aspects of the evolution of the emergency mental health system in Israel: process of change, funding, models and range of services, locations, and timing.
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