Mental health reform in Israel: Challenge and opportunity: Part I: Fundamentals of the reform and the mental health service system on the eve of the reform

In July 2015, the mental health reform of Israel went into effect.This reform, which transfers responsibility for hospital and ambulatory mental health services to the health funds, constitutes a major change inmental health services in Israel. It concludes a process of fifty years of Israel’s attempts to achieve this change. This paper examines the opportunities and challenges associated with implementation of this reform and comments on lessons other jurisdictions interested in reforming their mental health service system could learn from the Israeli experience. The study was of the exploratory and “formative” assessment type – an evaluation in the course of program implementation with the objective of improving its functioning and outcome. It relied on both quantitative data and interview-based qualitative data. The comprehensive interviews included discussions with various persons, represented various organizations and interest groups, connected to the reform decision and its implementation. The manuscript is divided into two major parts and published as two papers: The first describes the reform and analyzes the system prior to the reform and the second assesses the issues that should be dealt with following implementation.