The Israeli Law for the Rehabilitation in the Community of Persons With Psychiatric Disabilities: Achievements and Challenges

Objective: The Community Rehabilitation of Persons with Mental Health Disability Law (2000a) is one of Israel's most important pieces of social legislation. It grants persons with psychiatric disabilities the right to receive rehabilitation in the community. This article is a case study of the development and implementation of a policy that led to the Rehabilitation Reform and that has become an important component in Israel's comprehensive mental health reform. The purpose of the study was to review and analyze the law and its elements, examine its implementation during its first two decades of operation, and to identify the issues it faces entering its third decade of application. Method: The study examined the key components of the reform such as intended beneficiaries, financing, workforce, and services provided. It used Israel's official statistical data and drew upon a series of interviews with officials and experts on rehabilitation, mental health and social services. Results: In 2020, 30,000 persons were receiving community psychiatric rehabilitation services, constituting about one fifth of the estimated eligible population. In addition to the reform's achievements, this article also identifies a number of issues. Toward the end of the second decade, problems between the psychiatric Rehabilitation Unit and the mental health services became apparent. Conclusions and Implications for Practice: As the Rehabilitation Law enters its third decade, it is recommended to establish an independent committee of experts to examine needed modifications in light of the conclusions drawn about the first two decades of its implementation. Impact and Implications This article presents a case study of policy change, effected by an Israeli law guaranteeing persons with serious psychiatric disabilities eligibility for community psychiatric rehabilitation services. Analysis of the reform's first two decades showed great achievements, however, indicated that the services do not yet cover the entire intended beneficiaries population, and revealed frictions with the mental health establishment. The article concludes with recommendations for the third decade of the Rehabilitation Reform.