Jerusalem psychiatrist arrested for sexually assaulting and molesting patients for five years

As Reported in the Israeli site MyNet. (English text via Google Translate)

Neve Yaakov presented himself as a psychotherapist being anxious couples, a patient suspected of having committed indecent acts and other women. During interrogation he claimed that he did things without any sexual connotation

Haredi attending a patient suspected of defilement and indecent assault in patients more. The suspect, a resident of Neve Yaakov 44, was arrested this week by the Jerusalem Central Unit for suspected molesting his patients and even slept with one of them. According to the allegations, he hired an ultra-Orthodox organization treatment rooms located in Givat Shaul and there probably carried out his scheme.

The affair began a few weeks ago, then Jerusalem Central Unit received a complaint of ultra-Orthodox woman who claims that within the last treatment with the suspect is committed indecent acts. Among other things, she told the woman that he would sit her on it and pat it under your clothes. Immediately after receiving the complaint, the police began investigation. The researchers, led by Chief of youth exposure, Superintendent Golan Meiri, came another woman who claimed that he touched her vagina.

The suspect claimed during questioning that is anxious couples psychotherapist parity problems but deals mainly with individual women. He rented a room in the structure of the ultra-Orthodox Associations Givat Shaul where he received the women. It is suspected that he had treated this way Orthodox women for five years. Police point out that he used to sexually exploit the Mtoflotio significant number of cases.

Even before his arrest, trial proceedings against him took place in the Haredi community in so-called ‘Forum Regulation. Apparently the procedure did not produce fruit, and that’s what made the first complainant to contact the police. Near the police made the arrest raid on where the organization operates, and from there were taken additional evidence supporting the allegations. However, police point out that the organization itself has no connection to the event and there is no suspicion of its abnormal behavior.

In his interrogation, the suspect claimed that everything was carried out as part of treatment and without any sexual connotation. Police continue to investigate, among other things, trying to get other complainants and check the credentials required to perform treatments such as those committed by the suspect.

Jerusalem man says affair with psychiatrist damaged his mental health

A report out of Jerusalem

A 55-year-old man from Jerusalem intends to tell a Jerusalem court next month that a sexual relationship he had with his female psychiatrist in her private clinic damaged his mental health. The case is expected to set precedents concerning the psychiatrist-patient relationship.

The case, pertaining to 114 therapy sessions between October 2000 and November 2001, had been under a gag order since deliberations began in the Jerusalem District Court in January 2004. The psychiatrist, Tamar Kafri-Deutsch, denies ever sleeping with the man.

In March this year, Judge Zvi Zylbertal granted the complainant's request to make the details of the case public, except for the complainant's identity. "There is a distinct public interest in putting this issue on the agenda, to demonstrate the dangers of what could occur during psychological therapy," Zylbertal wrote in his ruling.

"The special relationship that is formed between patient and psychiatrist and the dependence that could grow from it - which could result in abuse - merit examination."

By making the case public, Zylbertal said he hoped to "increase awareness and prompt victims to come forward and complain to the authorities or seek compensation," as well as to "deter other therapists from crossing lines and boundaries, thereby sparing other patients future transgressions."

Zylbertal also chose to hear the complainant's case after becoming convinced that patient and psychiatrist indeed engaged in a romantic relationship - a fact that Kafri has consistently denied.

Although the court has yet to determine whether a sexual relationship between doctor and patient damaged the complainant's mental health, the court's ruling means that Kafri seriously violated the medical ethics code. The code states that "sexual and erotic contact between a therapist and a patient seeking psychological therapy is strictly forbidden and constitutes a grave ethical transgression and patient abuse, which could irrevocably damage the patient's mental health."

Israeli law had hitherto viewed sexual contact between psychiatrist and patient as a criminal offense carrying a sentence of up to seven years in prison. But the law has been made less stringent because of the case in question.

Kafri, according to the ruling, first met the complainant at a Health Ministry mental-health clinic in Jerusalem's Talpiot neighborhood, where the complainant's family doctor had referred him.

The psychiatrist then suggested that he come to her own clinics, one in Bnei Brak and the other in Jerusalem, for private treatment to prevent him from "falling between the cracks," as she put it. She repeatedly told the complainant not to mention this to other employees at the ministry's clinic, according to the ruling.

Kafri, also 55 years old, graduated in 1984 from Tel Aviv University as a medical doctor. She then specialized in psychiatry, serving at several public mental health facilities including Be'er Yaakov, Talbieh, Kfar Shaul and Hadassah University Hospital, Ein Karem. She also specialized in psychoanalysis. She described herself in court as an "accomplished and renowned psychiatrist privately treating many patients.

She added that she has stopped practicing psychiatry in recent years since she moved to the United States with her husband. Kafri cited this in requesting that the court squelch the story. "Those who were treated by Dr. Kafri in the past are entitled to know about this case," Zylbertal ruled.

Another issue in the indictment is payment that Kafri received from the complainant. He claimed that he paid the psychiatrist not only with money, but with gardening and minor construction work at her Jerusalem home.

Kafri explained that this was in the framework of "rehabilitative work." The Israel Psychiatric Association's ethics code from 1997 states that a psychiatrist can only receive monetary payment, which should be agreed on in advance, and must not receive anything else. The court calls the payment procedures "bizarre," adding that the complainant claims that this arrangement set the scene for a sexual affair.

The central piece of evidence in the case is a 70-minute telephone conversation, which was recorded, transcribed and submitted to the court in a 33-page document. In the document, Kafri replies to the complainant's observations about an "affair that was ignited" between them.

"I shouldn't have let it happen," Kafri said in the conversation. "We managed to viciously hurt one another - we were both very frivolous. We tried to ignore it, and then it hit us when we weren't expecting it. I had to put an end to it at some point because I saw what huge damage it was causing both of us."

Doctors charged with defrauding national insurance

We have this report from the Israeli newspaper Ha-aretz

Two physicians were indicted yesterday in the Rishon Letzion Magistrate's Court for repeatedly defrauding the National Insurance Institute between 2000 and 2007.

Dr. David Adivi, an orthopedist at Wolfson Medical Center in Holon, stands accused of taking bribes and breach of trust.

Dr. Mark Zeevin, the Health Ministry's district psychiatrist, is charged with providing false certificates and other counts of attempted fraud.

According to the charge sheet, Adivi, 64, from Rishon Letzion, received envelopes containing between NIS 500 and NIS 1,000 in cash, plus a coffee machine, from Yosef Tzemach. In exchange, he instructed various associates of Tzemach's on how to obtain disabled status from the NII. He also allegedly made sure that he sat on the disability committees before which Tzemach's associates appeared.

Zeevin allegedly took money from various people in exchange for fake psychiatric opinions that declared the recipients disabled. Tzemach was also indicted in January for advising people to increase their life insurance and disability policies and then staging accidents so they could receive the insurance money. He mediated between these individuals and five doctors, including Adivi and Zeevin, who produced false medical documents.

[...]

Israeli Miliatry Psychiatrist Convicted in Espionage Case

As reported in in the Israeli paper Ha'Aretz and elsewhere

A Tel Aviv court on Wednesday convicted Israel Defense Forces psychiatrist Captain David Shamir (Res.) with making contacts with a foreign agent, espionage, and attempting to harm national security.

Sentencing has not begun, but the charges carry penalties of up to a combined 25 years in prison.

The conviction came as part of a plea bargain that reduced the severity of the charges facing Shamir.

According to the original indictment, Shamir attempted to make contact with the Iranian Foreign Ministry, Hamas officials, and the Russian intelligence service the FSB, with the intention of selling them classified information he was exposed to during his military service.

The information reportedly included Medical Corps guidelines for emergency situations, the deployment and status of the Medical Corps, and guidelines for evacuating citizens in case of a missile attack.

Psychiatrist Among Those Arrested in Israeli Insurance Fraud Scheme

A Report in YNet News, there is certain to be more on this, as least in Israel

Israel Police National Economic Crimes Unit investigators Tuesday morning arrested 15 people —about half of whom are doctors — suspected of being involved in an insurance-fraud scheme.

Police have accused the 15 of inventing car accidents to defraud the National Insurance Institute of Israel (NII) and insurance companies of estimated millions of shekels.

In an operation dubbed "White Robe", conducted with the assistance of the NII and Avner insurance, a large scam was discovered whereby suspects used counterfit car accidents to receive money from the NII and insurance companies for damages and surgeries. Among those arrested are an assistant district psychiatrist, an orthopedic surgeon, and a radiologist.

Evidence collected by the police points to a "well-oiled" machine operated by several suspects, two of whom assisted the "claimants" by guiding them through the process of faking accidents, acquiring falsified doctors' forms, accompanying them until receiving money from the NII and insurance companies, and finally splitting this sum.

Health Ministry seeks inquiry into death of patient at psychiatric hospital

Report from the Israeli Newspaper Ha'Aretz - A truly disturbing set of circumstances

The Health Ministry's Northern District Psychiatrist, Dr. Eli Griner, has called for an independent investigation into the death last month of a 55-year-old former patient at the Mizra state psychiatric hospital in Acre. Her case was referred to the ministry's ombudsman, Prof. Shimon Glick.

The patient died on November 15 in Closed Ward No. 10. Griner's recommendation to Health Ministry Director General Avi Israeli was prompted by "substantial question marks" regarding the physical and mental treatment the patient received at the hospital, the product of a review of the case by his deputy, Dr. Nabil Jeraisi.

According to Mizra's internal review report, the patient was diagnosed with schizophrenia and slight retardation and lived at a Galilee hostel for mental patients. She was treated for years with psychiatric medications and for cardiac and thyroid conditions. On October 28 she was forcibly admitted to Mizra in a severely psychotic state that manifested as violent behavior toward those around her and psychomotor disquiet, which led to severe falls and bruising.

On November 6 she began having convulsions. She was sent to Western Galilee Hospital in Nahariya, where she spent eight days in an internal medicine ward. There she was found to have pneumonia, and the suggestion arose that her convulsions were an adverse reaction to a psychiatric drug she had received by injection. A substitute medication was recommended.

On November 15, after her return to Mizra, she was found to be suffering a speech disturbance, and was placed under observation. Her doctors decided that after she recovered from pneumonia she should receive electroshock therapy - a treatment that had previously brought about improvement in her mental state. In preparation for this treatment, she was referred for consultation with an internist and a neurologist.

On November 15, at 4:30 P.M., the patient was placed in a wheelchair in the ward and tied with a sheet to prevent her falling out. About five minutes later she was found in the chair, dead.

Mizra appointed an internal review, led by Dr. Mina Kushnir, which concluded that the hospital had acted correctly. But Jeraisi's team, while acknowledging that Mizra's staff had worked hard to treat the patient and addressed the medical recommendations of the Nahariya hospital, said that the cause of death "remains in our opinion unclear," and questioned part of the treatment.

In Griner's report to Israeli, the psychiatrist wrote that he cannot understand why the woman was not sent back to Nahariya immediately upon her return, since she displayed "dramatic changes for the worse in her condition" in a short period of time, to the point where she could not hold a pen in hand to sign her name.

Griner also asked why the woman was not examined the day she returned from the Nahariya hospital by Mizra's expert internists and neurologists. He noted that the doctors at Mizra began preparations for the course of ECT despite the patients's "poor physical condition."

Haaretz has learned that another patient died two years ago in that same closed ward at Mizra. In that case, the patient, a 32-year-old man from Peki'in, was admitted after his mental state deteriorated. Then too, an internal review headed by Dr. Kushnir ruled that "the treatment was without failings." The Health Ministry found that the patient had been "very heavily medicated" and that "without a doubt" some of the drugs he received increase the risk of cardiac arrest, but that there was no reason to suspect negligence. It was therefore decided that no external investigation was necessary.

Isreali Defense Force Psychiatrist suspected of attempting to spy for Iran

In a new twist of psychiatrists behaving badly, we have a case in international espionage. From the Jerusalem Post

A psychiatrist who serves in the IDF reserves is suspected of offering classified information to foreign intelligence officials, including those from Iran, police announced Friday morning.

45-year-old David Shamir, ranked as major in the army, was indicted on severe charges of attempted espionage, contacts with a foreign agent and perverting the course of justice.

He was arrested by the Shin Bet (Israel Security Agency) in cooperation with the Israel Police's Serious and International Crimes Unit on November 14, police said.

According to the prosecution, during his IDF reserve duty, the psychiatrist was exposed to classified material including emergency plans of the IDF Medical Corps, detailed plans for the deployment of medical units and control centers, procedures for providing psychiatric services to the home front during a war and tactics for evacuating civilians in the event of rocket attacks, as well as IDF intelligence and operations assessments.

The November 22 indictment served in the Petah Tikva Magistrate's Court asserts that "in April 2007, Shamir decided to provide information to hostile entities in exchange for money and he contacted the Iranian Foreign Ministry by electronic mail."

He allegedly introduced himself in the mail as a civilian and an Israeli officer "well tuned in to what goes on in Israel." Police said that during his interrogation, Shamir confessed that he told the Iranians he had widespread contacts with Israeli public figures and Israeli companies including those with security clearances.

The IDF psychiatrist purportedly expressed his willingness to cooperate with Iran, saying that he would be prepared "to provide further details." A few days later, he received a response by the Iranian officials but he didn't finalize an agreement with them, police said.

In addition, it is alleged that in August 2007, Shamir sent faxes from his home to the Iranian consulates in London and Turkey and, about a month ago, after receiving no responses, he faxed them again. Police said that after sending the faxes he destroyed them and saved the fax numbers to his cellular phone memory in order lessen the chances of detection.

Shamir told his interrogators that he was motivated by "greed."

Furthermore, on November 3, he allegedly turned to the Hamas-controlled al-Azhar University in the Gaza Strip where he introduced himself as an Israeli citizen interested in "joining the struggle." Police assert that he did this in order to create an opening for future cooperation between him and Hamas.

Shamir also allegedly wrote an anonymous e-mail to the Russian intelligence service, seeking clarification on its recruitment process and expressing willingness to join the organization.

Police requested that Shamir be remanded in custody until the end of legal proceedings and until now, his remand has been extended several times for the purpose of the investigation.

Shamir, who ran a drug rehabilitation clinic, was also found to be in possession of marijuana, police said.

"This fact surprised the investigators, in light of the fact that he is a civil servant in a government institution who as part of his job is supposed to treat suspects sent by the court for drug rehabilitation treatment," read a police statement.

Psychiatric hospital kept quiet about sexual assault

From the Ha'aretz Newspaper

A psychiatric hospital in the Galilee failed to report a sexual assault that occurred last summer between two patients, a male and a female, Haaretz has learned.

The 73-year-old male attacker was removed from the unisex psychogeriatric department at Mizra Psychiatric Hospital, where the assault had occurred in July. But some months later, the doctor in charge decided to transfer him back and house him with female patients.

The decision to move the attacker, a convicted killer diagnosed with schizophrenia, who was transferred to Mizra in May, prompted one of the institution's senior physicians to complain to management about potential risks. The senior doctor warned that returning the man to the mixed department put female patients in danger of being sexually assaulted.

The attacker, who had been convicted 24 years ago of killing his wife and one of his daughters, was eventually removed and transferred to an all-male ward.

The assault happened at night, when the attacker entered the room of a disabled 60-year-old woman suffering from severe dementia. He reportedly climbed in bed with her and started groping her breasts. Nurses removed the man after the victim yelled for help. The man reportedly told the doctor on duty that he had tried to have sex with the woman.

Sources in the Health Ministry told Haaretz that although Mizra's management had defined the assault as a "severe incident," it was not reported to the ministry, the district psychiatrist or the police. Additionally, the hospital did not report the incident to the victim's family. The woman is now hospitalized elsewhere, at a care facility in the center of the country.

By not reporting the incident, Mizra's management may have violated the ministry's protocol for such incidents. Proper procedures require all hospitals to "report any unusual event that could put patients in danger, and inform police of any case involving a suspected criminal offense."

In the ministry's official reaction, its spokesman said: "We do not view this case lightly, nor does Mizra's management. However, this is not the sort of event that requires hospitals to contact the ministry or the district psychiatrist and inform them about the circumstances of that occurrence."

The ministry went on to explain the hospital is exempt from reporting the incident because it does not involve "significant damage" to the patient or death, "as stipulated in the health ministry's orders to hospitals and medical institutions."

But a Health Ministry official told Haaretz there is no doubt in his mind that both from the moral and legal perspectives, Mizra should have reported the incident. "Mizra's Management had failed to meet the standards for the proper administration of a hospital," the official said.

The ministry learned of the incident only two weeks ago, approximately four months after it happened. The ministry became aware of the assault after the northern district's deputy psychiatrist, Dr. Nabil Gerassi, received the correspondence between Mizra's ward director and one of his senior staff, who warned against returning the attacker to the ward.

The correspondence revealed that the attacker, who after the assault had been transferred to the all-male ward, was transferred back to the unisex department on October 18. Dr. Yuli Wetchkov, head of the psychogeriatric department at Mizra, signed the transfer, based on the request and recommendation of Yulinna Naj, the head of the all-male ward.

The senior physician at Mizra who opposed the transfer, Dr. Michael Segal, then wrote Wetchkov and the institution's management to warn against the move. Upon reading his warning, management instructed Wetchkov to transfer the attacker back to the all-male ward.

Ten days ago, Wetchkov wrote Segal to tell him that the psychogeriatric department's handling of the incident was "professional and appropriate," and that the recommendation that the attacker be transferred back to the unisex ward was "done after much thought," Wetchkov added.

In its official reaction, the Health Ministry told Haaretz: "When the patient was hospitalized, he displayed no signs of violence or abnormal sexual behavior, and there was no reason to refrain from receiving him in the ward. During the two months of his stay before the incident, the man displayed no abnormal behavior.

"The incident itself did not result in sexual intercourse or rape. After the incident, them man was transferred to the all-male ward for two months. He was then put in the psychogeriatric department for a few days, during which he displayed no violent behavior. However, he was then transferred to the all-male department to reevaluate the degree of danger that he might pose to other patients.

"The incident called for an internal inspection, which was carried out and concluded, albeit a few days too late."

School psychologist gets one year in jail for molesting 8-year-old boy

From the Israeli newspaper Ha'aretz

Haifa District Court on Saturday sentenced a school psychologist convicted of molesting an 8-year-old boy whom he was treating to one year in prison.

The court added an 18-month suspended sentence, which will be in effect for three years.

The psychologist, Farid Shehadah, was employed in a school near Hadera. The verdict says that in August 2003, Shehadah summoned the boy, who was eight years old at the time, to his office for an examination. The boy arrived along with his sister and mother, and when the two left the room, Shehadah locked the door and molested the boy.

The verdict states that Shehadah continued to molest the boy throughout 2004.

Judges Ilan Schiff, Yitzhak Amit, and Hani Horowitz wrote that such crimes leave emotional scars, especially given the relationship of trust and dependency between a psychologist and a minor

Illegal hospitalizations endanger patients

From the Israeli paper Haaretz, some strange events in the Israeli psychiatric care system.

Dr. Eli Griner has seen enough. Griner, the head psychiatrist for the Northern District in the Ministry of Health, recently alerted the ministry's director general, Prof. Avi Yisraeli, to the issue of illegal involuntary hospitalizations of dangerous patients at the Mizra state psychiatric hospital in Acre.

In an unusually sharply-worded letter to Yisraeli, Griner said these hospitalizations endanger the patients and medical staff at the hospital as well as the general public.

"What more needs to happen for the ministry under your control to step in and put a halt to this blatant disregard for the law?" wrote Dr. Griner.

In a case mentioned by Dr. Griner in his letter, a dangerous psychiatric patient from the high-security ward at Sha'ar Menashe Mental Health Center in Hadera, where dangerous psychiatric patients from throughout the country are hospitalized, was transferred to a closed ward at Mizra in March. The transfer was approved by both hospital's managements, but they did not obtain the district psychiatrist's approval as required by law.

In August, the patient assaulted another patient on the ward, who required stitches in his head as a result. The dangerous patient was returned to Sha'ar Menashe after the incident. In its report on the attack, the ministry's legal department expressed "wonder that both hospitals did not see fit to at least inform the district psychiatrist of the transfer...."

A Haaretz investigation uncovered several additional cases in which the welfare of helpless psychiatric patients and the general public were jeopardized. The investigation was based on dozens of documents and internal, confidential reports.

One of these involved the suicide, on hospital grounds, of a double-leg amputee who had been hospitalized at Mizra for 32 years. The patient sneaked out of the building in the middle of the night without being noticed, got out of his wheelchair and laid under a parked bus in the hospital lot. In the morning, he was run over and killed by the bus.

The internal investigation committee found no fault with the patient's treatment, but the report nevertheless raises many questions about the care of psychiatric patients with physical disabilities. The investigation revealed that for years the patient had applied to be admitted into a group home, which rejected him because of his disability.

A ministry report cited shortages of basic foods at Mizra, including meat, cheeses and powdered milk.

According to a statement by a Health Ministry spokeswoman, most of the charges "were examined and found to be baseless and fallacious, and based on biased personal interpretation that does not match the interpretation of the ministry's legal department." Certain issues were still being examined and have been passed on to the relevant offices within the department. The spokeswoman did not indicate exactly what was determined to be "baseless" and "fallacious," by whom and according to what standard..

State petitions court over acquittal of psychiatrist on molestation charges

From this report from Isreal

The State Prosecution on Thursday petitioned the Supreme Court seeking to overturn the decision to acquit psychiatrist Marcello Spitz of child molestation charges.

In response, the health ministry said it would reconsider its decision to allow Spitz to resume practicing pending the court's decision.

A panel of Haifa District Court judges had acquitted Spitz by a vote of two to one, saying the prosecution was not able to prove his guilt beyond a reasonable doubt.

Spitz had been charged with repeatedly touching one of his patients. In their ruling, the judges said the witnesses' testimony was valid and that contrary to Spitz's claims he was not in a psychotic state.

However, they wrote that they had decided to aquit Spitz because they believed the patient's unstable mental state and will to leave psychiatric interment led him to believe a version of events of his own fabrication.

Judges had further doubts over the witnesses' claim that the acts were carried out by Spitz in an unlocked room while his mother was waiting outside and that he came forward only after the most serious incident.

In the petition, the State Prosecution claims the judges ignored the fact that Spitz lied in court, claiming he had diagnosed the youth as suffering from psychosis and delusions while records show he had not.

Psychiatrists fight against mental health services reform

It seems that psychiatrists in Isreal are fighting tooth and nail against Mental Health Reform. As seen in this report, it seems like they are protesting the end of a profitable business as usual system. While we present the report, we remain ever so skeptical of their arguments. It's always about the money, y'know.

The long-awaited reform of mental health services that will transfer responsibility for them from the Health Ministry to the four health funds will in fact "trigger their collapse," according to the Israel Medical Association (IMA) and the Israel Psychiatric Society. The two groups issued an emergency call on Wednesday to prevent its implementation on January 1.

Representatives of the two organizations, joined by heads of the Israel Society for Pediatric and Adolescent Psychiatry, the Government Doctors Union, the Psychologists Association and Social Workers Union, called for an urgent revamping of the reform so it would not harm patients and professionals in the mental health field.

The agreement reached in recent months by the Health Ministry and the Treasury for implementing the reform is a "serious perversion" of the planned reform, whose roots go back to recommendations of the 1989 State Judicial Commission on the Health System, they said.

"It will cause many patients to be thrown into the street without any treatment for them," they said.

Instead, they called for "a real reform, which is vital and necessary, in cooperation with the organizations of professionals who treat them."

When the National Health Insurance Law went into effect in January 1995, mental health services were supposed to be transferred gradually by the ministry to the health insurers, but the Treasury opposed it on the grounds that it would cost a lot of money and it never happened.

The main arguments in favor of the reform were that treating mental illness like physical illness would eliminate much of the stigma of psychiatric and psychological problems and that the ministry had an inadequate budget for services.

The IMA, the psychiatric society and the other professional organizations favored the reform concept, even though it has already led to the elimination of 4,000 psychiatric hospital beds, with stress placed on treating patients with newer medications and psychiatric and psychological counselling in the community.

But the Treasury, "which never supported the reform, searched for ways to make it fail, and it is carrying out only a reform of reducing services," the medical representatives said.

According to an agreement signed in September by the Health and Finance Ministries, 50 community mental health clinics and stations owned and run by the Health Ministry will be closed.

In addition, said opponents to the reform, the Treasury was allocating only NIS 160 million extra for implementation instead of the 300 million that is the minimum needed for the health funds to set up and provide adequate services.

"What is the logic of closing facilities before new ones open in the community?" they asked. "Why close clinics that have proven themselves to be professional and beneficial?"

Dr. Jacob Polakiewitz, head of the ministry's mental health services, denied the claims and charges.

The ministry will transfer to the health funds the NIS 1.1 billion it has spent each year on mental health services, including NIS 760 million for hospitalization and NIS 430 million for community-based services, he said. In addition, the health funds will share an additional NIS 40 million a year over four years, for a total of NIS 160 million more.

"Government psychiatric hospitals will continue to function as today, but the health funds will purchase services from them to treat their members. The health funds cannot provide community services on their own today," said Polakiewitz, "so initially they will purchase services from the existing clinics. They will then either purchase clinics or hire some or all of the professionals for their clinics or independent professionals."

The ministry official said he understood the fear of cuts, but that the intention was to expand rather than shrink services. Patients who suffer from anxiety, depression or trauma from life experiences would continue to get treatment, but from the health funds rather than the ministry, he said.

Only two percent of the population now receives psychiatric treatment, said opponents of the reform, while the norm in the Western world is 4% - and those countries do not suffer the stresses of war and terror and the history of suffering in the Holocaust that Israelis do.

Increasingly, psychiatrists' time with patients has been limited. Under the new program, only people with diagnosed psychiatric disorders will receive help, while those who suffer from stress and trauma from life events and experiences will be ineligible.

The reform would not save money, the opponents argued, as without real therapy, patients would suffer breakdowns and have to be hospitalized again.

Children and adolescents suffering from mental problems, especially those in the periphery, would suffer the most from the reform, the mental health professionals charged. Rehabilitation of patients would be dealt a death blow, they continued, as hostels, protected living arrangements, clubs and sheltered workshops that employ them would be wiped out from lack of budget.

The reform, they maintained, has "turned into the Treasury's reform, without any support from mental health professionals who dealt with the issues for 11 years. There is not one single factor that supports it. All think it will be a disaster."

Earlier this week, at a Jerusalem public health conference, Health Minister Ya'acov Ben-Yizri said he was proud that responsibility for mental health services would finally be moved to the insurers.

"One can't solve every problem in advance, but we will go ahead even if it steps on some toes and hurts the prestige and the livings of some groups," he said. "There will be special committees to monitor implementation and deal with problems. If we wait, it will never get done."