When Sara (not her real name), a recent immigrant from the U.S. living in the Golan, tried to commit herself for psychiatric hospitalization at the Ziv Medical Center in Tzfat because she had begun planning her own suicide, she was told not to. The doctor on call recommended against it because the hospital did not have an adequate staff of English-speakers and so he felt she would only become more depressed and deteriorate further in that hospital environment.
He told her that had she been a native Israeli he would have admitted her, but under the circumstances, the best thing he felt that he could do was to add an antipsychotic medication known as Risperdal to her current anti-depressant.
He then sent her home to her husband and three kids despite agreeing with her that, language barriers aside, she should be hospitalized in a psychiatric ward.
Everywhere Sara had turned she had been tragically misinformed, from a department head who assured her that either her doctor would speak English or a proper medical interpreter would be available to the hospital social worker who told her that it was, in fact, her responsibility to provide that interpreter.
None of that was true or accurate and Israelis, both immigrants and sabras, confront similar misinformation in the healthcare system every day.
When requesting to be hospitalized in another psychiatric facility, Sara was told that due to Ministry of Health regulations, she was subject to a policy referred to as אשפוז לפי אזור (hospitalization according to region), and that because she lived in the Golan, she could only be committed to the ward at Ziv or a facility in Akko, which, she was told, had even less resources for an English-speaker.
This, too, was not the whole truth as there are in fact procedures for requesting hospitalization outside of one’s region.
Sara’s husband, who didn’t know the full extent of her depression until he was forced into the role of medical interpreter despite his own limited Hebrew, stepped in after her new antipsychotic medication stopped doing the trick, when, rather than going back to Ziv, he intervened and had her seen immediately by a psychiatrist in nearby Kiryat Shmona who happened to be an acquaintance of his supervisor at work.
Sara’s condition has since improved thanks to the intervention of that acquaintance and not due to the government-run and supported “safety net”, which was never really there for her in the first place.
There is still no English-language suicide hotline in Israel, and support group options are extremely limited.
While the government has been making praiseworthy advances in recent years in terms of linguistic accessibility in the healthcare system, much of what has been suggested, promoted, and even dictated is not legally enforceable because it has come primarily in the form of a Ministry of Health director circular (No. 7/11), rather than a Knesset law, for example. The guidelines provided are generally vague, if well-intentioned.
The mental health system is not only problematic for English-speakers, either. As those who have visited a psychiatric facility in Israel can attest, scenes there seem spookily similar to something straight out of “One Flew Over the Cuckoo’s Nest”. The government has acknowledged as much and has placed great faith in transferring responsibility of Israel’s mental health system from the Ministry of Health to the health funds. That transfer is not set to take place until July 2015.
In the meantime (and let’s face it, surely after then as well), we can only continue striving to increase Israelis’ awareness of their rights within their own healthcare system regardless of the language they speak. Only through increased awareness can proper healthcare be based more on the legitimate mechanisms of that system and less on random personal connections and acquaintances.
If you have had a similar experience you’d like to share and/or would like to help make the Israeli healthcare system more accessible for English-speakers, contact: firstname.lastname@example.org.