Community psychiatry in border settlements in Israel

Summary An analysis of our work during two years in a community mental health clinic serving a small town and an agricultural area near the northern border of Israel was presented. The clinic was staffed by a team of psychiatrists, psychologists and social workers who came to the area for one and a half days every week from a university psychiatric hospital in the center of the country. Only the nurse was a resident of the clinic was an attempt to provide a border population with expert psychiatric services which had previously been lacking, while maintaining a close connection with the central psychiatric hospital. All this was done on a relatively low budget. In spite of the difficult working conditions, an ambulatory team, travelling to the place and serving a wide area which was often under emergency conditions, was able to do effective work. A total number of 485 patients was seen during the two years, only 60 of whom were hospitalised, and very few were referred for private psychotherapy.The success of the clinic's operation can be explained by appropriate initial classification of referrals, concentration on short term therapy, close cooperation between the team members and effective interaction with the relevant agencies in the community. The clinic handled patients from two population groups (the town of Kiryat Shmona and the villages of the area), which differed considerably from demographic, social and therapeutic points of view.