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Jerusalem - Litzman Wants Woman Only Psych Hospitals

Published on: December 1, 2009 11:18 PM
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Jerusalem - Deputy Health Minister Ya’acov Litzman’s idea of eventually hospitalizing only women at the Eitanim Mental Health Center in the Jerusalem Corridor and only male patients at the Kfar Shaul State Mental Health Center would probably end up costing more money and be very difficult to manage, according to Dr. Yehezkel Caine, director of Herzog Hospital in Jerusalem.

Caine, a modern Orthodox Jew, was reacting to the report in Ha’aretz Tuesday that Litzman wants to allow patients of only one gender in the two Jerusalem-area psychiatric hospitals - and perhaps other institutions around the country.

For about a quarter of a century, Herzog’s psychiatric beds have been allocated to women on one floor and men in a separate department on another. The patients never meet in the hallways, wards or dining rooms, said Caine. He recommended that model for institutions in which women have been victimized by male patients or those that suffer from problems of “immodesty.”

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Litzman told The Jerusalem Post on Tuesday night that he is consulting with professionals in the ministry’s psychiatric services department, where he “has received support” for his program. He disclosed that he intends to begin with separate departments within Eitanim and Kfar Shaul, but eventually to separate the sexes institutionally.

“I will discuss the plan with the works committees as well,” he said, “and I will not spend any additional money on housing the men and women patients separately.”

He added that the reason for his plan was “out of consideration for patients’ needs and without harming their treatment.”

Regarding criticism by the Israel Medical Association and others over his recent decisions related to religious positions - such as personally not recognizing lower-brain death as the moment of death - Litzman said he felt his opponents, even observant Jews, are “anti-haredi.”

The deputy minister said he has heard from families who refuse to institutionalize relatives out of concerns over what could happen in a mixed psychiatric hospital, but he did not claim that there have been any problems at Herzog, with its completely separate departments.

Caine suggested that if Litzman wanted complete separation of the sexes to ensure modesty and prevent sexual abuse of women patients, he could adopt the Herzog model. In fact, some time before Litzman - a Gur hassid from the Agudat Yisrael party - was named deputy minister, he stopped by the hospital in Jerusalem’s Givat Shaul neighborhood and asked questions about the separate departments.

Caine said that not only haredi and some modern Orthodox Jews want separation of the sexes within psychiatric hospitals, but also Muslims and many secular Jewish families. The Herzog director has been upset since Litzman took the helm at the ministry that due to budget cuts, his hospital has lost state financing for five of its then-75 beds.

“We treat more than 70, but we don’t get paid for the rest,” he declared. “We are now ready to have more in the separate women’s and men’s department. We are building now and will have significantly more space in three years.”

He said that psychiatric in-patient care in the Jerusalem area is “a mess” due to ministry cutbacks, and that the shortage of beds means overcrowding or people who need care “roaming the streets” instead.

“I am totally opposed to separate-sex hospitals,” said Caine. “The main reason is the staff. There isn’t the same number of men as women, and the ratio changes. Most hospitals have different sections for different levels of clinical severity: closed wards, semi-closed wards and the chronically ill. If sexes were completely separated, twice as many would be needed. Our sex-segregated departments have only closed wards and semi-closed wards, while other hospitals have three or four sections.

“And if the ministry is considering using doctors to treat patients of the same gender, that could never happen. It would be very difficult to have only female nurses for female patients, and even more difficult to have only male nurses for all male patients, as there are very few male nurses and many more male patients.”

Most other Jerusalem psychiatric departments, he continued, are mixed in gender, but with men and women in different rooms. In Kfar Shaul, the closed wards are divided by gender.

“In various mental hospitals around the country, there have been a few cases of rapes. Some argue that it is easier to manage patients in a single-gender environment,” said Caine, “but others say the mixed departments are better. I don’t know of any hard scientific evidence one way or another.”

But because of the largely religious patient population, Herzog has found separate departments to be best. He believes that “the separation came about long before he joined the hospital because this was considered suitable for the observant patient population we get.”

Herzog has not had cases of rape or other cross-sex violence because of the completely separate departments.

“Modesty lies in the beholder,” Caine opined. “Separation by hospital is unnatural; it would waste a lot of money. Society is mixed. It’s sad when there are isolated departments, but having different planets would be very bad.”

A psychiatrist who directs another public psychiatric hospital, insisting on anonymity, told The Post that he regretted Litzman “did not follow the policy of former health minister Nissim Dahan,” a former Shas MK who is widely regarded as having been one of the best health ministers ever.

“Dahan is haredi, but he never introduced his private religious views into his decisions. Litzman has done this often, and this is not the way to set public policy. Next will he want to have only male patients treated by male doctors and nurses? Will he want separate hospitals like extreme haredim want separate buses and sidewalks?”

Dr. Yitzhak Ziv-Ner, chairman of the State Physicians Union, wrote to Litzman saying that his plan was “unthinkable… illogical… and violated Basic Laws, and there is no such precedent in the Israeli health system. As it is, psychiatry has already suffered from prejudice, neglect and numerous shakeups in recent years. We worked hard, in cooperation with the Health Ministry, to stabilize the profession and have reached understandings on basic principles… Any change that would affect this is liable to damage the delicate balance we have achieved.”

The Movement for Quality Government demanded on Tuesday that Litzman immediately freeze his plan to separate psychiatric hospitals by gender, saying it was “unreasonable and based on non-professional considerations. In 21st-century Israel there is no room for separating men and women [by institution]. There is full sexual equality that is not dependent on the views of one man.” Principles are determined by democracy, Basic Laws ensuring equality and the High Court of Justice, he added.

The directors of the Eitanim or Kfar Shaul hospitals were unavailable for comment.


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Read Comments (17)  —  Post Yours »

1

 Dec 01, 2009 at 11:50 PM Charlie Hall Says:

My wife is a doctor and she treats both male and female patients. It isn't an issue.

2

 Dec 02, 2009 at 12:14 AM YitzchokM Says:

Reply to #1  
Charlie Hall Says:

My wife is a doctor and she treats both male and female patients. It isn't an issue.

this isn't about what you can or cannot do, Litzman is saying that some people "refuse to institutionalize relatives out of concerns over what could happen in a mixed psychiatric hospital". If they don't seek the help, we all end up losing.

3

 Dec 02, 2009 at 12:30 AM Anonymous Says:

Litzman is diggin a hole for himself that he will b'hsehm not be able to dig out from. He increaslingly performs like a political hack with no public health expertise and every word from his mouth make the professionals shudder. A few more proposals like this one will have convinced even his government supporters that he is a real threat to klal yisroel and must be removed from office asap.

4

 Dec 02, 2009 at 08:06 AM Anonymous Says:

stop making headlines, and start doing your job

5

 Dec 02, 2009 at 06:38 AM Anonymous Says:

Dr. Hall, I AM a (female) physician and I treat both male and female pts. I agree: Hasn't been an issue for me yet. Sorry, but this is just yet another disappointment on a long list of "mishandlings" and fauxes pas by the health ministry in the past 6 mos. Separate floors works just fine. but why should the state incur the extra expense of this move?

6

 Dec 02, 2009 at 06:42 AM Anonymous Says:

I do understand the need for separation of patients because their behavior does not always follow society's norms but separate floors might be enough. I can understand that using only same sex staff might prove impossible.

7

 Dec 02, 2009 at 06:55 AM meshugah Says:

separate psychiatric hospital - that's crazy!
(such an obvious joke was too hard to resist!)

8

 Dec 02, 2009 at 07:40 AM Anonymous Says:

Reply to #1  
Charlie Hall Says:

My wife is a doctor and she treats both male and female patients. It isn't an issue.

Great, your wife is a doctor. How does that deal with Litzman's idea. That more people would avail themselves of neccesary psychiatric care if thew genders were seperated?

And he was referring to the patients who are hospitalized not the doctors, I think that if you would think a little you woud understand the difference.

And WADR, we have no idea if your wife is any good, so talking about her is not proof, rather it is just a reason for your skewed judgement.
Besides, it would seem logical to seperate the sexes in a psych ward, as it is well known that certain conditions that manifest themselves in hypersexuality, bi-polar for instance. It would seem apropriate for patient safety. Read the story, they admit that there are instances of rape in mixed wards, yet none where they are totaly seperate.

9

 Dec 02, 2009 at 09:58 AM punch Says:

perhaps he should make a seperation even between the same sexes due to the fear some patients have because of being molested by someone of the same gender.
this litzman seems to be out of his mind!

10

 Dec 02, 2009 at 10:32 AM Brooklyn Doc Says:

I am a doctor, and I have to say that if it can be worked out financially, it would make sense. Ask females working in psych units how often male patients exposed themselves intentionally to them. I know of several such incidents. However, separate floors would be reasonable second best.
To #1, the fact that your wife treats males and females is irrelevant when discussing the behavior of psych patietns.

11

 Dec 02, 2009 at 12:25 PM formelly Says:

separate floors should be more than enough, since in psychiatric wards the doors are locked.

He is going overboard

12

 Dec 02, 2009 at 01:15 PM anonymous Says:

Reply to #3  
Anonymous Says:

Litzman is diggin a hole for himself that he will b'hsehm not be able to dig out from. He increaslingly performs like a political hack with no public health expertise and every word from his mouth make the professionals shudder. A few more proposals like this one will have convinced even his government supporters that he is a real threat to klal yisroel and must be removed from office asap.

this fine rav has he ever checked if all those who need mental assistance are receiving the care they need?

13

 Dec 02, 2009 at 04:30 PM visitor Says:

I personally visited patients at "Eitanim" numerous times & was apalled by- yes- the mixing of men & women.
I also had serious sucpicions regarding the staff as to the way a male nurse treats the females on a daily bases when the patients are there for a long time, & no one realy supervises their interaction.
and to say it's ok for a male doctor to treat women, i agree. But not for long periods of time and hours at end sometimes. I'm talking as a witness.

This is nothing less then a crisis for the mentally ill !

We are fortunate to have a person like Rabbi Litzman to stand up for these people no one else will stand up for !

The girl I visired at Eitanim said she was misshandled by the doctor & male nurse !

Maybe what she's saying is not true, but I'm sucpicious.

Please whoever has influence, help Rabbi Litzman.

14

 Dec 02, 2009 at 05:14 PM Anonymous Says:

Reply to #7  
meshugah Says:

separate psychiatric hospital - that's crazy!
(such an obvious joke was too hard to resist!)

It's actually not a joke! It's sad when people end up in a psychiatric hospital. Not all people who require hospitalization are crazy -They are ill, and need stabilization. A little sensitivity would be in order!

15

 Dec 02, 2009 at 06:40 PM Moishe Chaim Says:

Reply to #4  
Anonymous Says:

stop making headlines, and start doing your job

It looks like you don't know whats going on there, because, believe it or not, he is the only one on the job and is working hard.

16

 Dec 03, 2009 at 03:30 PM Anonymous Says:

I think this is a fantastic idea, and I am not chareidi, I am modern orthodox. I think that the care in these facilities is terrible-and I know firsthand because a relative of mine was in one of them. I think that separating the sexes would be one thing that would put into people's minds that these are people and take away the herd mentality that exists.
Then they have to move into talking to the families about the treatment plan, speaking english to the patient's families that have made aliyah and unfortunately find their relative in this hospital, and making decisions that take the family dynamic into consideration. And, I hate to say it, but American doctors would be a good idea also, especially if they are dealing with American patients.

17

 Dec 08, 2009 at 11:32 AM Anonymous Says:

Think it's definitely a Good Idea. Makes a lot of common sense, something that is so lacking today!

18

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