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Health services utilization in Jerusalem under terrorism.

Itzhak Levav1, Ilya Novikov, Alexander Grinshpoon

  • 1Mental Health Services, Ministry of Health, 2 Ben Tabai St., Jerusalem 91010, Israel. Itzhak.Levav@moh.health.gov.il

The American Journal of Psychiatry
|August 1, 2006
PubMed
Summary

Terrorism escalation in Jerusalem did not increase psychiatric service use among most residents. However, elderly individuals and those previously hospitalized showed increased mental health service utilization, alongside greater use of general medical and emergency services.

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Area of Science:

  • Public Health
  • Mental Health Services Research
  • Sociology of Health

Background:

  • Escalating terrorism poses significant public health challenges, impacting mental well-being and healthcare utilization.
  • Jerusalem, a city with ample medical and psychiatric services, provides a unique setting to study population responses to prolonged conflict.

Purpose of the Study:

  • To investigate the influence of escalating terrorism on the help-seeking behaviors of Jerusalem's general population.
  • To differentiate between short-term and long-term effects of terrorism on health service utilization.

Main Methods:

  • Time-series analyses were employed to assess health and mental health service usage patterns.
  • Data included primary medical care, ambulance calls, psychiatric clinics, hospitals, and telephone hotlines.

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  • Analyses accounted for seasonality, general trends, and specific impacts of the intifada.

    • Main Results:

    • Adult psychiatric outpatient visits remained stable, except for the elderly in ongoing care who showed increased short- and long-term use.
    • Psychiatric readmissions increased in the short term, while new hospitalizations decreased long-term.
    • General practitioner visits, ambulance calls, and hotline usage increased, indicating greater reliance on general and emergency health services.

    Conclusions:

    • Jerusalem residents, excluding the elderly and previously hospitalized, did not significantly increase their use of specialized psychiatric services during the intifada.
    • The population increased their use of general medical and emergency services, suggesting a potential underestimation of mental health needs or a preference for non-specialized care.
    • Findings suggest that the affected population may not perceive terrorism-related distress as requiring specialized mental health intervention.