The broadened framework of compulsory interventions in the new Israeli law. Their practical consequences.

Improved treatment efficacy and prognosis in modern psychiatry have mandated changes in the Israeli Mental Health Law. Since 1991, the conditions for compulsory intervention have broadened, beyond that of immediate physical danger. Concurrently, checks and balances over this process have increased. No compulsory treatment decisions are taken without a recent psychiatric examination by a specialist, and the uncooperative patient can be compelled to undergo such an examination. The overriding principle of least restrictive alliterative, coupled with the use of depot-neuroleptics, have led to the implementation of commitment to out-patient treatment. Detailed statistics related to uncooperative patients during 1994 reveal that a significant proportion of such patients become cooperative once the process is activated. Thus, changes in the law permit maximal exploitation of modem therapeutic improvements and permit earlier intervention. The number of compulsory hospitalizations has not, however, increased, thus indicating that an appropriate balance between the patient's right to treatment and right to decide has been achieved.