Israel's mental health services in general and its psychiatric hospitals in particular have been undergoing substantial structural change.

A specific instance of the changes is the merging of the Be'er Ya'akov, the Ness Tziona and the Israel Prisons Service mental health centers. This is the first such successful merger in Israel and has became a model for merging other mental health facilities. Directed by the Ministry of Health, the merger was protracted over many phases and highly complex consultations with the various service-provider bodies and the managements of the three institutions. Numerous steering committee meetings reviewed the merged center's operational model and long negotiations took place with the trades unions involved.

Selected clinical disciplines benefited from an extensive retraining program and both inpatient and outpatient services were reinforced with new specialist staff and other resources.

The merger was driven by structural, economic, therapeutic and ethical considerations, among them efficient resource use, increased cooperation within and between service systems, reinforcing and enriching human capital, providing a comprehensive response to consumer needs and optimal continuity of care.

The merger phases included: (a) establishing a unified management, (b) creating a new organizational structure (c) creating and implementing a new staff placement and mobility mechanism.

The presentation will set out the benefits of the merger to staff and clients, the structural outcomes, and the lessons learnt. The early experience of the merged center is offered for the benefit of other organizations considering a similar step.