According to Misrad HaBriut, a person may be eligible for Sal Shikum if all of the following apply:

• They are residents of Israel
• They are eighteen years of age or older
• They have been recognized by Bituach Leumi - בטוח לאומי - National Insurance Institute as having at least forty percent medical disability for mental-health reasons
• Their eligibility and personal rehabilitation plan have been approved by a Va’ada Ezorit Leshikoom – ועדת שיקום אזורית – Regional Rehabilitation Committee

Please note that, in practice, a person is usually expected to be in ongoing psychiatric or mental-health care (for example, followed by a psychiatrist or mental health clinic), since rehabilitation is meant to accompany treatment and not replace it.

A request for Sal Shikum usually cannot be submitted by:

• Individuals who are not in any regular psychiatric or mental-health care
• Individuals who actively oppose the process, even if family members wish to apply on their behalf
• People with active, ongoing drug or alcohol use, where current addiction is the main issue
• Individuals whose mental-health disability claim was rejected by Bituach Leumi, and who also do not meet criteria for an alternative Misrad HaBriut psychiatric evaluation track

Sal Shikum is a menu of possible services; each person receives only the services approved in their individual rehabilitation plan.

Sal Shikum may include support in the following areas:

Housing and community living

• Misgerot Diur Kehilati - מסגרות דיור קהילתיות - community-based housing frameworks such as hostels, supportive community frameworks, and sheltered housing
• Assistance with living arrangements for those who cannot live fully independently
• Ezra LeRechishat Tziud leDiur - עזרה לרכישת ציוד ראשוני לדיור - assistance in purchasing basic equipment for housing (for example, furniture and basic appliances)

Employment and vocational rehabilitation

• Hashlama veHadracha Ta’asukatit - השלמה והדרכה תעסוקתית - vocational evaluation and guidance
• Misgerot Ta’asuka Shikumit - מסגרות תעסוקה שיקומית - supported employment and rehabilitative workplaces
• Assistance with integration into the open labor market, when appropriate

Education and skills

• Hashlamat Hashkala - השלמת השכלה - support in completing education, such as basic schooling or matriculation
• Hachshara Miktzo’it - הכשרה מקצועית - professional training or courses when included as part of the rehabilitation plan

Social and community integration

• Misgerot Chevra uPnai - מסגרות חברה ופנאי - social clubs, leisure activities, and community frameworks to reduce isolation and improve social skills

Daily living and family support

• Temicha BeTafkidim Yomyomi’im - תמיכה בתפקודים יומיומיים - training and support in daily living skills (budgeting, cooking, using services in the community)
• In some cases, support frameworks for families to help them accompany the rehabilitation process
• Important distinction: Tipul Nafshi - טיפול נפשי - ongoing psychiatric and psychological treatment is usually covered by the Kupot Cholim - קופות חולים - health funds as part of the mental health services basket and not by Sal Shikum itself, although some rehabilitation frameworks may include therapeutic elements

Regular process

• The person files a disability claim with Bituach Leumi on mental-health grounds.
• If Bituach Leumi determines forty percent or more mental disability, this can serve as the basis for applying to Sal Shikum
• It is generally not possible to undergo a Misrad HaBriut authorized psychiatric evaluation for Sal Shikum at the same time as a disability claim with Bituach Leumi.
• A psychiatric evaluation ordered by Misrad HaBriut is valid only for Sal Shikum purposes and cannot be used for Bituach Leumi disability benefits, court proceedings, or other legal claims.
• Private psychiatric opinions, even by a treating psychiatrist, do not replace official disability determination or a Misrad HaBriut referral.

The applicant (or their treating team) should prepare:

• Recent psychiatric or psychological reports.
• Summaries from any hospitalizations, if relevant.
• Documentation from ongoing treatment in a Merkaz Br’iut Nafshit Kehilatit – מרכז בריאות נפשית קהילתית – community mental health clinic, private psychiatrist, social worker, or similar framework.

A personal rehabilitation program is created to reflect the person’s needs, abilities, and goals in areas like housing, employment, education, and social life.

This is usually done together with:

• Beit Cholim Psychiatri - בית חולים פסיכיאטרי - a psychiatric hospital (for someone approaching discharge)
• Merkaz Br’iut HaNefesh - מרכז בריאות נפש - a mental-health clinic or center
• Sherutei Revacha - שירותי רווחה - social services
• An existing community rehabilitation framework
• A private treating professional such as a psychiatrist, psychologist, social worker, occupational therapist, or nurse who knows the person’s situation

If there is no formal referring body, the person can apply independently, but must attach all relevant medical and social documentation.

Family members may help prepare and submit the application, but only with the person’s consent.

Applications for Sal Shikum are submitted through the online service

Applications can also be submitted:

• Through a referring body such as a hospital, clinic, or Sherutey Revacha.
• Directly by the person as a self-application, using the same gov.il service.

The completed forms and documents are sent to the Lishkat Br’iut Mechozit - לשכת בריאות מחוזית - District Health Bureau in the person’s area of residence.

Alternative track - without current Bituach Leumi recognition

In some circumstances, a person who does not currently have forty percent mental-health disability from Bituach Leumi can request a Misrad HaBriut authorized psychiatric evaluation for Sal Shikum

Typical elements of this track:

• The person completes the current Misrad HaBriut form requesting referral to an authorized psychiatrist for determining mental disability for rehabilitation. The form is accessed via the relevant Ministry or gov.il pages connected to Sal Shikum and psychiatric evaluation
• In the form, the person declares whether:
  • They have current Bituach Leumi recognition
  • They had such recognition in the past
  • Their previous claim was rejected
  • They do not intend to apply to Bituach Leumi in the coming year
• The form is submitted together with a current psychiatric medical report via the appropriate online channel (for example, a gov.il contact or service form to the Misrad HaBriut mental health department, linked from the Sal Shikum pages)

If the application is approved:

• Misrad HaBriut sends a certificate or referral and a list of authorized psychiatrists.
• The person schedules an appointment, brings the certificate and all requested documentation, and undergoes the evaluation.

Once all documentation has been received and processed, the Regional Rehabilitation Coordinator convenes a Va’ada Ezorit Leshikoom, as described above

The Va’ada Ezorit Leshikoom usually includes:

• Psychiatrist
• Social worker
• Occupational therapist
• Psychologist

The person is invited to attend the meeting so the Committee can understand their situation, needs, and goals directly. Family members or other supporters can often attend with the person’s consent.

The Committee typically meets within about one month of receiving all necessary documents, although timelines may vary by district.

After reviewing the documents and meeting the person, the Va’ada Ezorit Leshikoom may decide to:

• Approve the proposed rehabilitation plan in full
• Approve only some of the requested services
• Suggest changes or additions to the plan
• Reject the plan, with reasons

A written decision is also sent by mail to:

• The referring body, if there is one, or
• The person, for self-applications

If the plan is approved:

• The person and the Coordinator or referring body carry out a “market survey” of available rehabilitation frameworks and providers (housing programs, vocational frameworks, social clubs, etc.), using lists and information from district rehabilitation units and recognized providers
• They choose specific frameworks that match the approved plan and have space available

The Regional Rehabilitation Coordinator then issues budgetary approval, and the State funds participation in the approved services according to official tariffs and procedures.

The rehabilitation plan can be reviewed and updated periodically, depending on progress and changing needs.