War takes a heavy toll on mental health. In Israel, where conflicts have been part of the landscape for decades, the demand for mental health services has skyrocketed since October 7. The existing mental health system, already under stress prior to Simchat Torah, is struggling to meet this surge in demand, leaving many vulnerable individuals without adequate support.
Historically, mental health has been underfunded and stigmatized, not receiving the attention it deserves. While efforts have been made to improve access to care in recent years, significant gaps remain, particularly in remote areas and marginalized communities.
The incidence rate of PTSD in Israel is 9%, three times higher than in the US and other OECD countries. Israel has 50% fewer psychiatrists compared to the OECD average, and approximately 30% of Jewish Israelis avoid seeking mental health support due to stigma.
According to the Laszlo N. Tauber Family Foundation, which supports mental health programs in collaboration with Israel’s leading universities, an estimated NIS 4 billion needs to be invested to match the average mental health funding in OECD countries.
Without radical collaboration between public and private, using innovation and out-of-the-box thinking top down and bottom up, we cannot succeed. With it, we have the chance to shine, by taking the enormous trauma and turning it into national healing.
THE CONSTANT threat of violence, displacement, and loss experienced during times of conflict can have profound effects on mental well-being. While we speak primarily about PTSD, the impact can also result in anxiety, depression, and other disorders as individuals struggle to cope.
High levels of stress impact cardiovascular health, the immune system, and the endocrine system. Substance abuse, violence, and domestic abuse can increase. Research even shows a link between trauma and repeated cycles of violence, potentially leading to civil unrest in an already polarized society.
Seeking help after the October 7 attacks
Since October 7, people from every sector and of all ages have been seeking support to navigate the emotional fallout. While human beings are resilient, the constant existential threat and exposure to traumatic images takes its toll.
Unfortunately, the existing mental health system is ill-equipped to handle this influx. NGOs have seen calls increase from 100 to 1,000 per day, and long wait times to see a psychiatrist have become the norm in certain areas of the country.
Bureaucratic red tape further complicates the situation, with data not being shared effectively and a disconnect between prevention, treatment, and long-term care.
There are many new pop-up care providers, but they are not adequately trained to deal with trauma. It is impossible to create professional and specialized therapists in zero time. Part of the solution must be new forms of collaboration and innovation.
VARIOUS STAKEHOLDERS are stepping up to address the mental health crisis. Non-profit organizations, mental health advocates, and grassroots initiatives are working to fill the gaps. Their efforts range from providing counseling services and support groups to advocating for policy changes and destigmatizing mental illness.
Communities also play a crucial role, offering support through informal networks and organized community centers. These efforts provide support where formal services fall short, fostering a sense of belonging and solidarity.
Collective efforts can put trauma healing at the center of the national agenda. Coordinated efforts can lead to outsized impacts. Regular, open, and transparent communication among all partners is needed to build trust, ensure alignment, and understand the strengths everyone brings to the table. Just as the problem is complex and multi-faceted, so the response must be too, including not just the health system but welfare, education, and the community.
Immediate interventions are essential during times of conflict, but long-term strategies and coordinated efforts are needed to build a resilient mental health system, capable of withstanding future challenges.
This is the mandate of the ICAR Collective, fully dedicated to analyzing the impact of trauma and assessing priorities based on a macro-population health philosophy and generating new opportunities and synergies.
This includes encouraging investment in prevention and early intervention programs, integrating mental health into primary care services, and prioritizing research to inform evidence-based practices.
All this is driven by the cooperation between the amazing organizations already in the field. By adopting a holistic approach that addresses social determinants of health, Israel can lay the foundation of a healthier, more resilient society.
To address the high demand and professional shortage, we must move from the treatment-centric model to a prevention-oriented approach, focusing on community-based and group interventions.
Trauma healing protocols based on rigorous research encompassing public health, epidemiology, and the health economy must be established. Data-driven protocols will lead to better outcomes, and will take us one step closer to personalized care.
The government must coordinate across ministries, allocate adequate funding, implement mental health parity laws, and prioritize the integration of mental health into primary care services.
Increased awareness, education, and strategic communication about the needs in the field will help inform philanthropists where their contributions are most needed. We must then demonstrate the sustainability of interventions over time, to integrate them into the national healthcare system and reduce reliance on philanthropy.
The mental health crisis in Israel demands immediate and sustained action from all sectors of society. By addressing mental health needs comprehensively, Israel can mitigate the current crisis and build a stronger, more resilient future for all its citizens.
According to Dr. Craig Katz, a leading figure in the field of disaster psychiatry, “Disaster mental health is a marathon, not a sprint.”
Israeli society will be able to run this marathon because of its ability to innovate in the face of unique challenges. However, it requires the collaboration of everyone in the field to do so. Given that, we can take what seems to be an insurmountable challenge and transform it into a triumph.
The writer is a founding supporter of ICAR, Israel’s Collective Action for Resilience, which brings together leading experts in medicine, psychology, public health, philanthropy, and investment to accelerate trauma healing and safeguard the health, productivity, and security of Israel. Learn more at www.ICARcollective.org.