A recent report from State Comptroller Matanyahu Engelman highlights the strain on the mental health system in the wake of the October 7 Hamas-led attack and subsequent war. Engelman revealed that roughly three million adults have suffered from anxiety, depression, or post-traumatic stress disorder (PTSD) due to the events, Times of Israel reports.
“The mental health system, which had difficulty functioning even before October 7, collapsed in the first days of the war,” Engelman stated.
According to the findings released on Tuesday, despite the fact that 38% of the population exhibited moderate to severe symptoms of psychological distress, only 0.6% of the country had received professional mental health services through health management organizations (HMOs) and resilience centers in the six months following the attack.
“I warned about the failures in the field of mental health care in a letter to the prime minister about a month after the massacre,” Engelman wrote, “but all the deficiencies have yet to be fully corrected.”
The study, which the comptroller conducted in April 2024—six months after Hamas launched its assault on Israel, killing approximately 1,200 people and abducting 251 others—found major gaps in the system’s response.
Engelman noted that he had first presented his observations to the prime minister on November 13, 2023. This came after he toured the conflict zones in both the south and north shortly after the attacks and the war’s onset.
He criticized Health Minister Uriel Buso and ministry Director-General Moshe Bar Siman-Tov for failing to update the mental health system’s emergency protocols in preparation for war or other traumatic events. This was despite the fact that a National Emergency Management Authority (NEMA) assessment on the issue had been publicly available since 2001.
As the conflict forced thousands of Israelis to flee their homes, Engelman observed that the mental health system was unable to properly support evacuees.
The system operated “without a structured approach, alongside local volunteer initiatives, and without maintaining treatment continuity and documentation,” Engelman explained.
Among the 1,010 adults surveyed, one in three reported symptoms consistent with moderate to severe PTSD or depression, while about 20% said they were experiencing anxiety. The study estimates that around 900,000 people will eventually seek help for mental health concerns.
However, the report found that, since the attacks, fewer than 1% of Israelis have received mental health care from HMOs or resilience centers.
The study also highlighted that many of those struggling with PTSD, anxiety, and depression are reluctant to seek care. Among the respondents, 17% worried about privacy, and 5% said they were unable to find a suitable therapist. Meanwhile, 16% of those experiencing significant symptoms admitted they had not yet pursued treatment but planned to do so in the future.
One of the main barriers to seeking treatment is the extended waiting period.
“It is unthinkable that people would have to wait in line for about six months to receive treatment from a psychiatrist at a health insurance company,” Engelman remarked.
The report warned that the lack of timely care for so many suffering individuals could lead to long-term psychological damage and diminished quality of life.
Engelman attributed the shortcomings to a shortage of trained professionals, stating that HMOs and resilience centers lack the capacity to meet the current demand for care.
For example, only 440 out of the 10,500 children evacuated from Sderot—a mere 4%—received any mental health services. Among adults, just 11% of those displaced from southern and northern communities had been treated through health funds or resilience centers as of the end of March 2024.
The report also revealed that only 1% of survivors from the Nova music festival massacre had received assistance from public mental health services, despite data showing that people who directly experienced traumatic events or had immediate family members affected were nearly twice as likely to report severe psychological symptoms compared to those who were not directly involved.
Additionally, among the ZAKA volunteers who were involved in the grueling task of recovering and identifying bodies in the aftermath of the attacks, only 13% received treatment from the public health system.
In response, Buso defended the government’s handling of the crisis, stating that the October 7 events were unlike anything Israel had faced before.
“Tens of thousands of Israelis received immediate professional mental health treatment through various means available to the healthcare system, in an incident of mass casualties never before seen,” he said.
The health minister emphasized that mental health “has been the central focus of the healthcare system’s agenda” since the war began.
He also dismissed the report’s conclusions, arguing that “a self-reporting survey is fundamentally flawed and cannot predict the extent of those seeking mental health treatment. It may also cause real harm and lead to a sense of psychological helplessness in the general public.”
Professor Jonathan Huppert, Head of the Center for Trauma Recovery in the Department of Psychology at The Hebrew University of Jerusalem, echoed Buso’s concerns.
“The report relied entirely on a self-administered survey conducted at the height of the war in April 2024 and then estimates the extent of the population in need of mental health services,” Huppert said.
Buso stated that the ministry’s goal is to double the availability of mental health services in order to accommodate the growing needs stemming from the war, though this expansion depends on government funding for the healthcare system.
Despite the widespread need, Buso pointed out that not all individuals experiencing emotional distress necessarily require professional treatment.
“It’s likely that once there is closure, people are more likely to start the natural recovery process even without therapy,” Huppert said. “What percentage? That’s a good question.”
However, he added, “There’s no ability to move on because of the enormity of the event. We’re not at closure. We’re still managing the trauma… we’re still in trauma.”
{Matzav.com Israel}
This article ignores the real reason why so many Israelis are having mental health problems. Without ignoring the plight of the hostages and their families (It was tragic and can’t imagine what they are going through), Since October 7, hundreds, maybe thousands of soldiers who have come home from Gaza are experiencing debilitating PTSD. It has gotten so bad they can’t lead normal lives which is affecting their relationships with their friends and family. Many refuse orders to return to duty.
I have 2 sons serving in non-combat positions in the IDF right now (though one was in a combat position on Oct 8th and onward for a couple of weeks, but not anymore).
And I can vouch for the truth of your words.