Israel’s mental health time bomb
Post-traumatic stress disorder in the general population has increased by 70 per cent following the October 7 attacksPaul NukiGlobal Health Security EditorShow biographyPaul Nuki is Global Health Security. . .
Post-traumatic stress disorder in the general population has increased by 70 per cent following the October 7 attacksPaul NukiGlobal Health Security EditorShow biographyPaul Nuki is Global Health Security Editor at The Telegraph. A senior journalist and former editor at the Sunday Times, he leads coverage on global security threats including epidemics, biosecurity, and international health crises. He has also written and reported extensively on the conflict in Israel and the Middle East. Published09 August 2026 9:00am BSTThis month alone, three Israeli soldiers are reported to have died by suicide, two of them young women. It takes to 17 the number who have taken their own lives since the start of the year, a rate higher than at any point in the last 15 years. The month was made worse by the news last week that the boyfriend of Liron Barda, who was murdered at the Nova music festival during the October 7 massacre,had died beside the grave of his sweetheart. Bar Asraf, 30, was having trouble coping. He had recently told his mother he was struggling without his girlfriend, reportedly saying, “there’s no one who can replace her, no one to cheer me up”. These high profile tragedies are but the tip of a mental health crisis that is sweeping Israel, according to data collected by Clalit, the country’s largest health provider. The study found post-traumatic stress disorder (PTSD) in the general population had increased by 70 per cent in the wake of the October 7 attacks and subsequent conflict. Bar Asraf died by suicide at the grave of his girlfriend Liron Barda, who was murdered by Hamas at the Nova music festival massacre on October 7Credit: InstagramThe underlying rate of diagnosis is running at “three to four times” the level it was before the pandemic in 2018 and is showing no sign of slowing, according to Clalit’s data, which stretches to June this year. The new figures broadly match those of Israel’s three other health providers and suggest a total of about 60,000 cases of PTSD in Israel that are attributable to the conflict; cases that would not otherwise be expected. PTSD is a specific mental health condition with a high and standardised bar for diagnosis. Symptoms include intrusive thoughts and flashbacks, severe anxiety and emotional numbness over a prolonged period. For many, seemingly mundane triggers, including common colours, smells, tastes and sounds, constantly disrupt daily life, sometimes paralysing it. After the First World War, we called it shellshock. Professor Amir Krivoy, director of the Clalit-Geha Mental Health CenterCredit: Eyal Warshavsky/The TelegraphProfessor Amir Krivoy, director of the Clalit-Geha Mental Health Center, a large well equipped hospital just east of Tel Aviv, says the incidence of PTSD is likely to climb further in the short term at least. “The level is high and is remaining high,” he told the Telegraph. “Usually, you can see following a stressful event, there should be a decay, with resilience [building] and recovery processes taking place. “But unfortunately, because of the continuous war situation, with repeated bursts of acute stress activity like the war with Iran, we don’t see that. ”Worse, Prof Krivoy says Clalit’s PTSD data points to a much wider incidence of mental health complaints in Israel. “I’m using the PTSD as a guide because we have that data, but actually the level of the mental health situation is much larger,” he said. “Beyond PTSD, there could be double or or three times the number of people in need of mental health services in Israel. “The PTSD data shows the trend. It is likely to be the same for the other mental health issues like depression, anxiety, eating disorder, even psychosis. ”Mourners At the Nova Festival memorial siteCredit: Eyal WarshavskyClalit’s data, like that of the other Israeli health care providers, does not include active military personnel. Those cases are treated within the militaryand data on them is restricted. Nevertheless, last year a study published by the National Center for Traumatic Stress and Resilience at Tel Aviv University which tracked individuals serving in combat roles over six years, found that approximately 12 per cent of those who witnessed combat reported severe PTSD symptoms, rendering them unfit for duty. Prof Krivoy and his colleagues are medics and are not dismissive of the mental health difficulties that Palestinians and others in Gaza, the West Bank, Lebanon and other areas of the current conflict are suffering. One described the probable incidence of PTSDand other mental health issues in Gazaas “unimaginable”. The difference in Israel is that access to treatment, although stretched, is available, even if the system has had to be radically reconfigured to deal with it. Israeli civilians at an impact site after an Iranian ballistic missile strike in Tel AvivCredit: Eyal WarshavskyPsychology students and others with baseline expertise in the area have been drafted in by Clalit to man mental health helplines, triage patients and even provide basic counselling and therapy to those affected. “We don’t have enough psychiatrists and trained psychologists and because it takes 10 to 12 years to train people, we have had to improvise,” said Prof Krivoy. “So we have given social workers, art therapies and other related occupations the tools to treat PTSD. We give them accredited training and we have trained more than 1000 people like that in the last two years. ”A second layer of support is provided by a new cadre of “resilience coaches” for patients with less severe mental health issues. “Most are recent graduates with a related degree who are trained to give specific modules of support over one to three meetings with very specific and targeted goals,” says the professor. “As long as there is a fidelity to that advice, and that we know the target is very specific – for example, help in sleeping, help in solving problems, help in creating a schedule – it provides a good first level of engagement. ”The Clalit-Geha Mental Health Center in Tel AvivCredit: Eyal WarshavskyA serious issue with mental health complaints is that, without access to proper care, people can start to self medicate, using drink or drugs. In Israel, cannabis has long been available for certain conditions, and the use of it has become widespread, despite there not being a good evidence base for its use. “Unfortunately, it became more prevalent in Israel, the rate of prescribing increasing tenfold, with currently about 140,000 people with registration,” says Prof Krivoy. “For some people with PTSD, it can genuinely be beneficial but we see adverse effects. For example, people are becoming more agitated. Sometimes even manic. Sometimes to an extreme level, even psychotic. “Some say it helps with sleeping but we see adverse effects. For example, people are becoming more agitated. Sometimes even manic. Sometimes to an extreme level, even psychotic. “I have seen grandmothers like 70 years old come with psychosis of mania because they use medical cannabis … it’s not an innocent treatment. ”A weed pharmacy sign in Tel AvivCredit: Eyal WarshavskyIt is not that the researchers at Clalit are staid or prudish. A recent study at Clalit-HaEmek Medical Center in northern Israel using MDMA, the active ingredient of the recreational drug ecstasy, reported cautiously positive results for soldiers with PTSD. A recent study at the hospital using MDMA, the active ingredient of the recreational drug ecstasy, to treat Israeli soldiers with PTSD reported cautiously positive results. Approximately 80 per cent of participants who completed treatment reported a significant reduction in PTSD symptoms, with most no longer meeting the diagnostic criteria for the disorder. However, the researchers are at pains to stress that the study was small, the current follow-up time limited and the treatment strictly experimental. There is no standard treatment for PTSD, with approaches varying depending on the patient and their symptoms. A feeling of helplessness is widespread among Israel’s populationCredit: Eyal WarshavskyEye Movement Desensitisation and Reprocessing (EMDR), Interpersonal Psychotherapy (IPT) and Cognitive Processing Therapy (CPT) are among the evidence-based psychological therapies used by Clalit. The main challenge, says Prof Krivoy, is to get “precision diagnosis” and then to select the right treatment, or series of treatments for the patient. “The holy grail in PTSD is to find the correct treatment for the right person at the right time with the right carer,” he said. For those getting the right help, the prognosis is reasonable. “Around 80 per cent will recover and get back to life with minor residual symptoms. However, there are 15 to 20 per cent with chronic symptoms. All need a level of ongoing support. ”More than 30,000 children and adolescents are recognised as ‘terror victims’ by the Israeli authoritiesCredit: Eyal WarshavskyThe impact of the war on Israeli children is also frightening. There are more than 30,000 children and adolescents below the age of 18 that are recognised as “terror victims” by the Israeli authorities, says Prof Krivoy. He adds: “Some of them lost parents, one or even two parents. What will be the outcome of these children? We don’t know, but some already have PTSD and anxiety and depression and suicidality. “The real question is, what will be the prognosis in the next five to 10 years? We don’t know. But exposure to traumatic events at an early age is a risk factor for developing more severe forms of mental illness. ”Dr Jordan Lewinski, head of Clalit’s mental health services, oversees the delivery of services which, by necessity, must span the whole country. Clalit runs 14 hospitals and 1,600 clinics in Israel, giving it one of the world’s largest longitudinal medical databases, covering more than half of the country’s 10m-strong population. The problem is “everywhere,” says Dr Lewinski; the country has suffered a “national trauma”. Dr Jordan Lewinski, head of Clalit’s mental health servicesCredit: Eyal WarshavskyThis is not just a matter of people’s proximity to violent events, whether it be a missile blast, a shooting or to have been caught in the October 7 massacre itself. The country’s small population size and policy of near universal conscription mean that almost everyone knows someone who has been directly affected. But more than that: the massacre and its subsequent fallout has raised fundamental questions about the country’s security and its thinking. “The feeling of helplessness right now is widespread among the entire population,” said Dr Lewinski. “Everybody here since birth knows that what happened to us in the Holocaust and Israel was founded on the basis that we won’t let that happen again, but it did happen again. “This is why the trauma is universal. Everyone was taught, ‘we have a strong army, we will be able to protect ourselves’. But we weren’t able to protect ourselves, and that’s a delusionment; a very hard thing. “It’s as if you’re a child and your parent hurts you, molests you, whatever. It hits the foundation of what you believe: that the parents should be your protectors. ”The country’s mental health crisis could get worse before thinngs improveCredit: Eyal WarshavskyLike his colleagues, Dr Lewinski is ultimately optimistic the country’s mental health crisis can be managed. He notes that people ultimately adjust and recover, and unlike wars including the Second World War and Vietnam, mental health issues are today much better recognised and treated. But he adds that things could get worse before they improve, citing research from previous wars. “Usually, when there’s a war, there there is a decrease in in suicide and we see an increase after the war is finished. We saw it in the Vietnam War and in Israel also in the previous wars. “It’s because during a war everybody is with you in the same situation. Everybody is anxious, everybody is terrorised, so people understand you and you are not alone. It’s after wars that that changes”. Protect yourself and your family by learning more aboutGlobal Health Security