Gaza war triggers unprecedented Israeli mental health crisis

JERUSALEM – A mother describes in a newspaper column how her son, a military reservist, has smashed all the mirrors in his house.

On stage, a stand-up comedian talks about his struggle with post-traumatic stress disorder (PTSD). And in Parliament, a teenager pleads for help in dealing with her father’s explosive behaviour since returning from the Gaza war. 

Gaza is in physical ruin and Palestinians, many living in makeshift shelters and unsanitary conditions, are struggling with trauma likely to leave a mark for generations.

In Israel, there are thousands suffering from PTSD following the

October 2023 Hamas attack

and the subsequent two-year war, in what has become the country’s biggest-ever mental health crisis. 

Analysts of Israeli society say the trauma has sidelined support for coexistence with the Palestinians and is making another hawkish government more likely in elections due in 2026.

“People are in survival mode,” Professor Yafit Levin, who teaches psychology and social work at Ariel University, said.

“There’s a significant chance that a right-wing government will be elected again, because that’s what pushes the security button for Israelis.”

The crisis also has a steep economic price. According to a study by NATAL Israel Trauma and Resiliency Centre, it is likely to cost the economy 500 billion shekels (S$203.3 billion) over the next five years. This includes direct damage to employment and loss of productivity, as well as indirect costs such as increased traffic accidents, chronic disease, addictions and domestic violence. 

At the same time, the scale of mental health casualties has led the defence-tech sector into the field of trauma. GrayMatters Health uses an amygdala-based biomarker and computer simulation to help improve PTSD symptoms.

MAPS Israel is a non-profit that is examining the potential of group psychotherapy using psychedelics for PTSD. 

And in Sderot, one of the communities that came under the Hamas attack, a technological incubator supports start-ups that develop technologies and services in the field of PTSD. One such company, Voxwell.ai, is using artificial intelligence and vocal biomarkers to enable earlier screening for depression and anxiety risk. 

Experts say that even if the current ceasefire holds, the numbers of those afflicted – survivors of the Hamas invasion, first responders who arrived at the carnage and soldiers who fought in the war – will swell, leaving a lasting imprint on society for years to come.

“Based on our past experience, it’s going to take two or three decades to handle this,” said Professor Yair Bar-Haim, head of Tel Aviv University’s National Centre for Traumatic Stress and Resilience.  

It will similarly take decades to deal with the destruction and trauma in Gaza, where more than 70,000 have been killed and nearly two million displaced. The healthcare system has been severely damaged and it, too, will take years to rebuild. 

In Israel, along with PTSD, rates of depression and anxiety are at the highest level ever recorded, a coalition of mental health and welfare organisations says. It is urging Prime Minister Benjamin Netanyahu to allocate major resources for the “psychological rehabilitation and recovery of Israeli society as a whole”. 

The Defence Ministry’s rehabilitation department is treating 32,000 soldiers with mental health issues and post trauma, including about 13,000 added in the past two years. The total is expected to rise to 50,000 by 2028, the ministry said.

NATAL cites a study that says as many as 625,000 Israelis out of the 10-million-strong population have experienced or will experience psychological effects, and 60,000 to 80,000 will develop acute symptoms that will impair their ability to reintegrate into the workforce. 

This all lands on a society that, despite its tensions, both external and internal, has long ranked among the happiest in the world.

So far, that has not changed. While a recent survey found that a third of the population feels the need for psychological help, it also found that two-thirds of the population is “highly optimistic”.

The optimism also exists, to an extent, in the mental health field. Strong social cohesion and support are one of the best buffers against PTSD, said Professor Jonathan Huppert, head of the Hebrew University of Jerusalem’s Centre for Trauma Recovery. Israel embraces its veterans in a way that is quite distinct from the rejection Vietnam vets in the US faced in the 1970s.

First-line treatments involve cognitive behaviour therapies. In addition, a wide range of supplementary activities have been developed in Israel, as well as in India and Thailand, where young Israelis congregate following their army service. 

Many of the programmes are offered by non-profits such as Etgarim, founded by disabled veterans and rehabilitation professionals, and involve sports and outdoor activities. Another group, Arim Roshi, supports women, who have distinct needs and symptoms from men. 

Several of those living with PTSD spoke about their experiences on condition of using only their first names out of a desire for privacy.

Jamal, a Muslim Arab volunteer for Zaka, a non-profit rescue and recovery service, said he has been struggling after helping gather the remains of those murdered in their homes and cars, and outdoors. 

He cannot stand being in crowded places, is easily agitated and sleeps badly, waking every couple hours from nightmares. He is also not comfortable being on his own, something that makes it difficult for him in his work as a truck driver.

Michael, a Jewish reservist who watched a bomb kill two of his comrades and suffers sleepless nights and flashbacks, forcing him to quit his job, said: “I had to put on a mask; pretend that everything was OK. I have less patience and am more disconnected from those around me.”

The Defence Ministry is trying to boost awareness through advertising. One such ad depicts an exhausted young man dragging a stretcher with himself lying on it.

“You’ve come home. But you’re burdened with an injury, an injury that no one can see. You don’t have to carry it on your own,” the narrator says, as one after another, his family, friends and others join in to help him carry the stretcher. 

Prof Huppert, the psychologist, said trauma does not have to be a life sentence. 

“These reactions can be viewed in the same way that we think of infection,” he said. “With the proper treatment, you may still have a scar, but you can live your life fully.” BLOOMBERG