The horrific events of October 7 profoundly impacted various aspects of life, but it's widely recognized that they intensified an already severe mental health crisis in Israel, pushing trauma levels to unprecedented heights.
While numerous organizations have mobilized to address the crisis in trauma healing, a cohesive, systematic approach has not yet been obtained yet.
Recognizing this, we have committed to creating a structured framework to guide our efforts to accelerate trauma healing in Israel.
Laying the foundation
Before we could effectively address trauma, a thorough and inclusive assessment of the current landscape was essential. We needed a structured and comprehensive strategy tailored to meet the mental health needs of our population.
We began by mapping available services and solutions as well as identifying gaps that need to be bridged. We then looked at the requirements for addressing trauma across three levels of prevention and treatment:
Primary prevention – Implementing measures to prevent trauma before it occurs.
Secondary prevention – Providing interventions after the occurrence of traumatic events to prevent the development of serious mental health issues.
Treatment – Providing care to people who develop mental health conditions to help them manage symptoms, improve quality of life, and achieve better overall functioning.
Tertiary prevention – Offering ongoing support to prevent relapse and maintain resilience, particularly for individuals with conditions such as PTSD and major depression.
We also needed to assess the various levels that would be targeted:
National: Where policies and national interventions are formulated.
Community: Where solutions and resources are built for specific communities. This can be at a geographic level such as in a city or neighborhood, or it could encompass a specific population such as those who attended the Re'im Music Festivals, hostage families, etc.
Individual: Where personalized care and intervention must be provided (even if the care is provided as part of a group).
Because there is a significant imbalance between the supply of and the demand for mental health services in Israel, our approach prioritizes scalable and cost-effective solutions. In these challenging times, we recognize the importance of thinking and acting like a country with limited resources, ensuring that every measure is both efficient and impactful.
Resilient and inclusive mental health infrastructure
After completing a broad and thorough assessment of the field, we identified 8 priority areas that are crucial for addressing mental health in Israel. These imperatives form the backbone of a robust system that will provide comprehensive and accessible support for everyone who needs it and is tailored to meet the diverse needs of the Israeli population.
National Psychoeducation Campaign: Teaching the public about mental health, trauma, and resilience through psychoeducation has proven therapeutic benefits. A unified national campaign, supported by collaboration with government agencies, would enhance public education and outreach. This could also streamline access to critical services by simplifying messaging and improving search processes for those in need. Understanding that most individuals exposed to trauma do not develop PTSD can foster hope and reduce fear, enabling better self-recognition of when therapy may be necessary and when it may not. Such awareness can alleviate strain on mental health professionals and promote informed decisions about evidence-based therapies, ultimately improving overall mental health outcomes.
Trauma-informed Culture: Educating the public sector and civil servants about the effects of trauma and integrating this understanding into their everyday practices and policies helps to create a widespread cultural shift towards trauma-informed care, fostering a more resilient and understanding society. Trauma-informed civil servants can better recognize and respond to trauma, reducing re-traumatization and improving service outcomes. This systemic change ensures services are more accessible and effective, promoting community-wide healing and resilience, especially in times of crisis.
Democratizing First-Aid Trauma Training: Professionals such as police officers and teachers who come in contact with individuals who need mental health support must be trained to provide emotional first-aid in order to make the current support infrastructure more robust. With a shortage of professional therapists, it's essential to expand the network of support by training non-clinical emotional caregivers, such as students and retired individuals, to provide basic emotional support. Non-clinical caregivers can offer immediate assistance and emotional first aid, helping to bridge the gap until professional help is available. This approach also fosters community resilience and ensures that help is available at the grassroots level.
Screening and Surveillance at Scale: Trauma can lead to a range of problems, from an uptick in eating disorders to an increase in car accidents or domestic abuse. By implementing systems to monitor and understand trauma-related issues in real-time at the community and national level, we can respond more quickly and effectively. This proactive approach helps in early identification and intervention, reducing the long-term impact of trauma on individuals and the healthcare system. In order to successfully facilitate this, we need broad collaboration such as the use of Google and Meta to analyze public sentiment, the health funds to identify stress-related symptoms and complaints, and the education and labor infrastructures to assess absenteeism that could be related to mental health issues.
Innovative Tools, Methods and Therapies: The events of October 7 are expected to increase the prevalence of mental health disorders, underscoring the need for innovative approaches. Exploring and validating new preventive, diagnostic and therapeutic methods, technologies, and tools is key to advancing mental health care at two critical levels: accelerating the healing journey and providing personalized care tailored to individual experiences. By embracing new technologies and therapies, we can offer broader access to effective and diverse treatment options. This proactive strategy positions Israel as a leader in mental health innovation, potentially benefiting the global community.
Mental Health Workforce Capacity: Israel faces a significant shortage of mental health professionals, particularly in trauma care. Currently, there are only 1,000 active psychiatrists in the country, with 400 expected to retire in the next five years. During the same period, only 250 new psychiatrists are projected to enter the workforce. Additionally, most therapists lack trauma-specific training, as many focus on working with children or families and have limited exposure to trauma work. This gap in trauma expertise, combined with the psychiatrist shortage, is an issue in many countries. However, the situation in Israel has become critical following the events of October 7. The current mental health workforce is unable to meet the growing demand for services. Training existing professionals in trauma care and incorporating non-clinical caregivers can help address this crisis. A multi-faceted approach is essential to ensure timely and effective mental health support for those in need.
Quality Standard Implementation: Ensuring all mental health services meet high-quality standards is vital, especially in a crisis. High standards guarantee reliable and effective care for everyone, preventing the dilution of quality that can occur under pressure. This consistency builds trust in the mental health system, encouraging more people to seek help when they need it most. By maintaining these standards, we address immediate needs effectively and set a foundation for long-term resilience and well-being.
Data Sharing and Integration: In Israel, 95% of medical records linked to “physical” health are digital but in mental health, service provision is fragmented and uses separate and non-synchronized systems - for example, a primary care physician cannot always access his/her patients’ mental health records. Data sharing in mental health is essential to enable a holistic understanding of a patient's history, facilitate collaborative treatment among different healthcare providers, and allow for timely interventions, which across the system can help lower costs by reducing duplication, improving resource allocation, enhancing public health surveillance and identification of trends, and enabling better policy-making. In addition, data sharing is critical to enable research for evidence-based policies and allows us to get closer to personalized care where treatments are tailored to the individual’s unique genetic and clinical profile, improving outcomes in mental health care.
Success for the long term
By prioritizing these eight areas, we aim to establish a more resilient and supportive mental health system in Israel. These initiatives tackle the immediate shortage of professionals and lay the groundwork for enduring, sustainable mental health care. Together, we can ensure that everyone has access to the support they need to lead healthy and fulfilling lives.
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