Expert Insights on Mental Health Crisis in Israel: Impact of Recent Events and Trauma Treatment

2023-12-17 10:46:49

(CNN) — When Marina Golan traveled to Ukraine earlier this year, it was an emotional experience. Now 42 years old and a mother of two, she had left the country as a teenager when her family immigrated to Israel.

Golan was part of a delegation of Israeli psychologists who had volunteered to support the war-torn country with their expertise in trauma treatment.

While there, they gave workshops to doctors and teachers on the psychological management of trauma.

“It was very emotional and I felt like we were doing very important things. Our colleagues in Ukraine didn’t have this kind of knowledge, so they were very grateful to us,” Golan told CNN in a phone interview.

Just a few weeks later, the situation was reversed. “When the (Israel-Hamas) war started, I received messages from my colleagues in Ukraine asking if I needed their help now,” Golan said.

Like other mental health professionals, Golan has been working around the clock to deal with the fallout since Hamas’ surprise attack on October 7. In addition to having his own private clinic in central Israel, he supports children and their families in two schools.

Shock waves across the country

“I’ve been involved since day one,” she explained. “We had the first Zoom meeting that Saturday with the teachers, and then with the parents, to understand what kind of impact he had.”

Together, the therapists and teachers created a map that shows the “circles of impact, to understand what we are facing.”

Although the schools were not located in southern Israel where the attacks were focused, the shock waves were strong.

“I have a kid in second grade who visited his family on one of the kibbutzim and saw everything,” Golan said. “Some family members were murdered in front of his eyes.”

Bullet holes are seen in the decorated window of a kindergarten and nursery school destroyed during the Hamas attack on Kibbutz Be’eri. Christopher Furlong/Getty Images

Many of the people he sees are struggling with deep questions, he said. “A lot of people are trying to find some logical explanation to understand what happened and connect the dots.”

People have to get on with their lives to some extent despite the ongoing war with Hamas and uncertainty over the fate of the remaining hostages, but it is still too early to assess the impact on mental health, he said.

“This is still happening and people are just now starting to ask for mental health support,” she said.

According to Golan, there is another aspect that compounds the anguish and offers a stark contrast with Ukraine.

“Everyone understands what is happening in Ukraine and they are on their side,” he said. “In Israel we have the feeling that we need to convince everyone and make them understand that what is happening is really happening. “If someone doesn’t believe you, it’s like a double trauma.”

Dr. Ofrit Shapira-Berman is a psychoanalyst and professor at the School of Social Work and Social Welfare at the Hebrew University of Jerusalem.

An expert in trauma therapy, she leads the mental health team at First Line Med, a volunteer organization that provides services, equipment and counseling to Israelis affected by the events of October 7.

Up to 500 volunteer psychoanalysts support the families of those killed, injured and taken hostage, he told CNN in a telephone interview.

“The situation is not good,” he said. “Everyone’s mental health situation is getting worse.

“On October 6, all of us (psychoanalysts) did not have hours to give, but on October 8, we all found the hours that we did not have.

“We serve the survivors of the massacre and the grieving families and, of course, the kidnapped,” he exclaimed.

Shapira-Berman was supporting some of the hostages released by Hamas during the recent temporary truce.

For former hostages, mourning is just beginning

“We are only now beginning to see the deeper effects of trauma,” he said.

“Almost all of the people who were released have a parent or sibling still in captivity. They become increasingly depressed and afraid of what will happen to their loved ones.

“Others, when they returned to Israel, discovered that one of their parents was murdered.

“They’re just now starting to cry, so it’s very, very complicated,” he added.

Homelessness is also a problem. “Most of them, because they are members of the kibbutz, do not have a home to go to. Everything is ruined and they have to live with their families,” said Shapira-Berman, who added that she continues to see the same issues arise.

“The most painful thing I hear from all of them is that they can no longer trust humanity.”

Survivor guilt is also widespread, he said. “Anyone who hasn’t lost someone feels both blessed and guilty, and the people who survived the massacres feel guilty too.

The release of some of the hostages was closely followed throughout Israel. Erik Marmor/Getty Images

“I have personally treated someone who lost their entire family. He said there are some families from his kibbutz that emerged with three generations and one dog, all alive.

“His parents and three sisters were murdered. It’s very difficult for the people who lost everyone. “I have no idea how he is going to continue with his whole life.”

According to Shapira-Berman, in an already overburdened mental health system, help is largely coming from grassroots initiatives.

“Public mental health agencies might not cope with the number of people who needed help on October 6,” he said, adding that the average wait time for therapy before the attacks was 18 months.

Prof. Eva Gilboa-Schechtman is a professor of psychology and director of the Emotional Processing Laboratory at the Multidisciplinary Brain Research Center at Bar-Ilan University.

He explained to CNN that recent research shows that the proportion of people struggling with mental health problems has almost doubled since the terrorist attacks.

“The events of October 7 occurred at a time when Israeli society was in crisis, so things were already difficult enough in terms of social cohesion and general mood of the country,” he said in a telephone interview, referring to the months of fighting terrorism. government demonstrations that preceded the attacks.

Another thing he explained in dialogue with CNN is that Israel is a small country and military service is mandatory, so the impact has been far-reaching.

“I live in central Tel Aviv and although I was not personally involved in the events of October 7, I know two people who were kidnapped. Four people from my lab are serving in the reserves, as are so many of my children’s friends or my friends’ children.”

Gilboa-Schechtman believes the unfolding mental health crisis has “several epicenters.”

“There is an epicenter around the families of those kidnapped, another around the dead and injured people,” he said.

Another focuses on professionals, such as emergency workers who treated victims and cyber experts who have tracked down hours of horrific footage filmed by Hamas.

“Another circle is families and spouses who serve in the military, young mothers with two or three children,” he said. “Then there is a sea of ​​other people in less direct contact, and some are responding very intensely to the situation.”

Families of those serving in the IDF are also struggling with the impact of war on mental health. Amir Levy/Getty Images

Everyone is affected, he said, especially since war is taking place in our hands, thanks to smartphone technology and social media.

“We are constantly bombarded by information, wanted and unwanted. Exposure levels are extremely high.

“We all see it on television, on social media, with our friends, our families, when we go out, when the sirens sound.”

“It’s almost impossible to switch off and people have mixed emotions regarding it. They think, ‘I should be watching that because it happened to my friends, colleagues and compatriots.'”

And while civil society has been very effective in closing gaps in government support, “I assume there will eventually be a burnout,” Gilboa-Schechtman said. “It is no secret that the country has been overwhelmed by events.”

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