Israel needs more mental health services in English

The data about suicide in Israel is perplexing, without clear trends that help provide direction for mental health care and treatment. In recent years, particularly during COVID, suicide rates have fluctuated, alternating between annual inclines and declines.

While Dr. Tzvia Seligman, director of the Trauma Treatment Center for Sexual Assault at Tel Aviv Sourasky Medical Center, recently informed the Knesset that there has been an “unusually high number of suicides” since October 7, the reality is that for many who have suicide ideation, the mental health challenges did not begin when this war started.

Unfortunately, there are no specific statistics or research on youth and adult Anglo suicide rates in Israel, but communities with large populations of English-speaking immigrants have been hard hit in recent years.

Not enough English-speaking professionals

We must not ignore the suicide-risk population that already felt stigmatized by its mental health condition and insufficiently supported before October 7 and may feel it to a more heightened degree now. Israel’s public mental health services are overloaded, and patients can wait months for an appointment with an English-speaking professional.

This is particularly alarming for patients who have carried out an unsuccessful suicide attempt, as they are at great risk for a repeated attempt.

Unfortunately, studies show that most psychologists do not want to work with those who have considered, threatened, or attempted suicide. Mental health practitioners express their sense of inadequate training or lack of experience.

Research in Israel indicates that therapists here are more likely to decline to work with suicide-risk patients and instead refer them to other clinicians at higher rates than referrals for depressed patients.

Suicide risk is complex, with the possibility of many varying contributing factors, including medications, additional mental health conditions, family history and family functionality, support networks, and exposure to others who have attempted or committed suicide.

Studies conducted in the United States show that when members of the US military return home, they arrive back in communities that do not understand PTSD or wartime experiences.

The American Psychological Association notes that among military veterans, there is a 1.5x higher rate of suicide deaths than in broader society.

Causes include stress and trauma from military experience, as well as a lack of community engagement, high levels of loneliness, and the challenges of returning to civilian life when returning home.

However, most Israeli veterans have a significantly different experience when they complete their mandatory draft time or return home from reserve service; their suicide rates are lower because they have more positive experiences after military service, often resulting from high rates of community support and a strong ability to self-forgive for moral compromises mandated by war.

Further to the Israeli research from the 2021 study suggesting that a greater sense of belonging and social connectivity can help reduce suicide ideation, in Israel today, the shared experiences of the current war, along with the shared grieving, fear, anxiety, and determination to overcome Hamas may be antidotes for decreasing suicide risk among returning soldiers as well as in the broader population that has been facing increased rates of stress and anxiety since October 7.

While Israel is investing tremendous resources into the current war, it is vital that we do not ignore the “other population,” those who struggled with mental health issues and suicide ideation before October 7.

Their suicide risk is not a result of military service or Hamas aggression, and often they lack the community support and psychological care in their native English that are critical components for improving their mental health and well-being.

There are only a few trained and experienced English-speaking mental health experts specializing in or even willing to work with suicide-risk patients; these patients, alongside their family and friends, feel helpless in the struggle to cope with and address their challenges within a country and healthcare system already overwhelmed even before October 7.

As Israel prepares for an influx of olim (immigrants) from North America and around the world, we must be equipped to address and treat mental health conditions. It is critical to initiate greater research specific to understanding suicide in the Anglo community in Israel and to determine the best evidence-based treatments and care.

We also must provide more training and education to help licensed practitioners increase their skills, abilities, and confidence in serving this community. And finally, we must ensure accessibility and prevent any hindrances that may be stopping Anglos from getting the help they need.

The writer, founder and director of The Israel Association of Mental Health Professionals (Get Help Israel), is a practicing trauma therapist and mental health advocate focused on increasing support and improving professional mental health care for Israelis, with a particular focus on the Anglo community.