Charting a path forward for mental health care in the wake of war - opinion

Over six months have passed since the start of the Israel-Hamas war, marking a critical juncture for the future of our nation. As Israel’s military activities have shifted throughout the months, Israeli hospitals have adjusted their healthcare priorities to match the new realities on the ground.

In the immediate aftermath of October 7, our attention was largely devoted to physical rehabilitation and providing urgent medical care to wounded civilians and soldiers. Going beyond the physical challenges, mental health and rehabilitation have emerged as our top priorities.

Across the country, we are seeing efforts to address and mitigate the looming mental health pandemic caused by the war. However, as we delegate resources and manpower to solve this challenge, we must understand and overcome barriers to develop the best solutions to advance mental healthcare in Israel.

The upcoming Passover holiday focuses on the themes of freedom – liberation, and redemption – a topic extremely relevant, given everything we have endured. Six months following October 7, Passover offers us an opportunity to reset, recharge, and focus on preparing ourselves for the challenges ahead. By implementing well-thought-out programs and processes, we can help a generation heal from a collective trauma.

Incorporating mental health support into triage

Immediately following October 7, we established a procedure for psychiatric teams to begin treating injured soldiers and civilians as soon as they arrived in the emergency room (ER) before any operations were performed. This early intervention was crucial for patients to begin processing their trauma and help prevent further deterioration of their mental state. Throughout hospitalization, the same psychiatric teams continued treating the same patients to ensure continuity and stability.

This proactive approach is crucial to prevent patients from evolving from Acute Stress Disorder (ASD) to post traumatic stress disorder (PTSD), a far more difficult disorder to treat and manage. This process of psychiatric intervention at the earliest stage of medical care should be established across the country.

Caring for veterans

In the weeks and months following October 7, many veterans from previous conflicts have been turning to hospitals, mental health centers, and primary care physicians for support. Treating these patients requires a delicate balance that prioritizes care without detrimentally affecting mental welfare.

While treating patients in a hospital ward is often preferred, when it comes to mental health patients, this can be detrimental. Remaining in a ward can create feelings of loneliness and helplessness, and some patients can develop stigma about their mental health, feeling they are dependent on medical support to live – and are excluded from society. Instead of confining mental health patients to hospitals, we must develop other routes to deliver these important interventions.

Alternative inpatient clinics, situated on hospital campuses and under the supervision of physicians, can offer the best of both worlds, providing critical care while minimizing stigma. Veterans can stay in dormitories for a short period of up to two weeks alongside other patients who have similar medical requirements. Together, this group can meet with instructors and therapists to receive personalized treatment and support, helping patients understand that they are not alone.

Increasing access nationwide

Many people affected by the conflict live in the periphery, far from Israel’s medical centers in the center of the country. For this reason, we have expanded our mental healthcare provision, bringing resources to under-supported areas of the country.

In collaboration with several non-profits, we will open new mental health centers and strengthen existing facilities with a focus on the North and South of the country. These centers will expand access to resources, supporting both patients and their families. We cannot forget the relatives and friends of these patients who experience high levels of stress and anguish when seeing their loved ones in pain, they need our support too.

Now is the time to pool our resources – to provide the necessary staff and technology – to optimize the success of these initiatives.

Addressing the shortage of doctors

Israel faces a significant physician shortage across all fields of medicine. However, we are particularly lacking psychiatrists, psychologists, and mental health workers. To meet the increasing demand for mental health services, we must train and certify more professionals. A new center is being established to train 600 new health providers a year, to offer multi-disciplinary treatment for PTSD and mental disorders.

We must also think creatively about providing comprehensive mental health support. Psychiatrists and psychologists are the gatekeepers of mental healthcare, yet social workers, art therapists, music therapists, and pet therapists, can all improve a patient’s well-being. New technology tools, including user-friendly AI solutions, will also play an important role in treating patients. A multi-layered approach to care will enable us to provide each patient with the tailored attention they need while lessening the burden on psychiatrists and psychologists.

As we approach Passover, a time of renewal, we hope that this season will enable everyone to heal. The responsibility for mental healthcare does not fall solely on medical staff. When spending time with family this holiday, we can all play our part by checking in, having open conversations about our mental state, and supporting one another.

As a nation, we have suffered, but we are undoubtedly, as the last six months have shown, stronger together. 

With clear vision, collaboration, training, and support, we will succeed in rebuilding minds and lives.

The writer holds a PhD and is vice president for global affairs at the Sheba Medical Center.