The hidden cost of war: Israel’s deadly mental health crisis

In the aftermath of October 7, many Israelis have experienced loss, uncertainty, stress and anxiety, all of which lead to a population struggling to maintain its mental health. Sadly, some have been unable to cope with these challenges, leading to staggering suicide rates across the nation. 

Surveys conducted by the Association of Pediatricians, Goshen – Community Child Health & Well Being and the Maccabi Health Fund recently revealed that Israel is grappling with a major mental health crisis. Eighty-three percent of children are undergoing emotional distress yet only a small proportion of them are receiving treatment. Among adults, 48% report their mental health taking a turn for the worse.

Last week, Dr. Tzvia Seligman, director of the Trauma Treatment Center for Sexual Assault at Tel Aviv Sourasky Medical Center, told the Knesset, “Do you know how many people have taken their own lives since October 7? Unusually high numbers of suicides. There is a significant loss.”

Suicidality is a broad concept which refers to an individual entertaining thoughts of self-harm which can eventually lead to one carrying out the act of suicide itself. Between these two extremes, there is a range of behaviors, including threatening suicide and non-fatal suicide attempts.

When a person is at a crossroads in their life, when hope is replaced with despair, life can become filled with thoughts of death and the idea of continued existence can be one of anguish. The distress can’t be ignored, even if the cries are silent. Yet, society tends to ignore the painful phenomenon of suicide, which is why it’s critical in today’s current climate to be aware of the warning signs. 

This complex and tragic, yet largely hidden, phenomenon should concern the general public. Suicide is one of the main causes of death in the Western world, with a variety of factors driving it. At the same time, suicidality isn’t always lethal and can be preventable. However, a war against suicide must not only be waged by the person being impacted, but by society as a whole.

Those most at risk for suicidality include teenagers and young adults, members of the LGBT community, victims of sexual assault and domestic violence, single and divorced men, immigrants and the elderly. 

At-risk individuals are ones who have expressed suicidal thoughts or have attempted suicide in the past, and those with low self-esteem, post-trauma, a history of behavioral disorders, anxiety and addiction. There are also external factors at play, which can include a family history of abuse and suicide, or a lack of a support network of community, family and friends.

Today, Israel finds itself in the throes of collective trauma, with many of its citizens at risk of mental health challenges. Exposure to horrific footage from October 7, myriad reports of murder and overall cruelty can all increase one’s feeling of helplessness over time, and may reduce one’s natural aversion to pain, fear, self-harm and even death.

What should we look out for? When a person talks about a desire to say goodbye to loved ones and shows feelings of despair with no end in sight, indicates that their feelings of helplessness are overwhelming, or displays a general lack of energy or an ability to function, these are all warning signs. Additionally, excessive drinking and drug consumption, mood changes, changes in sleeping and eating patterns, increased anxiety, a sudden interest in risky activities, losing interest in hobbies and withdrawing from personal relationships should all ring alarm bells.

Research has repeatedly shown that the way the media covers suicide cases can trigger the public, whereby viewers imitate the suicide act and suicide attempts increase. Yet covering this phenomenon can also encourage those in distress to seek the help they need. Responsible coverage emphasizes how suicide can be prevented and can debunk myths around the phenomenon. Depression can be reduced as long as people know where to go for help.

An article published by a British medical journal in 2020 found that news coverage around suicide has increased dramatically as of late. Of course, not every story about suicide is linked to an incident where one attempts to carry out the act, but irresponsible coverage can lead to a wave of those who try to do so. In order to avoid this, suicide cases must be investigated in accordance with professional regulations and standards.

Researchers refer to this phenomenon as the “Werther Effect,” which is based on increased suicide rates in Germany and Europe occurring after a book called “The Sorrows of Young Werther” was published in 1774, describing the protagonist’s suicide in great detail.

As a result, mental health organizations, including the World Health Organization, have developed guidelines for responsible media coverage around suicide. This includes suggesting the media not publish the method of suicide and where the suicide took place, to avoid legitimizing the person’s choice to commit the act or to glorify suicide. These guidelines also recommend providing information on how to treat mental illness and offering resources to do so, and where to turn if one has suicidal thoughts.

It’s our duty as a society to shatter myths around suicide and raise awareness around the facts, in normative times but even more importantly during wartime. If someone is crying for help, listen to them without judgment, and refrain from telling them to be quiet or from preaching to them. If someone says they are “tired of living,” believe them. Don’t minimize their words.

This is a time to be empathetic and offer hope, not to dismiss those in need. This is a time when channels of communication must always remain open. Most importantly, continue to pay attention, as sometimes the quietest cries for help are the ones we need to listen to the most.

Deuteronomy 30:19 states, “I call heaven and earth to witness against you today, that I have set before you life and death, the blessing and the curse. So, choose life in order that you may live, you and your descendants.”

God gives us obstacles to overcome in life and it is our duty to choose to live. 

We must enable our community to choose life.