Research into the mental health of people who lived through the 7 October 2023 attack has expanded steadily, with certain findings indicating that psychological distress among survivors can reach intensities comparable to those associated with physical injury.

Haim spent three decades driving a school bus and, by accounts of those around him, was attentive to the children in his care. His marriage to Irit ran thirty years, and together they raised six children who are now adults. In the weeks before the attack, his daughter had let him know she was carrying his first grandchild.

Eighteen days after the attack, Haim drove to an isolated spot and took his own life. His wife Irit later recalled that he had loved his work and his passengers, and that on the morning of 7 October their son — a first responder — had told them something terrible had occurred. In the days that followed, Haim had made his way to synagogue to sit with children whose fathers had left to serve.

Games and music filled the time they spent together, with songs rising between them as he joined in their play. Once Shabbat had ended, he took a seat before the television and cried.

Late that night, a request came from Haim's supervisor — would he be willing to take his bus into Kibbutz Be'eri to bring children out to safety? He gave an affirmative reply without any pause. Arriving home around 5 a.m., Haim told Irit he had been unable to do anything for the people on board, noting that his passengers had sat without a word for more than two hours.

The following day, while Irit went back to her position at Clalit Health Services, Haim remained at home watching footage of the attack on television. Haim had a bus route waiting for him when schools brought students back for shortened days on 25 October. Her phone call to him that afternoon went unanswered.

A text message arrived telling her a death by suicide had occurred, and Irit recalled knowing at once it was Haim — she hurried back to find neighbours gathered outside the family home. The assessment proved accurate.

At the shiva gathering held in Haim's memory, one visitor recounted how Haim had intervened at a moment when that man's child faced a life-threatening situation, an act that had stayed with the family ever since. Irit recounted her family's experience to roughly 100 English-speaking journalists from around the world during a recent online seminar hosted by the Clalit Research Institute, an event held under the title "Israel's Mental Health Front: Three Years Since October 7." She told attendees that she had explained to her children that their father's death by suicide stemmed from a broken heart, and that she continues to regard him as a hero.

His situation belonged to a group of patients whose illness had not been identified before treatment began. One incident drew attention to how individual loss can mirror a mental health challenge felt across communities nationwide.

Geha Mental Health Center researcher Amir Krivoy outlined the scale of obstacles facing those working on the problem. Clalit, the country's largest public health insurer with around five million enrolled members — roughly half the total population — holds detailed electronic records covering their mental health histories. Prof. Krivoy noted that the population had faced a succession of stressors dating from 2020 onward, spanning pandemic-era lockdowns, social divisions tied to proposed judicial changes, a cross-border attack by Hamas, the subsequent conflict in Gaza, and ballistic strikes from Iran, all of which, in his assessment, combined to produce both acute and prolonged psychological strain across the population.

Data from Clalit placed 2018 and 2019 as the last years of stable baseline health, with the population already under strain before the events of 7 October brought conditions to their lowest recorded point. Rates of both ongoing stress disorders and post-traumatic stress conditions have climbed in the years that followed, with communities near the country's northern and southern boundaries bearing a notably heightened share of those effects.

Displacement was associated with mental health strain roughly ten times that recorded among residents who remained in place, though the data do not establish that leaving home directly caused that difference. Clinicians working with young patients have documented a pattern of post-traumatic stress disorder diagnoses appearing at rates not previously recorded across both children and adolescents.

Across all four public health funds, projections placed the number of Israelis who developed clinical post-traumatic stress disorder between October 2023 and December 2025 at roughly 60,000, with approximately half of those cases falling within the Clalit membership base. Krivoy recounted operating a medical facility in Sderot, a southern city where 53 people lost their lives across the violence and its aftermath — a toll that included 37 residents and visitors, 11 police officers, three soldiers, and two firefighters — and pointed to survey findings showing that roughly nine out of ten people in the area were unable to sleep through the night.

Concerns mounted that a further incident of that kind could occur. Two years after the onset, a share of those affected had yet to pursue a diagnosis, held back by the discomfort of leaving home. Without intervention, the number of cases like theirs is expected to grow over the years ahead.

Prior experience points to the population's capacity to cope with adversity, yet health professionals stress that early identification of psychological distress — and prompt intervention — remains the foundation of effective care. Nufar Bar-Lipshatz, a developmental psychologist practising at a Clalit clinic in Beit She'an, told those gathered at the seminar that the population continues to navigate the psychological weight of an unresolved conflict, though recovery remains a possibility that depends on sustained outside support.

Clalit therapists were deployed in groups to reach families who had been displaced to Eilat and remained there throughout the months following the attack. Housed in hotels with no clear timeline for returning home, many of those affected encountered a mental health professional for the first time.

Bar-Lipshatz noted that the adults were invited to share their experiences openly, while the children were given materials to construct model homes — an approach aimed at gaining a clearer picture of the family's circumstances. She added that those same children, now two decades from adulthood, would one day hold a hand in shaping how society functions. Among those affected, a number of relatives were killed, wounded, or taken captive.

Problems lingered after the alarm had sounded. Feelings of security remain out of reach for the child. Bar-Lipshatz pointed out that children often pick up on household tension through their parents' expressions and tone of voice, even when adults choose not to address it openly, and that worries about abduction or a parent's death in military service can take hold in a child's mind yet go unspoken.

Research indicates that such conditions may be associated with heightened behavioural challenges and obstacles to academic progress. Some children developed a stutter in the wake of emotional distress. Group sessions pairing toddlers aged three and four with their parents were put together by a team of therapists. During one gathering, an alarm prompted staff to escort the group to a designated shelter, where yoga, movement, and play activities kept everyone occupied.

Mental health coverage entering the basket of services that insurers are legally required to provide happened only in 2015, according to Ran Balicer — who holds roles at the Clalit Research Institute as its founding director and chief innovation officer, serves as deputy director-general, and carries a faculty appointment at Ben-Gurion University in Beersheba. Pressure on an already strained situation mounted when COVID-19 took hold. Following the 7 October attack, health funds disclosed that their mental health divisions were contending with budget shortfalls, understaffed teams, and appointment queues that had pushed waiting times well past what guidelines would ordinarily allow.

Research conducted after the 11 September attacks found that roughly one in 25 people across the United States reported lasting psychological effects tied to the event. Around one in seven Israelis had a direct personal connection to the events of 7 October.

A joint research effort between Clalit and the Myers-JDC-Brookdale Institute drew on responses from 2,500 participants across the country. Rates of depression, recorded at 34% during January 2024, had not dropped below clinical thresholds by the time this report was compiled. That figure, recorded at 27%, has since dropped to 20%. Rates of PTSD among the group stood at 32 percent before dropping to 20 percent. Roughly a fifth of the adult population described ongoing difficulties that left their day-to-day activities substantially disrupted.

Three changes reshaped how Clalit approached patient care: general practitioners received retraining to take on a broader therapeutic role, dedicated mental health coaches joined the workforce, and the organisation deployed both digital tools and an AI-driven screening platform. Physicians now contact patients flagged as high-risk rather than waiting for those individuals to schedule appointments on their own. Of the 8,000 people identified, roughly 1,500 received mental health outreach contact each week, with follow-up care continuing for those already engaged.