Mental Health of Children and Adolescents in Israel Post-October 7: A Multi-System Analysis of Needs, Responses, and Policy Implications

Background and Purpose

The October 7, 2023 events and the subsequent war have significantly disrupted the mental health of many children in Israel. Numerous children experienced loss, injury, displacement, parental absence due to military reserve duty, and prolonged disruption of normal routines. This situation necessitates an in-depth examination of the effects of ongoing collective trauma on children's mental health.

This study aimed to systematically document and analyze professional knowledge regarding the needs of children in Israel after October 7 and to identify effective therapeutic approaches for children experiencing psychological trauma during this ongoing crisis. Additionally, the study examined the prevalence of post-traumatic stress disorder (PTSD) among adolescents and identified key risk and protective factors associated with PTSD.

Methods

The qualitative component of this study comprised 20 in-depth interviews with child mental health experts, educators, NGO representatives, and policymakers. Data analysis employed reflective thematic methodology. The quantitative component surveyed 744 adolescents (ages 14-18), examining post-traumatic stress symptoms, subjective well-being, personal resilience, and social support.

Results

The qualitative research identified multiple layers of trauma exposure, from direct exposure to events to indirect exposure through media. A significant finding was that the ongoing nature of the conflict and continuous traumatic exposure complicate the application of traditional post-traumatic treatment approaches. Additionally, pre-existing conditions, including COVID-19 effects and political tensions, further exacerbated children's psychological distress. Parental involvement in children's lives and mental health treatment emerged as critical factors affecting children's ability to cope with trauma.

Significant challenges in providing treatment were also identified, including shortages of mental health professionals, especially in peripheral areas, and lack of evidence-based protocols for treating ongoing collective trauma. Additionally, there are difficulties in providing services to minority communities. The shared traumatic experience also affects therapists and their ability to provide treatment.

Despite these challenges, several effective interventions were identified. Cognitive-behavioral therapy (CBT) approaches and group interventions were highlighted as evidence-based. Parent-inclusive interventions were presented as essential for promoting children's mental health.

The quantitative component found that 42% of participants exhibited symptoms indicating a high probability of PTSD, with higher prevalence among girls and those with poor health and economic status. Additionally, over half of respondents reported emotional distress due to exposure to graphic content on social media. However, participants reporting more substantial family support and higher levels of personal resilience reported lower levels of post-traumatic symptoms and higher subjective well-being.

Conclusions and Implications

The findings indicate the need for changes in child and adolescent mental health services: expanding professional training in trauma-focused treatments, implementing group interventions in schools and communities, supporting therapists, developing culturally appropriate responses for minority communities, and creating protocols for treating ongoing collective trauma. Comprehensive intervention addressing the implications of media exposure on adolescent mental health is required. Additionally, it is recommended to strengthen community mental health infrastructure and develop support programs for parents.