TEL AVIV, Israel – Three years after the October 7, 2023 Hamas attacks, one in five Israelis continues to experience severe impairment in daily functioning because of mental health difficulties, according to a new national study.
The latest findings from the National Mental Health Barometer, conducted by the Clalit Health Services Research Institute and the Myers JDC Brookdale Institute, reveal the enduring psychological impact of the attacks and subsequent war.
Although most Israelis are showing signs of recovery, a substantial segment of the population continues to struggle with anxiety, depression, post-traumatic stress, and difficulties maintaining everyday relationships.
The study, based on a nationally representative sample of Israel’s general population and updated through May 2026, found that approximately 20% reported severe mental health-related functional impairment.
That figure remained unchanged between October 2024 and May 2026, even as reported psychological symptoms declined.
Unprecedented Exposure to National Trauma
Researchers found that approximately 15% of respondents experienced the highest level of personal exposure to traumatic events.
That included individuals present during the October 7 attacks or subsequent terrorist incidents, as well as those who personally knew someone killed, injured or abducted during the attacks or ensuing fighting.
The researchers described the scale of exposure as extraordinary by international standards.
For comparison, approximately 4% of the population experienced direct exposure following the September 11, 2001 terrorist attacks in the United States.
The study also found that nearly one-third of Israelis reported feeling a need for mental health treatment.
Among respondents who had ever received a mental health diagnosis, 23% said they were first diagnosed after October 7.
Researchers identified another concerning pattern: exposure to disturbing images, videos and media coverage was strongly associated with symptoms of anxiety, depression and post-traumatic stress.
Although the findings do not establish a causal relationship, they support recommendations to limit unnecessary exposure to graphic material.
Young Women Face the Greatest Difficulties
Women reported higher levels of psychological distress and functional impairment than men, with the most severe effects concentrated among younger women.
- 32% of women aged 18 to 35 reported impaired functioning.
- 26% of women older than 35 reported impairment.
- 19% of men, across the age groups examined, reported impairment.
- 20% of the overall population reported severe mental health-related impairment.
Approximately one-third of women younger than 35 also exceeded the clinical threshold for symptoms of anxiety, depression or post-traumatic stress.
The findings identify younger women as a particularly vulnerable population requiring continued attention and targeted mental health support.
Social Relationships Among the Hardest Hit
One of the study’s most significant findings concerns how psychological distress affects social relationships.
Researchers examined five areas of daily functioning, including household responsibilities, employment or education, leisure activities, and personal relationships.
While work and household functioning remained comparatively stable, social activities and relationships were more disrupted.
Half of respondents reported that their leisure activities had been affected, while 35% reported difficulty forming or maintaining close relationships.
The findings are especially troubling because Israelis themselves identified social connections as among the strongest sources of resilience.
Approximately 50% cited support from family and friends as helping them cope, while about 40% identified hobbies, sports and maintaining a routine as important sources of stability.
Post-Traumatic Stress Proves Particularly Persistent
Although symptoms of psychological distress have generally declined since October 7, recovery has been uneven.
During the study period, approximately one-third of Israelis crossed the clinical threshold for at least one of three conditions: anxiety, depression, or post-traumatic stress.
Among those who experienced clinically significant anxiety symptoms, approximately half subsequently returned to the normal range.
Recovery was considerably slower among those reporting post-traumatic stress symptoms.
Only 38% of that group returned to the normal range, meaning more than 60% continued to experience substantial symptoms.
The findings suggest that a significant portion of those affected by the attacks and war may require sustained mental health support rather than short-term intervention.
Many Israelis Still Do Not Seek Treatment
Despite widespread recognition of mental health needs, substantial barriers to treatment remain.
Approximately one-third of respondents said they felt they needed mental health care.
Among those who reported needing treatment, roughly half had not sought professional help.
Of those who did not seek treatment, 23% said they preferred to manage their difficulties independently, while 17% expressed dissatisfaction with the treatment options available through the healthcare system.
Researchers said the findings show the need to expand access to mental health services and offer more flexible approaches suited to different populations and preferences.
Family and Community Support Are Essential
The study also highlighted the importance of support systems outside the formal healthcare sector.
Approximately 66% of respondents rated their family support as high, while 39% reported receiving strong community support.
However, 31% said they lacked strong support from either family or community.
Researchers found that stronger perceived support was associated with greater resilience and lower levels of psychological distress.
The findings reinforce the importance of maintaining community connections, particularly as some Israelis withdraw from social activities and personal relationships.
Researchers Warn of Chronic Psychological Distress
Prof. Ran Balicer, deputy director general and head of the Innovation Division at Clalit Health Services, said the findings demonstrate the lasting consequences of the national trauma.
“The findings we have systematically collected over the past three years show that alongside a steady increase in the proportion of people receiving mental health treatment, psychological distress is becoming chronic for a significant part of the population and is accompanied by deep functional impairment,” Balicer said.
He described the scale of direct and indirect exposure to trauma as unprecedented and emphasized the need for expanded services.
“We have much work ahead to continue expanding mental health services, remove barriers to access and make proactive and diverse treatment more accessible, tailored specifically to groups at risk.”
Hadar Samuel, an expert researcher on the Health Policy team at the Myers JDC Brookdale Institute, said the findings reveal two simultaneous realities.
“As we expected, most of the population is recovering. Alongside this, there is a substantial core of people who continue to struggle and fight,” Samuel said.
She expressed particular concern about the deterioration of social connections.
“People are reducing their leisure activities, struggling to maintain close relationships and in some cases becoming more isolated, precisely when family, friends, routine and activity are among the key sources of support they themselves identify as helping them cope.”
Samuel emphasized that the response cannot depend exclusively on professional mental health services.
“Family, community and social connections are an integral part of the resilience infrastructure,” she said.
A Nation Recovering, but Not Yet Healed
Three years after the deadliest attack against Jews since the Holocaust, the study paints a picture of a society demonstrating resilience while continuing to carry profound psychological wounds.
Most Israelis are gradually recovering, but a substantial minority continues to experience distress that interferes with everyday life.
The persistence of post-traumatic stress, the disproportionate impact on younger women, and the erosion of social relationships point to challenges that will extend well beyond the immediate aftermath of war.
For Israel, the findings suggest that national recovery will require more than expanded clinical treatment.
It will also depend on rebuilding the relationships, routines, and community networks that help people regain a sense of security and belonging.
The physical destruction of October 7 was immediately visible. Researchers warn that its psychological consequences will take much longer to overcome.
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